Abstract
To report a rare case of endogenous endophthalmitis caused by carbapenem-resistant hypervirulent Klebsiella pneumoniae (CR-hvKP). A retrospective chart review was conducted. The isolates were characterized by hypermucoviscosity, resistance genes, virulence genes, and multilocus sequence typing. A 47-year-old diabetic woman acquired carbapenem-resistant K. pneumoniae (CRKP) nosocomial pneumonia. Metastatic endophthalmitis occurred in the right eye a week after the occurrence of CRKP bloodstream infection (BSI). Visual acuity decreased to light perception within 3 days. Although vitrectomy relieved ocular pain, endophthalmitis deteriorated due to uncontrollable BSI, and developed to corneal perforation. The strains isolated from bronchoalveolar lavage fluid, blood, and intraocular pus originated from the same clone. The pathogen was hypermucoviscous, belonged to sequence type 11, harbored resistance genes blaKPC-2, blaTEM, blaSHV, rmtB, and virulence genes rmpA2, iucABCD, iroBCD. Endogenous endophthalmitis caused by CR-hvKP has emerged, which is a treatment challenge for both ophthalmologists and physicians.
References
Mar 3, 2004·The Journal of Experimental Medicine·Chi-Tai FangJin-Town Wang
Jul 28, 2004·Gene·Ying-Tsong ChenHwei-Ling Peng
Apr 13, 2005·Clinical Infectious Diseases : an Official Publication of the Infectious Diseases Society of America·Jiun-Ling WangShan-Chwen Chang
Jan 15, 2010·The Journal of Antimicrobial Chemotherapy·Caroline DallenneGuillaume Arlet
Dec 21, 2010·American Journal of Ophthalmology·Marcus AngSoon-Phaik Chee
Nov 23, 2011·Retina·Suhwan LeeJoo Yong Lee
May 2, 2012·Journal of Chemotherapy·Fatih HorozogluAtes Yanyali
Oct 27, 2012·The Lancet Infectious Diseases·L Kristopher SiuFeng-Yee Chang
Jan 11, 2013·Virulence·Alyssa S ShonThomas A Russo
Jul 10, 2013·BMC Microbiology·Tianming LiMin Li
Jul 10, 2014·Journal of Ocular Pharmacology and Therapeutics : the Official Journal of the Association for Ocular Pharmacology and Therapeutics·Muammer OzcimenErkan Erdogan
Aug 26, 2014·Graefe's Archive for Clinical and Experimental Ophthalmology = Albrecht Von Graefes Archiv Für Klinische Und Experimentelle Ophthalmologie·Muammer OzcimenErkan Erdogan
Aug 26, 2015·The Journal of Infection·Yawei ZhangHui Wang
Sep 27, 2015·Clinical Microbiology and Infection : the Official Publication of the European Society of Clinical Microbiology and Infectious Diseases·A OlivaV Vullo
Apr 7, 2016·Diagnostic Microbiology and Infectious Disease·Dan-Dan WeiYang Liu
Jun 17, 2016·Microbiology and Molecular Biology Reviews : MMBR·Michelle K Paczosa, Joan Mecsas
Dec 15, 2016·Frontiers in Cellular and Infection Microbiology·Meiping YeMinggui Wang
Apr 8, 2017·Frontiers in Microbiology·Yan-Fang MeiXian-Wei Cao
Apr 27, 2017·The Lancet Infectious Diseases·Belén Gutiérrez-GutiérrezUNKNOWN REIPI/ESGBIS/INCREMENT Investigators
Sep 3, 2017·The Lancet Infectious Diseases·Danxia GuSheng Chen
May 2, 2018·Antimicrobial Agents and Chemotherapy·Yu FengZhiyong Zong
May 17, 2018·Ocular Immunology and Inflammation·Emmett T CunninghamManfred Zierhut
May 26, 2018·The Journal of Antimicrobial Chemotherapy·Yen-Hua HuangTsuey-Ching Yang
Citations
Sep 8, 2020·BMC Infectious Diseases·Yue WangYu Di
Mar 6, 2021·Journal of Global Antimicrobial Resistance·Peng LanYunsong Yu
May 18, 2021·IDCases·Fadi HassaninHailah Al Hussain
Jun 24, 2021·Annals of Clinical Microbiology and Antimicrobials·John Alexander McHardyGuduru Gopal Rao
Aug 7, 2021·Scientific Reports·Kuan-Jen ChenChi-Chun Lai