Emerg Infect Dis. 2018 Feb;24(2):221-229. doi: 10.3201/eid2402.170957.
Liver abscesses containing hypervirulent Klebsiella pneumoniae have emerged during the past 2 decades, originally in Southeast Asia and then worldwide. We hypothesized that hypervirulent K. pneumoniae might also be emerging in France. In a retrospective, monocentric, cohort study, we analyzed characteristics and outcomes for 199 consecutive patients in Paris, France, with liver abscesses during 2010-2015. We focused on 31 patients with abscesses containing K. pneumoniae. This bacterium was present in most (14/27, 52%) cryptogenic liver abscesses. Cryptogenic K. pneumoniae abscesses were more frequently community-acquired (p<0.00001) and monomicrobial (p = 0.008), less likely to involve cancer patients (p<0.01), and relapsed less often (p<0.01) than did noncryptogenic K. pneumoniae liver abscesses. K. pneumoniae isolates from cryptogenic abscesses belonged to either the K1 or K2 serotypes and had more virulence factors than noncryptogenic K. pneumoniae isolates. Hypervirulent K. pneumoniae are emerging as the main pathogen isolated from cryptogenic liver abscesses in the study area.
在过去的 20 年中，含有高毒力肺炎克雷伯菌的肝脓肿已经出现，最初在东南亚，然后在全球范围内出现。我们假设高毒力肺炎克雷伯菌也可能在法国出现。在一项回顾性、单中心、队列研究中，我们分析了 2010 年至 2015 年间在法国巴黎的 199 例连续肝脓肿患者的特征和结局。我们重点研究了 31 例含有肺炎克雷伯菌的脓肿患者。这种细菌存在于大多数（14/27，52%）不明原因的肝脓肿中。隐匿性肺炎克雷伯菌脓肿更常发生在社区获得性感染（p<0.00001）和单一细菌感染（p = 0.008），较少涉及癌症患者（p<0.01），复发率也较低（p<0.01）。与非隐匿性肺炎克雷伯菌肝脓肿相比。来自隐匿性脓肿的肺炎克雷伯菌分离株属于 K1 或 K2 血清型，并且具有比非隐匿性肺炎克雷伯菌分离株更多的毒力因子。高毒力肺炎克雷伯菌正在成为研究区域隐匿性肝脓肿的主要病原体。
