Primary osteomyelitis caused by hypervirulent Klebsiella pneumoniae

Bonnie C. Prokesch, Michael TeKippe, Jiwoong Kim, Prithvi Raj, Erin Mc Elvania TeKippe, David E. Greenberg

Research output: Contribution to journalReview article

31 Citations (Scopus)

Abstract

Klebsiella pneumoniae is the most clinically relevant species of this genus, known to cause both community-acquired and nosocomial infections worldwide. In the past two decades, a distinct hypervirulent strain of K pneumoniae, characterised by its hypermucoviscous phenotype, has emerged as a clinically significant pathogen responsible for highly invasive infections. We present a case of osteomyelitis due to hypervirulent K pneumoniae reported in the USA. Genomic testing of the K pneumoniae isolate was performed due to the striking clinical presentation of the infection as well as the hypermucoid nature of the isolates, raising the suspicion for possible infection with the hypervirulent strain. Whole-genome sequencing and additional PCR testing demonstrated the isolate to be a K1 serotype, sequence type 23 strain expressing rmpA and rmpA2. Given the multiple reports of this pathogen causing invasive infections, clinicians should be aware of the possible presentation of metastatic and severe infection, including osteomyelitis, due to the hypervirulent strain of K pneumoniae not typical of classic K pneumoniae variants. In this Grand Round, we review the clinical features of hypervirulent K pneumoniae and its link to invasive infections, and discuss the need for improved awareness and identification of the pathogen.

Original languageEnglish (US)
Pages (from-to)e190-e195
JournalThe Lancet Infectious Diseases
Volume16
Issue number9
DOIs
StatePublished - 2016

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Klebsiella pneumoniae
Osteomyelitis
Pneumonia
Infection
Teaching Rounds
Community-Acquired Infections
Community Hospital
Cross Infection
Genome
Phenotype
Polymerase Chain Reaction

ASJC Scopus subject areas

  • Infectious Diseases

Cite this

Primary osteomyelitis caused by hypervirulent Klebsiella pneumoniae. / Prokesch, Bonnie C.; TeKippe, Michael; Kim, Jiwoong; Raj, Prithvi; TeKippe, Erin Mc Elvania; Greenberg, David E.

In: The Lancet Infectious Diseases, Vol. 16, No. 9, 2016, p. e190-e195.

Research output: Contribution to journalReview article

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