No abstract available.
Humans ; Klebsiella ; Klebsiella pneumoniae

We investigated the effect of toxin-antitoxin (TA) systems in bla(CTX-M-15)-bearing plasmids of Klebsiella pneumoniae on persister formation. The persister formation rate was notably high in transconjugants in plasmids bearing TA system than the transconjugants in plasmids bearing no TA systems. Activation of relA and spoT expression was higher in transconjugants with plasmids bearing TA systems. Thus, TA systems in plasmids may contribute to the maintenance of bla(CTX-M-15)-bearing plasmids and host survival via persister formation.
Klebsiella pneumoniae ; Klebsiella ; Plasmids

No abstract available.
Cellulitis* ; Klebsiella pneumoniae* ; Klebsiella* ; Leg*

BACKGROUND: Accurate detection of extended spectrum beta-lactamase (ESBL) is important because ESBLproducing organisms may appear susceptible to oxyimino- beta-lactams in standard susceptibility tests, but are considered to be clinically resistant to these drugs. And continued monitoring of isolation trend of ESBL-producing organisms is essential for the guideline settlement of antibiotic usage and infection control program. METHODS: Disk diffusion test using the Clinical and Laboratory Standards Institute's ESBL phenotypic confirmatory test were performed on 5,511 clinical isolates of Escherichia coli, Klebsiella pneumoniae, Klebsiella oxytoca, and Proteus mirabilis during the recent six years (April 2001-March 2007). The ESBL producer was defined as an organism showing an increase in the zone diameter of > or =5 mm for either cefotaxime or ceftazidime with clavulanic acid versus that without clavulanic acid (CTC confirmatory test, CZC confirmatory test, respectively). RESULTS: The ESBL-positive rates were 34.8% in K. pneumoniae, 9.3% in K. oxytoca, 8.4% in E. coli, and 6.5% in P. mirabilis. Among the ESBL-positive organisms, the detection rates of ESBL CTC and CZC confirmatory tests were as follows: 91.3% vs 68.7% in K. pneumoniae, 96.3% vs 44.4% in K. oxytoca, 94.8% vs 45.4% in E. coli, and 100% vs 20% in P. mirabilis. ESBL-producing K. pneumoniae had shown a continuously increasing trend from 24.3% in 2001 to 46.4% in 2006. CONCLUSION: Both of the ESBL confirmatory tests should be simultaneously tested for the accurate detection of ESBL-producing K. pneumoniae, K. oxytoca, E. coli, and P. mirabilis. In addition, an active infection control approach is needed for ESBL-producing K. pneumoniae.
beta-Lactamases* ; beta-Lactams ; Cefotaxime ; Ceftazidime ; Clavulanic Acid ; Diffusion ; Escherichia coli* ; Escherichia* ; Infection Control ; Klebsiella oxytoca ; Klebsiella pneumoniae ; Klebsiella* ; Mirabilis ; Pneumonia ; Proteus mirabilis* ; Proteus*

BACKGROUND: Accurate detection of organisms producing extended-spectrum beta-lactamase (ESBL) and AmpC beta-lactamase is very important for treatment of patients. However, unlike the ESBL confirmatory test, there are no guidelines for detection of organisms producing AmpC beta-lactamase. We evaluated a detection method using boronic acid (BA) for ESBL and AmpC beta-lactamase. METHODS: Clinical isolates of Escherichia coli, Klebsiella pneumoniae, Klebsiella oxytoca, and Proteus mirabilis showing intermediate resistance or resistance to cefoxitin (FOX) or positive for ESBL were tested. A > or =5 mm increase in zone diameter of ceftazidime/clavulanic acid/BA (CAZ/CA/BA) and/or cefotaxime/clavulanic acid/BA (CTX/CA/BA) versus CAZ/BA and/or CTX /BA was considered positive for ESBL. Likewise, a > or =5 mm increase in zone diameter of FOX/BA and/or cefotetan/BA (CTT/BA) versus FOX and/or CTT alone was considered positive for AmpC beta-lactamase. RESULTS: Among 622 clinical isolates, ESBL positive rates by the CLSI ESBL confirmatory test or by the BA method were 18.1% or 18.4% for E. coli, 38.3% or 40.4% for K. pneumoniae, 8.7% or 8.7% for K. oxytoca, and 14.8% or 14.8% for P. mirabilis, respectively. AmpC beta-lactamase positive rates using the BA method were 3.7% for E. coli, 33.3% for K. pneumoniae, 0% for K. oxytoca, and 7.4% for P. mirabilis. The detection rates of coproducing ESBL and AmpC beta-lactamase were 2.4% in E. coli 27.1% in K. pneumoniae, and 3.7% in P. mirabilis. CONCLUSION: The ESBL confirmatory method using BA was found to enhance the detection of ESBLs, even when potentially masked by AmpC beta-lactamase.
Bacterial Proteins ; beta-Lactamases ; Boron ; Cefoxitin ; Escherichia ; Escherichia coli ; Humans ; Klebsiella ; Klebsiella oxytoca ; Klebsiella pneumoniae ; Masks ; Mirabilis ; Penicillinase ; Pneumonia ; Proteus ; Proteus mirabilis

No abstract available.
Cellulitis* ; Klebsiella pneumoniae* ; Osteomyelitis*

No abstract available.
Glycoproteins* ; Immunity, Cellular ; Klebsiella pneumoniae* ; Klebsiella*

BACKGROUND: This study was conducted to evaluate the impact of the media type used for direct identification of colonies on the surveillance culture of carbapenem-resistant Enterobacteriaceae (CRE) by matrix assisted laser desorption ionization-time of flight mass spectrometry (MALDI-TOF MS). METHODS: CRE surveillance culture isolates were subjected to species identification using the MALDI Biotyper (Bruker Daltonics, Germany) for 2 months starting in March 2017. Four types of media were evaluated: blood agar (BA), Mueller Hinton agar (MH), MacConkey agar (Mac), and MacConkey agar containing imipenem of 1 µg/mL (IMP-Mac). CRE-like colonies on IMP-Mac and their subculture colonies on the other media were tested after overnight incubation and extended incubation for one additional day. The percent identification and score value were analyzed for each media types and incubation time when the identification was correct at the genus level. RESULTS: A total of 117 isolates were identified as 84 Klebsiella pneumoniae, 12 Escherichia coli, 9 Enterobacter cloacae, 5 Klebsiella oxytoca, 4 Enterobacter aerogenes, and 2 Raoultella ornithinolytica. The successful identification rates (SIR) for BA and MH were 98.3% and 97.4% (P=0.9), respectively, while those for Mac and IMP-Mac were 82.1% (P < 0.001) and 70.9% (P < 0.001), respectively. After extended incubation, SIRs were decreased to 96.6%, 96.6% (P=1.0), 61.5% (P < 0.001), and 58.1% (P < 0.001) on BA, MH, Mac, and IMP-Mac, respectively. The average score values were significantly lower for Mac (2.017±0.22) and IMP-Mac (1.978±0.24) than for BA (2.213±0.16) (P < 0.001). CONCLUSIONS: The low performance of the MALDI Biotyper applied directly to the colonies grown on Mac or IMP-Mac indicates that subculture on BA or MH is preferable before identification by MALDI-TOF MS.
Agar ; Enterobacter aerogenes ; Enterobacter cloacae ; Enterobacteriaceae* ; Escherichia coli ; Imipenem ; Klebsiella oxytoca ; Klebsiella pneumoniae ; Mass Spectrometry ; Spectrometry, Mass, Matrix-Assisted Laser Desorption-Ionization*

Background and Objectives: During infection, Reactive oxygen species (ROS) signaling is activated to protect the cells from invading microorganisms. However, a high level of ROS may also damage the host tissue. The anthocyanin delphinidin is known to have a strong antioxidant activity that protects cells from oxidative damage. This study explored the potential of crude anthocyanin extract from the fruit of Solanum melongena (Eggplant) and Delphinidin-3-glucoside in enhancing the innate immunity in Caenorhabditis elegans against Staphylococcus aureus and Klebsiella pneumoniae. Methodology: Caenorhabditis elegans was used to study innate immune response because it lacks adaptive immunity. First, the sublethal concentration of S. melongena crude anthocyanin extract (SMCAE) and Delphinidin-3-glucoside (D3G) in C. elegans was determined. The sublethal concentration of SMCAE and D3G was used to supplement the nematodes during its exposure to S. aureus and K. pneumoniae. The survival rate was then observed until day five post-L4. SMCAE and D3G were also tested for probable antimicrobial activity against Staphylococcus aureus and Klebsiella pneumoniae. Results and Conclusion This study found that both SMCAE and D3G showed no inhibitory effect on the growth of the bacteria. However, both SMCAE and D3G enhanced the survival of the nematode when exposed to S. aureus and K. pneumoniae. Overall, this study indicates that the anthocyanin delphinidin in S. melongenacrude extract protected the C. elegans against S. aureus and K. pneumoniaeinfection through its antioxidant activity.
Anthocyanins ; Caenorhabditis elegans ; Klebsiella pneumoniae

A sixty-seven-year-old man was admitted to a hospital with symptoms of high fever and chill. Bacterial isolates were obtained from sputum and blood. These isolates were identified as Klebsiella terrigena by API 20E (BioMerieux, Marcy-l'Etoile, France). K. terrigena is very rarely isolated from humans and no case of K. terrigena bacteremia has been reported yet. We analyzed partial 16S rRNA gene sequences of these isolates. The 16S rRNA gene sequences were matched with that of Klebsiella pneumoniae (ATCC 13886). 16S rRNA gene sequencing has been recently introduced in clinical laboratories for unidentified organisms by conventional biochemical tests. For the precise identification of bacteria rarely causing clinical infection, it might be considered to use genotypic methods, such as 16S rRNA gene sequencing.
Bacteremia ; Bacteria ; Fever ; Genes, rRNA ; Humans ; Klebsiella pneumoniae* ; Klebsiella* ; Sputum