Clinical and Microbiological Characteristics of Invasive and Hypervirulent Klebsiella pneumoniae Infections in a Teaching Hospital in China

Purpose To investigate the clinical and microbiological characteristics of invasive and hypervirulent Klebsiella pneumoniae (HvKP) in a teaching hospital in Southern China. Patients and methods A total of 495 non-repetitive K. pneumoniae strains were isolated from Dongguan People's Hospital affiliated to Southern Medical University in 2018. Multivariate analysis was performed using the patients' clinical data to identify the risk factors for HvKP. Results Eighty-one isolates were HvKP (16.4%, 81/495), of which 43 (53.1%) were invasive HvKP, whereas 38 (46.9%) were non-invasive HvKP. The incidence of extended spectrum beta-lactamases (ESBLs) in HvKP and classic K. pneumoniae (cKP) were 7.4% (6/81) and 28.0% (116/414), respectively (p 0.05). The most prevalent virulence genes in HvKP were rmpA 98.7% (80/81), followed by rmpA2 (82.7%, 67/81), iroN (98.7%, 80/81), and iutA 90.1% (70/81). There was no significant difference in the distribution of virulence genes between invasive HvKP and non-invasive HvKP isolates (P>0.05). Conclusion Invasive HvKP infection in this study was positively associated with diabetes as independent risk factors. Antibiotic therapy combined with surgical drainage is one of the most effective treatment measures of HvKP infection. Adequate attention should be paid to HvKP infection in clinical and microbiological laboratories.