1887

Abstract

community-acquired pyogenic liver abscess (PLA) is an emerging infectious disease. The gene (for egulator of ucoid henotype A) has been reported to be associated with PLA in prevalence studies. NTUH-K2044, a K1 PLA isolate, carries three genes: two large-plasmid-carried genes (p- and p-) and one chromosomal gene (c-). In this study, we re-examined the role of in PLA pathogenesis to clarify the relationship of and capsular serotype to virulence. Using isogenic gene deletion strains and complemented strains of NTUH-K2044, we demonstrated that only p- enhanced expression of capsular polysaccharide synthesis () genes and capsule production. Nevertheless, the lethal dose and competitive index indicated that p- does not promote virulence in mice. The prevalence of these three and capsular types in 206 strains was investigated. This revealed a correlation of with six PLA-related capsular types (K1, K2, K5, K54, K57 and KN1). However, the correlation of with K1 strains from the West was less obvious than with the strains from Asia (17/22 vs 39/39,  = 0.0019). Among the three genes, p- was the most prevalent. Due to the strong correlation with PLA-related capsular types, p- could serve as a surrogate marker for PLA. We found an association of p- with three widely spaced loci in a large plasmid (30/32). Therefore, could be co-inherited together with virulence genes carried by this plasmid.

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2011-12-01
2019-10-18
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References

  1. Abbott S. L.. ( 2003;). Klebsiella, Enterobacter, Citrobacter, Serratia, Plesiomonas, and Other Enterobacteriaceae, , 8th edn.. Washington, DC:: American Society for Microbiology;.
    [Google Scholar]
  2. Applied Biosystems ( 2001;). Relative Quantitation of Gene Expression. Applied Biosystems User Bulletin. Foster City, CA:: Applied Biosystems;.
    [Google Scholar]
  3. Brisse S., Fevre C., Passet V., Issenhuth-Jeanjean S., Tournebize R., Diancourt L., Grimont P.. ( 2009;). Virulent clones of Klebsiella pneumoniae: identification and evolutionary scenario based on genomic and phenotypic characterization. . PLoS ONE 4:, e4982. [CrossRef][PubMed]
    [Google Scholar]
  4. Chang S. C., Fang C. T., Hsueh P. R., Chen Y. C., Luh K. T.. ( 2000;). Klebsiella pneumoniae isolates causing liver abscess in Taiwan. . Diagn Microbiol Infect Dis 37:, 279–284. [CrossRef][PubMed]
    [Google Scholar]
  5. Chaplin M. F.. ( 1986;). Monosaccharides. . In Carbohydrate Analysis: a Practical Approach, pp. 1–36. Edited by Chaplin M. F., Kennedy J. F... UK:: IRL Press;.
    [Google Scholar]
  6. Cheng D. L., Liu Y. C., Yen M. Y., Liu C. Y., Wang R. S.. ( 1991;). Septic metastatic lesions of pyogenic liver abscess. Their association with Klebsiella pneumoniae bacteremia in diabetic patients. . Arch Intern Med 151:, 1557–1559. [CrossRef][PubMed]
    [Google Scholar]
  7. Cheng H. Y., Chen Y. S., Wu C. Y., Chang H. Y., Lai Y. C., Peng H. L.. ( 2010;). RmpA regulation of capsular polysaccharide biosynthesis in Klebsiella pneumoniae CG43. . J Bacteriol 192:, 3144–3158. [CrossRef][PubMed]
    [Google Scholar]
  8. Chiu C. T., Lin D. Y., Liaw Y. F.. ( 1988;). Metastatic septic endophthalmitis in pyogenic liver abscess. . J Clin Gastroenterol 10:, 524–527. [CrossRef][PubMed]
    [Google Scholar]
  9. Chou H. C., Lee C. Z., Ma L. C., Fang C. T., Chang S. C., Wang J. T.. ( 2004;). Isolation of a chromosomal region of Klebsiella pneumoniae associated with allantoin metabolism and liver infection. . Infect Immun 72:, 3783–3792. [CrossRef][PubMed]
    [Google Scholar]
  10. Chuang Y. P., Fang C. T., Lai S. Y., Chang S. C., Wang J. T.. ( 2006;). Genetic determinants of capsular serotype K1 of Klebsiella pneumoniae causing primary pyogenic liver abscess. . J Infect Dis 193:, 645–654. [CrossRef][PubMed]
    [Google Scholar]
  11. Chung D. R., Lee S. S., Lee H. R., Kim H. B., Choi H. J., Eom J. S., Kim J. S., Choi Y. H., Lee J. S. et al. & other authors ( 2007;). Emerging invasive liver abscess caused by K1 serotype Klebsiella pneumoniae in Korea. . J Infect 54:, 578–583. [CrossRef][PubMed]
    [Google Scholar]
  12. Erbing C., Kenne L., Lindberg B., Lönngren J., Sutherland I.W.. ( 1976;). Structural studies of the capsular polysaccharide from Klebsiella Type 1. . Carbohydr Res 50:, 115–120. [CrossRef][PubMed]
    [Google Scholar]
  13. Fang C. T., Chuang Y. P., Shun C. T., Chang S. C., Wang J. T.. ( 2004;). A novel virulence gene in Klebsiella pneumoniae strains causing primary liver abscess and septic metastatic complications. . J Exp Med 199:, 697–705. [CrossRef][PubMed]
    [Google Scholar]
  14. Fang F. C., Sandler N., Libby S. J.. ( 2005;). Liver abscess caused by magA+ Klebsiella pneumoniae in North America. . J Clin Microbiol 43:, 991–992. [CrossRef][PubMed]
    [Google Scholar]
  15. Fang C. T., Lai S. Y., Yi W. C., Hsueh P. R., Liu K. L., Chang S. C.. ( 2007;). Klebsiella pneumoniae genotype K1: an emerging pathogen that causes septic ocular or central nervous system complications from pyogenic liver abscess. . Clin Infect Dis 45:, 284–293. [CrossRef][PubMed]
    [Google Scholar]
  16. Fung C. P., Chang F. Y., Lee S. C., Hu B. S., Kuo B. I., Liu C. Y., Ho M., Siu L. K.. ( 2002;). A global emerging disease of Klebsiella pneumoniae liver abscess: is serotype K1 an important factor for complicated endophthalmitis?. Gut 50:, 420–424. [CrossRef][PubMed]
    [Google Scholar]
  17. Hsieh P. F., Lin T. L., Lee C. Z., Tsai S. F., Wang J. T.. ( 2008;). Serum-induced iron-acquisition systems and TonB contribute to virulence in Klebsiella pneumoniae causing primary pyogenic liver abscess. . J Infect Dis 197:, 1717–1727. [CrossRef][PubMed]
    [Google Scholar]
  18. Hsieh P. F., Lin H. H., Lin T. L., Wang J. T.. ( 2010;). CadC regulates cad and tdc operons in response to gastrointestinal stresses and enhances intestinal colonization of Klebsiella pneumoniae. . J Infect Dis 202:, 52–64. [CrossRef][PubMed]
    [Google Scholar]
  19. Karama E. M., Willermain F., Janssens X., Claus M., Van den Wijngaert S., Wang J. T., Verougstraete C., Caspers L.. ( 2008;). Endogenous endophthalmitis complicating Klebsiella pneumoniae liver abscess in Europe: case report. . Int Ophthalmol 28:, 111–113. [CrossRef][PubMed]
    [Google Scholar]
  20. Keynan Y., Karlowsky J. A., Walus T., Rubinstein E.. ( 2007;). Pyogenic liver abscess caused by hypermucoviscous Klebsiella pneumoniae. . Scand J Infect Dis 39:, 828–830. [CrossRef][PubMed]
    [Google Scholar]
  21. Ko W. C., Paterson D. L., Sagnimeni A. J., Hansen D. S., Von Gottberg A., Mohapatra S., Casellas J. M., Goossens H., Mulazimoglu L. et al. & other authors ( 2002;). Community-acquired Klebsiella pneumoniae bacteremia: global differences in clinical patterns. . Emerg Infect Dis 8:, 160–166. [CrossRef][PubMed]
    [Google Scholar]
  22. Kohayagawa Y., Nakao K., Ushita M., Niino N., Koshizaki M., Yamamori Y., Tokuyasu Y., Fukushima H.. ( 2009;). Pyogenic liver abscess caused by Klebsiella pneumoniae genetic serotype K1 in Japan. . J Infect Chemother 15:, 248–251. [CrossRef][PubMed]
    [Google Scholar]
  23. Ku Y. H., Chuang Y. C., Yu W. L.. ( 2008;). Clinical spectrum and molecular characteristics of Klebsiella pneumoniae causing community-acquired extrahepatic abscess. . J Microbiol Immunol Infect 41:, 311–317.[PubMed]
    [Google Scholar]
  24. Lai Y. C., Peng H. L., Chang H. Y.. ( 2003;). RmpA2, an activator of capsule biosynthesis in Klebsiella pneumoniae CG43, regulates K2 cps gene expression at the transcriptional level. . J Bacteriol 185:, 788–800. [CrossRef][PubMed]
    [Google Scholar]
  25. Lin T. L., Lee C. Z., Hsieh P. F., Tsai S. F., Wang J. T.. ( 2008;). Characterization of integrative and conjugative element ICEKp1-associated genomic heterogeneity in a Klebsiella pneumoniae strain isolated from a primary liver abscess. . J Bacteriol 190:, 515–526. [CrossRef][PubMed]
    [Google Scholar]
  26. Link A. J., Phillips D., Church G. M.. ( 1997;). Methods for generating precise deletions and insertions in the genome of wild-type Escherichia coli: application to open reading frame characterization. . J Bacteriol 179:, 6228–6237.[PubMed]
    [Google Scholar]
  27. Liu Y. C., Cheng D. L., Lin C. L.. ( 1986;). Klebsiella pneumoniae liver abscess associated with septic endophthalmitis. . Arch Intern Med 146:, 1913–1916. [CrossRef][PubMed]
    [Google Scholar]
  28. Ma L. C., Fang C. T., Lee C. Z., Shun C. T., Wang J. T.. ( 2005;). Genomic heterogeneity in Klebsiella pneumoniae strains is associated with primary pyogenic liver abscess and metastatic infection. . J Infect Dis 192:, 117–128. [CrossRef][PubMed]
    [Google Scholar]
  29. Mizuta K., Ohta M., Mori M., Hasegawa T., Nakashima I., Kato N.. ( 1983;). Virulence for mice of Klebsiella strains belonging to the O1 group: relationship to their capsular (K) types. . Infect Immun 40:, 56–61.[PubMed]
    [Google Scholar]
  30. Nadasy K. A., Domiati-Saad R., Tribble M. A.. ( 2007;). Invasive Klebsiella pneumoniae syndrome in North America. . Clin Infect Dis 45:, e25–e28. [CrossRef][PubMed]
    [Google Scholar]
  31. Nassif X., Fournier J. M., Arondel J., Sansonetti P. J.. ( 1989a;). Mucoid phenotype of Klebsiella pneumoniae is a plasmid-encoded virulence factor. . Infect Immun 57:, 546–552.[PubMed]
    [Google Scholar]
  32. Nassif X., Honoré N., Vasselon T., Cole S. T., Sansonetti P. J.. ( 1989b;). Positive control of colanic acid synthesis in Escherichia coli by rmpA and rmpB, two virulence-plasmid genes of Klebsiella pneumoniae. . Mol Microbiol 3:, 1349–1359. [CrossRef][PubMed]
    [Google Scholar]
  33. Pan Y. J., Fang H. C., Yang H. C., Lin T. L., Hsieh P. F., Tsai F. C., Keynan Y., Wang J. T.. ( 2008;). Capsular polysaccharide synthesis regions in Klebsiella pneumoniae serotype K57 and a new capsular serotype. . J Clin Microbiol 46:, 2231–2240. [CrossRef][PubMed]
    [Google Scholar]
  34. Pan Y. J., Lin T. L., Hsu C. R., Wang J. T.. ( 2011;). Use of a Dictyostelium model for isolation of genetic loci associated with phagocytosis and virulence in Klebsiella pneumoniae. . Infect Immun 79:, 997–1006. [CrossRef][PubMed]
    [Google Scholar]
  35. Rahimian J., Wilson T., Oram V., Holzman R. S.. ( 2004;). Pyogenic liver abscess: recent trends in etiology and mortality. . Clin Infect Dis 39:, 1654–1659. [CrossRef][PubMed]
    [Google Scholar]
  36. Reed L. J., Muench H.. ( 1938;). A simple method of estimating fifty per cent endpoints. . Am J Hyg 27:, 493–497.
    [Google Scholar]
  37. Struve C., Bojer M., Nielsen E. M., Hansen D. S., Krogfelt K. A.. ( 2005;). Investigation of the putative virulence gene magA in a worldwide collection of 495 Klebsiella isolates: magA is restricted to the gene cluster of Klebsiella pneumoniae capsule serotype K1. . J Med Microbiol 54:, 1111–1113. [CrossRef][PubMed]
    [Google Scholar]
  38. Tang H. L., Chiang M. K., Liou W. J., Chen Y. T., Peng H. L., Chiou C. S., Liu K. S., Lu M. C., Tung K. C., Lai Y. C.. ( 2010;). Correlation between Klebsiella pneumoniae carrying pLVPK-derived loci and abscess formation. . Eur J Clin Microbiol Infect Dis 29:, 689–698. [CrossRef][PubMed]
    [Google Scholar]
  39. Wacharotayankun R., Arakawa Y., Ohta M., Tanaka K., Akashi T., Mori M., Kato N.. ( 1993;). Enhancement of extracapsular polysaccharide synthesis in Klebsiella pneumoniae by RmpA2, which shows homology to NtrC and FixJ. . Infect Immun 61:, 3164–3174.[PubMed]
    [Google Scholar]
  40. Wang J. H., Liu Y. C., Lee S. S. J., Yen M. Y., Chen Y. S., Wang J. H., Wann S. R., Lin H. H.. ( 1998;). Primary liver abscess due to Klebsiella pneumoniae in Taiwan. . Clin Infect Dis 26:, 1434–1438. [CrossRef][PubMed]
    [Google Scholar]
  41. Wu K. M., Li L. H., Yan J. J., Tsao N., Liao T. L., Tsai H. C., Fung C. P., Chen H. J., Liu Y. M. et al. & other authors ( 2009;). Genome sequencing and comparative analysis of Klebsiella pneumoniae NTUH-K2044, a strain causing liver abscess and meningitis. . J Bacteriol 191:, 4492–4501. [CrossRef][PubMed]
    [Google Scholar]
  42. Yang C. C., Yen C. H., Ho M. W., Wang J. H.. ( 2004;). Comparison of pyogenic liver abscess caused by non-Klebsiella pneumoniae and Klebsiella pneumoniae. . J Microbiol Immunol Infect 37:, 176–184.[PubMed]
    [Google Scholar]
  43. Yeh K. M., Kurup A., Siu L. K., Koh Y. L., Fung C. P., Lin J. C., Chen T. L., Chang F. Y., Koh T. H.. ( 2007;). Capsular serotype K1 or K2, rather than magA and rmpA, is a major virulence determinant for Klebsiella pneumoniae liver abscess in Singapore and Taiwan. . J Clin Microbiol 45:, 466–471. [CrossRef][PubMed]
    [Google Scholar]
  44. Yu W. L., Ko W. C., Cheng K. C., Lee H. C., Ke D. S., Lee C. C., Fung C. P., Chuang Y. C.. ( 2006;). Association between rmpA and magA genes and clinical syndromes caused by Klebsiella pneumoniae in Taiwan. . Clin Infect Dis 42:, 1351–1358. [CrossRef][PubMed]
    [Google Scholar]
  45. Yu W. L., Ko W. C., Cheng K. C., Lee C. C., Lai C. C., Chuang Y. C.. ( 2008;). Comparison of prevalence of virulence factors for Klebsiella pneumoniae liver abscesses between isolates with capsular K1/K2 and non-K1/K2 serotypes. . Diagn Microbiol Infect Dis 62:, 1–6. [CrossRef][PubMed]
    [Google Scholar]
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