| アイテムタイプ |
リポジトリ登録用アイテムタイプ（シンプル）(1) |
| 公開日 |
2025-10-24 |
| タイトル |
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タイトル |
Severe co-infection caused by difficult-to-diagnose hypermucoviscous Klebsiella pneumoniae K1-ST82 in a patient with COVID-19: a case report |
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言語 |
en |
| 言語 |
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言語 |
eng |
| キーワード |
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言語 |
en |
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主題Scheme |
Other |
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主題 |
COVID-19 |
| キーワード |
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言語 |
en |
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主題Scheme |
Other |
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主題 |
Co-infection |
| キーワード |
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言語 |
en |
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主題Scheme |
Other |
|
主題 |
Hypermucoviscous Klebsiella pneumoniae |
| キーワード |
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言語 |
en |
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主題Scheme |
Other |
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主題 |
ST82 |
| キーワード |
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言語 |
en |
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主題Scheme |
Other |
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主題 |
String test |
| キーワード |
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言語 |
en |
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主題Scheme |
Other |
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主題 |
Whole-genome sequencing |
| 資源タイプ |
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資源タイプ識別子 |
http://purl.org/coar/resource_type/c_6501 |
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資源タイプ |
journal article |
| アクセス権 |
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アクセス権 |
open access |
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アクセス権URI |
http://purl.org/coar/access_right/c_abf2 |
| 著者 |
Itoga, Masamichi
Hayashi, Wataru
Kayama, Shizuo
Yu, Liansheng
Sugawara, Yo
Kimura, Masahiko
Hanada, Hiroyuki
Tasaka, Sadatomo
Sugai, Motoyuki
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| 抄録 |
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内容記述タイプ |
Abstract |
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内容記述 |
Background
Co-infection with Klebsiella pneumoniae presents a significant concern in hospitalized patients with coronavirus disease (COVID-19), increasing the risk of severe disease progression. Hypervirulent (hv) and hypermucoviscous (hm) K. pneumoniae (Kp) has gained prominence in Asia due to its capacity to cause invasive community-acquired infections. However, recognition of hvKp/hmKp co-infections in the context of COVID-19 remains limited. We report a severe case of rapidly progressing co-infection with hmKp exhibiting “difficult-to-diagnose” phenotypes in a hospitalized patient with COVID-19.
Case presentation
A 61-year-old woman with COVID-19 initially exhibited mild symptoms resembling the common cold. However, her condition rapidly deteriorated over 7 days, leading to hospital admission with the development of dyspnea. The patient required supplemental oxygen, antibiotic treatment, and mechanical ventilation. Gram-negative bacteria with atypical phenotypes were isolated from alveolar lavage fluid and blood cultures. Both strains formed small, glossy, non-lactose-fermenting colonies on clinically relevant media and were susceptible to ampicillin. Conventional biochemical tests failed to identify the Enterobacteriales strains owing to the urease-negative phenotype. Consequently, the identification of K. pneumoniae was difficult until matrix-assisted laser desorption ionization time-of-flight mass spectrometry (MALDI-TOF MS) analysis was performed. A positive string test indicated mucoviscosity, but with variability in the material used for stretching colonies. Whole-genome sequencing performed on the MiSeq and GridION platforms revealed the blood-derived strain JARB-RN-0063 as belonging to serotype K1 and sequence type (ST) 82. The hvKp-associated genes rmpA and iroCD were located on a 5.0-Mb chromosome, and iucABCD-iutA was identified on a 217.9-kb IncFIB(K)/IncR-type plasmid. Therefore, JARB-RN-0063 was genetically classified as hvKp with a Kleborate virulence score of 3. The intrinsic penicillinase gene blaSHV was defective owing to an IS1F element insertion, resulting in the strain being atypically susceptible to ampicillin.
Conclusions
This is the first case of severe COVID-19-associated co-infection with a difficult-to-diagnose K. penummoniae strain. Notably, co-infection by the hmKp K1-ST82 clone exhibited atypical phenotypes, including stunted growth, non-lactose fermentation, urease-negative reaction, ampicillin susceptibility, and abnormal mucoviscosity, posing diagnostic challenges for clinical laboratories and impedes the identification of hvKp/hmKp. Delayed identification may worsen patient outcomes, highlighting the need for increased clinical awareness of such difficult-to-diagnose clones to prevent deterioration. |
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言語 |
en |
| 内容記述 |
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内容記述タイプ |
Other |
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内容記述 |
BMC Infectious Diseases volume 24, Article number: 1215 (2024) |
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言語 |
en |
| 書誌情報 |
en : BMC Infectious Diseases
巻 24,
号 1,
発行日 2024
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| 関連情報 |
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関連タイプ |
isIdenticalTo |
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識別子タイプ |
DOI |
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関連識別子 |
https://doi.org/10.1186/s12879-024-10092-x |
| ISSN |
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収録物識別子タイプ |
EISSN |
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収録物識別子 |
1471-2334 |
| 権利情報 |
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権利情報 |
© The Author(s) 2024. This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article’s Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/. |
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言語 |
en |
| 出版タイプ |
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出版タイプ |
VoR |
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出版タイプResource |
http://purl.org/coar/version/c_970fb48d4fbd8a85 |
| 出版者 |
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出版者 |
BMC（Part of Springer Nature） |
|
言語 |
en |
s12879-024-10092-x.pdf (1.2 MB)
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