Breakthrough and persistent bacteremia due to serotype K1 Klebsiella pneumoniae in an immunocompetent patient
Herein, we report a case of breakthrough and persistent bacteremia due to serotype K1 Klebsiella pneumoniae in an immunocompetent 53- year-old man. He was diagnosed with pyogenic spondylitis owing to back pain and based on magnetic resonance imaging findings. On admission, several imaging studies we...
| Main Authors: | , , , |
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| Format: | Article |
| Language: | English |
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Elsevier
2020-01-01
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| Series: | IDCases |
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| Online Access: | http://www.sciencedirect.com/science/article/pii/S2214250920302018 |
| _version_ | 1818651817691578368 |
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| author | Taketomo Maruki Daisuke Taniyama Yumi Tsuchiya Tomohide Adachi |
| author_facet | Taketomo Maruki Daisuke Taniyama Yumi Tsuchiya Tomohide Adachi |
| author_sort | Taketomo Maruki |
| collection | DOAJ |
| description | Herein, we report a case of breakthrough and persistent bacteremia due to serotype K1 Klebsiella pneumoniae in an immunocompetent 53- year-old man. He was diagnosed with pyogenic spondylitis owing to back pain and based on magnetic resonance imaging findings. On admission, several imaging studies were taken to search for other abscesses and infective endocarditis; however, there were no significant findings. Additionally, blood cultures were negative. Upon treatment with intravenous ampicillin/sulbactam, the patient’s symptoms improved. However, eleven days after admission, the patient experienced a fever and worsening back pain. Blood cultures were taken again, and K. pneumoniae was detected, which showed sensitivity to ampicillin/sulbactam. Fourteen days after admission, K. pneumoniae was detected again, suggesting breakthrough and persistent bacteremia with K. pneumoniae. The source of the K. pneumoniae infection was unknown. The antimicrobial regimen was changed to a combination of ceftriaxone and gentamicin. Sixty days after admission, the patient was discharged without any sequelae. The isolated K. pneumoniae strains were found to carry rmpA and were confirmed as serotype K1; thus, detected hypervirulent K. pneumoniae (HvKP). HvKP is an increasingly recognized pathotype of K. pneumoniae characterized clinically by its ability to cause organ- or life-threatening infections in healthy persons. To the best of our knowledge, our case is the first report of spondylitis due to confirmed HvKP. Moreover, HvKP caused breakthrough and persistent bacteremia on an immunocompetent patient. |
| first_indexed | 2024-12-17T02:12:08Z |
| format | Article |
| id | doaj.art-1da2f7653ea74f8381e88f76cb06373a |
| institution | Directory Open Access Journal |
| issn | 2214-2509 |
| language | English |
| last_indexed | 2024-12-17T02:12:08Z |
| publishDate | 2020-01-01 |
| publisher | Elsevier |
| record_format | Article |
| series | IDCases |
| spelling | doaj.art-1da2f7653ea74f8381e88f76cb06373a2022-12-21T22:07:30ZengElsevierIDCases2214-25092020-01-0121e00893Breakthrough and persistent bacteremia due to serotype K1 Klebsiella pneumoniae in an immunocompetent patientTaketomo Maruki0Daisuke Taniyama1Yumi Tsuchiya2Tomohide Adachi3Corresponding author at: Department of Infectious Diseases, Tokyo Saiseikai Central Hospital, 1-4-17 Mita, Minato-ku, Tokyo 108-0073, Japan.; Department of Infectious Diseases, Tokyo Saiseikai Central Hospital, Tokyo, JapanDepartment of Infectious Diseases, Tokyo Saiseikai Central Hospital, Tokyo, JapanDepartment of Infectious Diseases, Tokyo Saiseikai Central Hospital, Tokyo, JapanDepartment of Infectious Diseases, Tokyo Saiseikai Central Hospital, Tokyo, JapanHerein, we report a case of breakthrough and persistent bacteremia due to serotype K1 Klebsiella pneumoniae in an immunocompetent 53- year-old man. He was diagnosed with pyogenic spondylitis owing to back pain and based on magnetic resonance imaging findings. On admission, several imaging studies were taken to search for other abscesses and infective endocarditis; however, there were no significant findings. Additionally, blood cultures were negative. Upon treatment with intravenous ampicillin/sulbactam, the patient’s symptoms improved. However, eleven days after admission, the patient experienced a fever and worsening back pain. Blood cultures were taken again, and K. pneumoniae was detected, which showed sensitivity to ampicillin/sulbactam. Fourteen days after admission, K. pneumoniae was detected again, suggesting breakthrough and persistent bacteremia with K. pneumoniae. The source of the K. pneumoniae infection was unknown. The antimicrobial regimen was changed to a combination of ceftriaxone and gentamicin. Sixty days after admission, the patient was discharged without any sequelae. The isolated K. pneumoniae strains were found to carry rmpA and were confirmed as serotype K1; thus, detected hypervirulent K. pneumoniae (HvKP). HvKP is an increasingly recognized pathotype of K. pneumoniae characterized clinically by its ability to cause organ- or life-threatening infections in healthy persons. To the best of our knowledge, our case is the first report of spondylitis due to confirmed HvKP. Moreover, HvKP caused breakthrough and persistent bacteremia on an immunocompetent patient.http://www.sciencedirect.com/science/article/pii/S2214250920302018Klebsiella pneumoniaeHypervirulentSerotype K1rmpABreakthrough bacteremiaString test |
| spellingShingle | Taketomo Maruki Daisuke Taniyama Yumi Tsuchiya Tomohide Adachi Breakthrough and persistent bacteremia due to serotype K1 Klebsiella pneumoniae in an immunocompetent patient IDCases Klebsiella pneumoniae Hypervirulent Serotype K1 rmpA Breakthrough bacteremia String test |
| title | Breakthrough and persistent bacteremia due to serotype K1 Klebsiella pneumoniae in an immunocompetent patient |
| title_full | Breakthrough and persistent bacteremia due to serotype K1 Klebsiella pneumoniae in an immunocompetent patient |
| title_fullStr | Breakthrough and persistent bacteremia due to serotype K1 Klebsiella pneumoniae in an immunocompetent patient |
| title_full_unstemmed | Breakthrough and persistent bacteremia due to serotype K1 Klebsiella pneumoniae in an immunocompetent patient |
| title_short | Breakthrough and persistent bacteremia due to serotype K1 Klebsiella pneumoniae in an immunocompetent patient |
| title_sort | breakthrough and persistent bacteremia due to serotype k1 klebsiella pneumoniae in an immunocompetent patient |
| topic | Klebsiella pneumoniae Hypervirulent Serotype K1 rmpA Breakthrough bacteremia String test |
| url | http://www.sciencedirect.com/science/article/pii/S2214250920302018 |
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