Klebsiella variicola Is a Frequent Cause of Bloodstream Infection in the Stockholm Area, and Associated with Higher Mortality Compared to K. pneumoniae
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{"title"=>"Klebsiella variicola is a frequent cause of bloodstream infection in the Stockholm area, and associated with higher mortality compared to K. pneumoniae", "type"=>"journal", "authors"=>[{"first_name"=>"Makaoui", "last_name"=>"Maatallah", "scopus_author_id"=>"53866931100"}, {"first_name"=>"Malin", "last_name"=>"Vading", "scopus_author_id"=>"37108874900"}, {"first_name"=>"Muhammad Humaun", "last_name"=>"Kabir", "scopus_author_id"=>"56432244000"}, {"first_name"=>"Amina", "last_name"=>"Bakhrouf", "scopus_author_id"=>"18633819500"}, {"first_name"=>"Mats", "last_name"=>"Kalin", "scopus_author_id"=>"36904591200"}, {"first_name"=>"Pontus", "last_name"=>"Nauclér", "scopus_author_id"=>"6506159998"}, {"first_name"=>"Sylvain", "last_name"=>"Brisse", "scopus_author_id"=>"7003389142"}, {"first_name"=>"Christian G.", "last_name"=>"Giske", "scopus_author_id"=>"8533832000"}], "year"=>2014, "source"=>"PLoS ONE", "identifiers"=>{"pui"=>"600595825", "sgr"=>"84913568907", "issn"=>"19326203", "pmid"=>"25426853", "scopus"=>"2-s2.0-84913568907", "doi"=>"10.1371/journal.pone.0113539", "isbn"=>"1932-6203 (Electronic)\r1932-6203 (Linking)"}, "id"=>"2a65879d-840f-39ed-ab4c-3fc03ccf4a3b", "abstract"=>"Clinical isolates of Klebsiella pneumoniae are divided into three phylogroups and differ in their virulence factor contents. The aim of this study was to determine an association between phylogroup, virulence factors and mortality following bloodstream infection (BSI) caused by Klebsiella pneumoniae. Isolates from all adult patients with BSI caused by K. pneumoniae admitted to Karolinska University Hospital, Solna between 2007 and 2009 (n = 139) were included in the study. Phylogenetic analysis was performed based on multilocus sequence typing (MLST) data. Testing for mucoid phenotype, multiplex PCR determining serotypes K1, K2, K5, K20, K54 and K57, and testing for virulence factors connected to more severe disease in previous studies, was also performed. Data was retrieved from medical records including age, sex, comorbidity, central and urinary catheters, time to adequate treatment, hospital-acquired infection, and mortality, to identify risk factors. The primary end-point was 30- day mortality. The three K. pneumoniae phylogroups were represented: KpI (n = 96), KpII (corresponding to K. quasipneumoniae, n = 9) and KpIII (corresponding to K. variicola, n = 34). Phylogroups were not significantly different in baseline characteristics. Overall, the 30-day mortality was 24/139 (17.3%). Isolates belonging to KpIII were associated with the highest 30-day mortality (10/34 cases, 29.4%), whereas KpI isolates were associated with mortality in 13/96 cases (13.5%). This difference was significant both in univariate statistical analysis (P = 0.037) and in multivariate analysis adjusting for age and comorbidity (OR 3.03 (95% CI: 1.10-8.36). Only three of the isolates causing mortality within 30 days belonged to any of the virulent serotypes (K54, n = 1), had a mucoid phenotype (n = 1) and/or contained virulence genes (wcaG n = 1 and wcaG/allS n = 1). In conclusion, the results indicate higher mortality among patients infected with isolates belonging to K. variicola. The increased mortality could not be related to any known virulence factors, including virulent capsular types or mucoid phenotype.", "link"=>"http://www.mendeley.com/research/klebsiella-variicola-frequent-cause-bloodstream-infection-stockholm-area-associated-higher-mortality", "reader_count"=>50, "reader_count_by_academic_status"=>{"Unspecified"=>1, "Researcher"=>12, "Student > Doctoral Student"=>5, "Student > Ph. D. Student"=>10, "Student > Postgraduate"=>5, "Student > Master"=>7, "Other"=>4, "Student > Bachelor"=>4, "Lecturer"=>1, "Professor"=>1}, "reader_count_by_user_role"=>{"Unspecified"=>1, "Researcher"=>12, "Student > Doctoral Student"=>5, "Student > Ph. D. Student"=>10, "Student > Postgraduate"=>5, "Student > Master"=>7, "Other"=>4, "Student > Bachelor"=>4, "Lecturer"=>1, "Professor"=>1}, "reader_count_by_subject_area"=>{"Unspecified"=>3, "Engineering"=>1, "Biochemistry, Genetics and Molecular Biology"=>8, "Agricultural and Biological Sciences"=>22, "Medicine and Dentistry"=>8, "Computer Science"=>1, "Immunology and Microbiology"=>6, "Linguistics"=>1}, "reader_count_by_subdiscipline"=>{"Engineering"=>{"Engineering"=>1}, "Medicine and Dentistry"=>{"Medicine and Dentistry"=>8}, "Immunology and Microbiology"=>{"Immunology and Microbiology"=>6}, "Agricultural and Biological Sciences"=>{"Agricultural and Biological Sciences"=>22}, "Computer Science"=>{"Computer Science"=>1}, "Linguistics"=>{"Linguistics"=>1}, "Biochemistry, Genetics and Molecular Biology"=>{"Biochemistry, Genetics and Molecular Biology"=>8}, "Unspecified"=>{"Unspecified"=>3}}, "reader_count_by_country"=>{"New Zealand"=>1, "Netherlands"=>1, "Brazil"=>2, "Spain"=>1}, "group_count"=>1}

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Figshare

  • {"files"=>["https://ndownloader.figshare.com/files/1807965", "https://ndownloader.figshare.com/files/1807966", "https://ndownloader.figshare.com/files/1807967"], "description"=>"<div><p>Clinical isolates of <i>Klebsiella pneumoniae</i> are divided into three phylogroups and differ in their virulence factor contents. The aim of this study was to determine an association between phylogroup, virulence factors and mortality following bloodstream infection (BSI) caused by <i>Klebsiella pneumoniae.</i> Isolates from all adult patients with BSI caused by <i>K. pneumoniae</i> admitted to Karolinska University Hospital, Solna between 2007 and 2009 (n = 139) were included in the study. Phylogenetic analysis was performed based on multilocus sequence typing (MLST) data. Testing for mucoid phenotype, multiplex PCR determining serotypes K1, K2, K5, K20, K54 and K57, and testing for virulence factors connected to more severe disease in previous studies, was also performed. Data was retrieved from medical records including age, sex, comorbidity, central and urinary catheters, time to adequate treatment, hospital-acquired infection, and mortality, to identify risk factors. The primary end-point was 30- day mortality. The three <i>K. pneumoniae</i> phylogroups were represented: KpI (n = 96), KpII (corresponding to <i>K. quasipneumoniae</i>, n = 9) and KpIII (corresponding to <i>K. variicola</i>, n = 34). Phylogroups were not significantly different in baseline characteristics. Overall, the 30-day mortality was 24/139 (17.3%). Isolates belonging to KpIII were associated with the highest 30-day mortality (10/34 cases, 29.4%), whereas KpI isolates were associated with mortality in 13/96 cases (13.5%). This difference was significant both in univariate statistical analysis (P = 0.037) and in multivariate analysis adjusting for age and comorbidity (OR 3.03 (95% CI: 1.10–8.36). Only three of the isolates causing mortality within 30 days belonged to any of the virulent serotypes (K54, n = 1), had a mucoid phenotype (n = 1) and/or contained virulence genes (<i>wcaG</i> n = 1 and <i>wcaG</i>/<i>allS</i> n = 1). In conclusion, the results indicate higher mortality among patients infected with isolates belonging to <i>K. variicola</i>. The increased mortality could not be related to any known virulence factors, including virulent capsular types or mucoid phenotype.</p></div>", "links"=>[], "tags"=>["mortality", "mucoid phenotype", "Virulence factors", "Klebsiella pneumoniae", "pcr", "multilocus sequence typing", "bsi", "ci", "Karolinska University Hospital", "virulence factor contents", "mlst"], "article_id"=>1252638, "categories"=>["Biological Sciences"], "users"=>["Makaoui Maatallah", "Malin Vading", "Muhammad Humaun Kabir", "Amina Bakhrouf", "Mats Kalin", "Pontus Naucler", "Sylvain Brisse", "Christian G. Giske"], "doi"=>["https://dx.doi.org/10.1371/journal.pone.0113539.s001", "https://dx.doi.org/10.1371/journal.pone.0113539.s002", "https://dx.doi.org/10.1371/journal.pone.0113539.s003"], "stats"=>{"downloads"=>8, "page_views"=>27, "likes"=>0}, "figshare_url"=>"https://figshare.com/articles/_Klebsiella_variicola_Is_a_Frequent_Cause_of_Bloodstream_Infection_in_the_Stockholm_Area_and_Associated_with_Higher_Mortality_Compared_to_K_pneumoniae_/1252638", "title"=>"<i>Klebsiella variicola</i> Is a Frequent Cause of Bloodstream Infection in the Stockholm Area, and Associated with Higher Mortality Compared to <i>K. pneumoniae</i>", "pos_in_sequence"=>0, "defined_type"=>4, "published_date"=>"2014-11-26 02:48:22"}
  • {"files"=>["https://ndownloader.figshare.com/files/1807945"], "description"=>"<p>CPE = carbapenemase-producing <i>Enterobacteriaceae.</i></p><p>*Two isolates CTX-M-1, one SHV-ESBL, one CTX-M-1+SHV-ESBL in genotypic analysis.</p><p>**VIM, CTX-M-1, CMY-2 in genotypic analysis.</p><p>No of isolates with non-susceptibility (intermediate and resistant) to antimicrobials.</p>", "links"=>[], "tags"=>["mortality", "mucoid phenotype", "Virulence factors", "Klebsiella pneumoniae", "pcr", "multilocus sequence typing", "bsi", "ci", "Karolinska University Hospital", "virulence factor contents", "mlst"], "article_id"=>1252620, "categories"=>["Biological Sciences"], "users"=>["Makaoui Maatallah", "Malin Vading", "Muhammad Humaun Kabir", "Amina Bakhrouf", "Mats Kalin", "Pontus Naucler", "Sylvain Brisse", "Christian G. Giske"], "doi"=>"https://dx.doi.org/10.1371/journal.pone.0113539.t005", "stats"=>{"downloads"=>3, "page_views"=>15, "likes"=>0}, "figshare_url"=>"https://figshare.com/articles/_No_of_isolates_with_non_susceptibility_intermediate_and_resistant_to_antimicrobials_/1252620", "title"=>"No of isolates with non-susceptibility (intermediate and resistant) to antimicrobials.", "pos_in_sequence"=>0, "defined_type"=>3, "published_date"=>"2014-11-26 02:48:22"}
  • {"files"=>["https://ndownloader.figshare.com/files/1807942"], "description"=>"<p>Clinical characteristics of patients with invasive infection caused by <i>K. pneumoniae/variicola</i><b>.</b></p>", "links"=>[], "tags"=>["mortality", "mucoid phenotype", "Virulence factors", "Klebsiella pneumoniae", "pcr", "multilocus sequence typing", "bsi", "ci", "Karolinska University Hospital", "virulence factor contents", "mlst"], "article_id"=>1252617, "categories"=>["Biological Sciences"], "users"=>["Makaoui Maatallah", "Malin Vading", "Muhammad Humaun Kabir", "Amina Bakhrouf", "Mats Kalin", "Pontus Naucler", "Sylvain Brisse", "Christian G. Giske"], "doi"=>"https://dx.doi.org/10.1371/journal.pone.0113539.t004", "stats"=>{"downloads"=>4, "page_views"=>21, "likes"=>0}, "figshare_url"=>"https://figshare.com/articles/_Clinical_characteristics_of_patients_with_invasive_infection_caused_by_K_pneumoniae_variicola_/1252617", "title"=>"Clinical characteristics of patients with invasive infection caused by <i>K. pneumoniae/variicola</i><b>.</b>", "pos_in_sequence"=>0, "defined_type"=>3, "published_date"=>"2014-11-26 02:48:22"}
  • {"files"=>["https://ndownloader.figshare.com/files/1807940"], "description"=>"<p>*Compared to KpI where the prevalence was 56.5% (13/23) in patients who died and. 77.6% (83/107) in patients who survived.</p><p>Comparison between patients with 30-day mortality and survivors.</p>", "links"=>[], "tags"=>["mortality", "mucoid phenotype", "Virulence factors", "Klebsiella pneumoniae", "pcr", "multilocus sequence typing", "bsi", "ci", "Karolinska University Hospital", "virulence factor contents", "mlst"], "article_id"=>1252615, "categories"=>["Biological Sciences"], "users"=>["Makaoui Maatallah", "Malin Vading", "Muhammad Humaun Kabir", "Amina Bakhrouf", "Mats Kalin", "Pontus Naucler", "Sylvain Brisse", "Christian G. Giske"], "doi"=>"https://dx.doi.org/10.1371/journal.pone.0113539.t003", "stats"=>{"downloads"=>3, "page_views"=>20, "likes"=>0}, "figshare_url"=>"https://figshare.com/articles/_Comparison_between_patients_with_30_day_mortality_and_survivors_/1252615", "title"=>"Comparison between patients with 30-day mortality and survivors.", "pos_in_sequence"=>0, "defined_type"=>3, "published_date"=>"2014-11-26 02:48:22"}
  • {"files"=>["https://ndownloader.figshare.com/files/1807934"], "description"=>"<p>N = number of STs or samples subjected for analysis. Sites = length of sequences after alignments. Net Sites = length of sequences subjected for analysis (the gaps or missing data are rejected from analysis). S = polymorphic sites. Hap = haplotypes. Hd = haplotypic diversity. π = nucleotide diversity. θ = average number of nucleotide differences per site. Ka/Ks<b> = </b>ratio of the number of non-synonymous substitutions per non-synonymous site (Ka) to the number of synonymous substitutions per synonymous site (Ks).</p><p>Nucleotide polymorphism within the seven housekeeping genes used for MLST<b>.</b></p>", "links"=>[], "tags"=>["mortality", "mucoid phenotype", "Virulence factors", "Klebsiella pneumoniae", "pcr", "multilocus sequence typing", "bsi", "ci", "Karolinska University Hospital", "virulence factor contents", "mlst"], "article_id"=>1252610, "categories"=>["Biological Sciences"], "users"=>["Makaoui Maatallah", "Malin Vading", "Muhammad Humaun Kabir", "Amina Bakhrouf", "Mats Kalin", "Pontus Naucler", "Sylvain Brisse", "Christian G. Giske"], "doi"=>"https://dx.doi.org/10.1371/journal.pone.0113539.t001", "stats"=>{"downloads"=>3, "page_views"=>62, "likes"=>0}, "figshare_url"=>"https://figshare.com/articles/_Nucleotide_polymorphism_within_the_seven_housekeeping_genes_used_for_MLST_/1252610", "title"=>"Nucleotide polymorphism within the seven housekeeping genes used for MLST<b>.</b>", "pos_in_sequence"=>0, "defined_type"=>3, "published_date"=>"2014-11-26 02:48:22"}
  • {"files"=>["https://ndownloader.figshare.com/files/1807937"], "description"=>"<p>CCI to CCVII are an arbitrary designations of clonal complexes found in the present study, each complex formed only by two STs.</p><p>eBURST analysis of the MLST data: illustration of clonal complexes based on STs and their allelic profiles.</p>", "links"=>[], "tags"=>["mortality", "mucoid phenotype", "Virulence factors", "Klebsiella pneumoniae", "pcr", "multilocus sequence typing", "bsi", "ci", "Karolinska University Hospital", "virulence factor contents", "mlst"], "article_id"=>1252612, "categories"=>["Biological Sciences"], "users"=>["Makaoui Maatallah", "Malin Vading", "Muhammad Humaun Kabir", "Amina Bakhrouf", "Mats Kalin", "Pontus Naucler", "Sylvain Brisse", "Christian G. Giske"], "doi"=>"https://dx.doi.org/10.1371/journal.pone.0113539.t002", "stats"=>{"downloads"=>3, "page_views"=>51, "likes"=>0}, "figshare_url"=>"https://figshare.com/articles/_eBURST_analysis_of_the_MLST_data_illustration_of_clonal_complexes_based_on_STs_and_their_allelic_profiles_/1252612", "title"=>"eBURST analysis of the MLST data: illustration of clonal complexes based on STs and their allelic profiles.", "pos_in_sequence"=>0, "defined_type"=>3, "published_date"=>"2014-11-26 02:48:22"}
  • {"files"=>["https://ndownloader.figshare.com/files/1807932"], "description"=>"<p><b>A</b>: Radial phylogenetic tree of 139 isolates based on the concatenated sequences of seven MLST loci performed using the Neighbor-joining method based on a Jukes-Cantor distance matrix. Main bootstrap values obtained are highlighted on at the main node of the phylogeny. The tree was rooted using the nucleotide sequences of the seven genes of <i>E. coli</i> and considered as an out-group. Each phylogroup was clearly separated from others. Colors of isolates symbols are specific of each phylogroups. Blue color corresponds to the KpI phylogroup, green corresponds to KpII, and red corresponds to KpIII. Empty symbols correspond to the references strains specific for each phylogroups. <b>B</b>: Minimal Spanning Tree (MST) analysis of <i>Klebsiella pneumoniae</i> strains based on MLST allelic profiles. Each circle corresponds to an ST. The area of each circle corresponds to the number of isolates. The relationships between strains are indicated by the connections between the isolates and the lengths of the branches linking them. Black lines connecting pairs of STs indicate that they differ in one allele (thick lines), two and three alleles (thin), or four to seven alleles (dashed). Colors of isolates symbols are specific to each phylogroup: blue - KpI, green - KpII and red - KpIII. Grey zones surround STs differing in one allele forming a clonal complex. <b>C</b>: NeighborNet graph based on seven concatenated housekeeping genes, illustrating the recombination within and among phylogroups. Colors surrounding each zone are specific of each phylogroup. Blue color corresponds to the KpI phylogroup, green corresponds to KpII, and red corresponds to KpIII.</p>", "links"=>[], "tags"=>["mortality", "mucoid phenotype", "Virulence factors", "Klebsiella pneumoniae", "pcr", "multilocus sequence typing", "bsi", "ci", "Karolinska University Hospital", "virulence factor contents", "mlst"], "article_id"=>1252607, "categories"=>["Biological Sciences"], "users"=>["Makaoui Maatallah", "Malin Vading", "Muhammad Humaun Kabir", "Amina Bakhrouf", "Mats Kalin", "Pontus Naucler", "Sylvain Brisse", "Christian G. Giske"], "doi"=>"https://dx.doi.org/10.1371/journal.pone.0113539.g001", "stats"=>{"downloads"=>0, "page_views"=>10, "likes"=>0}, "figshare_url"=>"https://figshare.com/articles/_Phylogenetic_representation_of_all_isolates_/1252607", "title"=>"Phylogenetic representation of all isolates.", "pos_in_sequence"=>0, "defined_type"=>1, "published_date"=>"2014-11-26 02:48:22"}

PMC Usage Stats | Further Information

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  • {"unique-ip"=>"31", "full-text"=>"26", "pdf"=>"11", "abstract"=>"0", "scanned-summary"=>"0", "scanned-page-browse"=>"0", "figure"=>"0", "supp-data"=>"0", "cited-by"=>"0", "year"=>"2015", "month"=>"10"}
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  • {"unique-ip"=>"41", "full-text"=>"40", "pdf"=>"12", "abstract"=>"0", "scanned-summary"=>"0", "scanned-page-browse"=>"0", "figure"=>"4", "supp-data"=>"1", "cited-by"=>"0", "year"=>"2015", "month"=>"12"}
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  • {"unique-ip"=>"105", "full-text"=>"119", "pdf"=>"9", "abstract"=>"0", "scanned-summary"=>"0", "scanned-page-browse"=>"0", "figure"=>"9", "supp-data"=>"3", "cited-by"=>"0", "year"=>"2018", "month"=>"1"}
  • {"unique-ip"=>"6", "full-text"=>"11", "pdf"=>"0", "abstract"=>"0", "scanned-summary"=>"0", "scanned-page-browse"=>"0", "figure"=>"0", "supp-data"=>"0", "cited-by"=>"0", "year"=>"2018", "month"=>"2"}
  • {"unique-ip"=>"130", "full-text"=>"158", "pdf"=>"12", "abstract"=>"0", "scanned-summary"=>"0", "scanned-page-browse"=>"0", "figure"=>"7", "supp-data"=>"1", "cited-by"=>"0", "year"=>"2018", "month"=>"3"}
  • {"unique-ip"=>"323", "full-text"=>"405", "pdf"=>"23", "scanned-summary"=>"0", "scanned-page-browse"=>"0", "figure"=>"0", "supp-data"=>"1", "cited-by"=>"0", "year"=>"2019", "month"=>"1"}
  • {"unique-ip"=>"306", "full-text"=>"383", "pdf"=>"20", "scanned-summary"=>"0", "scanned-page-browse"=>"0", "figure"=>"3", "supp-data"=>"0", "cited-by"=>"0", "year"=>"2018", "month"=>"11"}
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  • {"unique-ip"=>"176", "full-text"=>"201", "pdf"=>"13", "scanned-summary"=>"0", "scanned-page-browse"=>"0", "figure"=>"3", "supp-data"=>"2", "cited-by"=>"0", "year"=>"2018", "month"=>"5"}
  • {"unique-ip"=>"184", "full-text"=>"210", "pdf"=>"17", "scanned-summary"=>"0", "scanned-page-browse"=>"0", "figure"=>"3", "supp-data"=>"2", "cited-by"=>"0", "year"=>"2018", "month"=>"6"}
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Relative Metric

{"start_date"=>"2014-01-01T00:00:00Z", "end_date"=>"2014-12-31T00:00:00Z", "subject_areas"=>[{"subject_area"=>"/Biology and life sciences/Taxonomy", "average_usage"=>[338, 519]}, {"subject_area"=>"/Computer and information sciences", "average_usage"=>[327, 511]}, {"subject_area"=>"/Computer and information sciences/Data management", "average_usage"=>[365, 545]}, {"subject_area"=>"/Medicine and health sciences", "average_usage"=>[285]}, {"subject_area"=>"/Medicine and health sciences/Hematology", "average_usage"=>[256]}, {"subject_area"=>"/Medicine and health sciences/Pharmacology", "average_usage"=>[286]}]}
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