Institute of Infectious Diseases and Vaccinology, National Health Research Institutes, Miaoli, Taiwan.
Lancet Infect Dis. 2012 Nov;12(11):881-7. doi: 10.1016/S1473-3099(12)70205-0.
Klebsiella pneumoniae is a well known human nosocomial pathogen. Most community-acquired K pneumoniae infections cause pneumonia or urinary tract infections. During the past two decades, however, a distinct invasive syndrome that causes liver abscesses has been increasingly reported in Asia, and this syndrome is emerging as a global disease. In this Review, we summarise the clinical presentation and management as well the microbiological aspects of this invasive disease. Diabetes mellitus and two specific capsular types in the bacterium predispose a patient to the development of liver abscesses and the following metastatic complications: bacteraemia, meningitis, endophthalmitis, and necrotising fasciitis. For patients with this invasive syndrome, appropriate antimicrobial treatment combined with percutaneous drainage of liver abscesses increases their chances of survival. Rapid detection of the hypervirulent strain that causes this syndrome allows earlier diagnosis and treatment, thus minimising the occurrence of sequelae and improving clinical outcomes.
肺炎克雷伯菌是一种众所周知的人类医院获得性病原体。大多数社区获得性肺炎克雷伯菌感染引起肺炎或尿路感染。然而，在过去的二十年中，亚洲越来越多地报道了一种独特的侵袭性综合征，引起肝脓肿，这种综合征正在成为一种全球性疾病。在这篇综述中，我们总结了这种侵袭性疾病的临床表现和治疗以及微生物学方面。糖尿病和细菌的两种特定荚膜类型使患者易发生肝脓肿和以下转移性并发症：菌血症、脑膜炎、眼内炎和坏死性筋膜炎。对于患有这种侵袭性综合征的患者，适当的抗菌治疗结合肝脓肿的经皮引流可提高其生存机会。快速检测引起这种综合征的高毒力菌株可实现更早的诊断和治疗，从而减少后遗症的发生，改善临床结果。
