Detection of multiple hypervirulent Klebsiella pneumoniae strains in a New York City hospital through screening of virulence genes

The ‘hypervirulent’ variant of Klebsiella pneumoniae (hvKp) is a predominant cause of community-acquired pyogenic liver abscess in Asia, and is an emerging pathogen in Western countries. hvKp infections have demonstrated ‘metastatic’ dissemination in immunocompetent hosts, an unusual mode of infection associated with severe complications. Two cases alerted us to its possible presence at Columbia-NYP. Since there is no gold standard to detect this pathogen, we employed a combination of virulence gene PCR, PFGE, sequence-based genotyping and phenotypic assays, resulting in the largest hvKp surveillance study in Western countries. We find increased prevalence compared to earlier studies and demonstrate the successful introduction of multiple strains of hvKp into New York City. hvKp has at least as high mortality and morbidity as classic Kp (including MDR strains), and existing hepatobiliary tract disease may be a risk factor for infection.

Article in press, Clinical Microbiology and Infection. Read the full text here.