The prevalence of rectal carriage of Klebsiella pneumoniae amongst diabetic patients and their clinical relevance in Taiwan: A five-year prospective study
Background/purpose: Pyogenic liver abscess (PLA) and bacteremia caused by Klebsiella pneumoniae is a common complication among patients with diabetes mellitus (DM). The aim of this study is to investigate the prevalence of rectal carriage and serotype distribution of K. pneumoniae amongst DM patient...
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doaj-27efe7c2d7b84ccf9cb49cb3f257f6e32020-11-24T21:32:41ZengElsevierJournal of Microbiology, Immunology and Infection1684-11822018-08-01514510518The prevalence of rectal carriage of Klebsiella pneumoniae amongst diabetic patients and their clinical relevance in Taiwan: A five-year prospective studyYu-Tsung Huang0Ju-Ying Jiang1Meng-Shiuan Hsu2Hsin-Sui Hsu3Chun-Hsing Liao4Po-Ren Hsueh5Department of Internal Medicine, Far-Eastern Memorial Hospital, New Taipei City, Taiwan; Department of Laboratory Medicine, National Taiwan University Hospital, National Taiwan University College of Medicine, Taipei, TaiwanDepartment of Internal Medicine, Far-Eastern Memorial Hospital, New Taipei City, TaiwanDepartment of Internal Medicine, Far-Eastern Memorial Hospital, New Taipei City, TaiwanDepartment of Internal Medicine, Far-Eastern Memorial Hospital, New Taipei City, TaiwanDepartment of Internal Medicine, Far-Eastern Memorial Hospital, New Taipei City, Taiwan; Department of Medicine, Yang-Ming University, Taipei, Taiwan; Corresponding author. Department of Internal Medicine, Far-Eastern Memorial Hospital, Number 21, Section 2, Nan-Ya South Road, New Taipei City, Taiwan.Department of Laboratory Medicine, National Taiwan University Hospital, National Taiwan University College of Medicine, Taipei, Taiwan; Department of Internal Medicine, National Taiwan University Hospital, National Taiwan University College of Medicine, Taipei, TaiwanBackground/purpose: Pyogenic liver abscess (PLA) and bacteremia caused by Klebsiella pneumoniae is a common complication among patients with diabetes mellitus (DM). The aim of this study is to investigate the prevalence of rectal carriage and serotype distribution of K. pneumoniae amongst DM patients and their clinical relevance. Methods: We prospectively collected rectal swabs for K. pneumoniae culture in asymptomatic DM patients from March 2008 to June 2009. Seven capsular serotypes that were commonly associated with PLA were determined by capsular polysaccharide synthesis (cps) genotyping. Microbiologically confirmed bacterial infections were evaluated 1 and 5 years after initial enrolment of the patients. Results: A total of 100 male and 62 female patients (mean age, 56.6 years) were enrolled. Of these, 77 (47.5%) had rectal K. pneumoniae colonization. Colonizers were older than non-colonizers (p = 0.03). Sex, fasting blood glucose, and initial HbA1C were not statistically different (p = 0.26, 0.18, and 0.31, respectively). Among the 65 available isolates, 22 (33.8%) belonged to the seven main serotypes. During the 5-year's follow-up, 21 patients developed microbiologically documented bacterial infections but none of them developed PLA and bacteremia. Risk factors for bacterial infection within 5 years included initial glycosylated hemoglobin (HbA1C) > 10% or first-year average HbA1C > 10%. Conclusion: Although nearly half of asymptomatic DM patients had rectal carriage of K. pneumoniae and one-third of them colonized by isolates belonging to the seven serotypes related to PLA, none of them subsequently developed PLA and colonized patients did not have higher risk of microbiologically confirmed bacterial infections. Keywords: Klebsiella pneumoniae, Pyogenic liver abscess, Diabetes mellitus, Bacterial infections, Rectal carriagehttp://www.sciencedirect.com/science/article/pii/S1684118217301196 |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Yu-Tsung Huang Ju-Ying Jiang Meng-Shiuan Hsu Hsin-Sui Hsu Chun-Hsing Liao Po-Ren Hsueh |
spellingShingle |
Yu-Tsung Huang Ju-Ying Jiang Meng-Shiuan Hsu Hsin-Sui Hsu Chun-Hsing Liao Po-Ren Hsueh The prevalence of rectal carriage of Klebsiella pneumoniae amongst diabetic patients and their clinical relevance in Taiwan: A five-year prospective study Journal of Microbiology, Immunology and Infection |
author_facet |
Yu-Tsung Huang Ju-Ying Jiang Meng-Shiuan Hsu Hsin-Sui Hsu Chun-Hsing Liao Po-Ren Hsueh |
author_sort |
Yu-Tsung Huang |
title |
The prevalence of rectal carriage of Klebsiella pneumoniae amongst diabetic patients and their clinical relevance in Taiwan: A five-year prospective study |
title_short |
The prevalence of rectal carriage of Klebsiella pneumoniae amongst diabetic patients and their clinical relevance in Taiwan: A five-year prospective study |
title_full |
The prevalence of rectal carriage of Klebsiella pneumoniae amongst diabetic patients and their clinical relevance in Taiwan: A five-year prospective study |
title_fullStr |
The prevalence of rectal carriage of Klebsiella pneumoniae amongst diabetic patients and their clinical relevance in Taiwan: A five-year prospective study |
title_full_unstemmed |
The prevalence of rectal carriage of Klebsiella pneumoniae amongst diabetic patients and their clinical relevance in Taiwan: A five-year prospective study |
title_sort |
prevalence of rectal carriage of klebsiella pneumoniae amongst diabetic patients and their clinical relevance in taiwan: a five-year prospective study |
publisher |
Elsevier |
series |
Journal of Microbiology, Immunology and Infection |
issn |
1684-1182 |
publishDate |
2018-08-01 |
description |
Background/purpose: Pyogenic liver abscess (PLA) and bacteremia caused by Klebsiella pneumoniae is a common complication among patients with diabetes mellitus (DM). The aim of this study is to investigate the prevalence of rectal carriage and serotype distribution of K. pneumoniae amongst DM patients and their clinical relevance. Methods: We prospectively collected rectal swabs for K. pneumoniae culture in asymptomatic DM patients from March 2008 to June 2009. Seven capsular serotypes that were commonly associated with PLA were determined by capsular polysaccharide synthesis (cps) genotyping. Microbiologically confirmed bacterial infections were evaluated 1 and 5 years after initial enrolment of the patients. Results: A total of 100 male and 62 female patients (mean age, 56.6 years) were enrolled. Of these, 77 (47.5%) had rectal K. pneumoniae colonization. Colonizers were older than non-colonizers (p = 0.03). Sex, fasting blood glucose, and initial HbA1C were not statistically different (p = 0.26, 0.18, and 0.31, respectively). Among the 65 available isolates, 22 (33.8%) belonged to the seven main serotypes. During the 5-year's follow-up, 21 patients developed microbiologically documented bacterial infections but none of them developed PLA and bacteremia. Risk factors for bacterial infection within 5 years included initial glycosylated hemoglobin (HbA1C) > 10% or first-year average HbA1C > 10%. Conclusion: Although nearly half of asymptomatic DM patients had rectal carriage of K. pneumoniae and one-third of them colonized by isolates belonging to the seven serotypes related to PLA, none of them subsequently developed PLA and colonized patients did not have higher risk of microbiologically confirmed bacterial infections. Keywords: Klebsiella pneumoniae, Pyogenic liver abscess, Diabetes mellitus, Bacterial infections, Rectal carriage |
url |
http://www.sciencedirect.com/science/article/pii/S1684118217301196 |
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