The First Case of Community-Acquired Pneumonia Due to Capsular Genotype K2-ST86 Hypervirulent Klebsiella pneumoniae in Okinawa, Japan: A Case Report and Literature Review

Figures & data

Figure 1 Radiological findings of the present case. Chest X-ray revealing lobar pneumonia on bilateral lung fields (A). Computed tomography showing multiple consolidation with air-bronchogram, nodules, and ground-glass attenuation on bilateral lung fields (B1–4).

Figure 2 Multiplex PCR. The present strain harbored iutA, rmpA, entB, and mrkD genes.

Table 1 The Characteristics of Nine Adult Cases with Community-Acquired Pneumonia Due to Hypervirulent Klebsiella pneumoniae Including the Present Case [14–16]

Present Case		Review + Present Case (N = 10)		%
Clinical characteristics		Clinical characteristics
Age (years)	79	Average age (range) (years)	66.3 (39–90)
Sex	Female	Sex (Male)	7	70
Underlying disease		Underlying disease
Diabetes mellitus	No	Diabetes mellitus	4	40
Malignancy	No	Malignancy	1	10
Immunosuppression use	No	Immunosuppression use	1	10
Complication		Complication
Bacteremia	Yes	Bacteremia	5	50
Septic shock	Yes	Septic shock	7	70
Metastatic infection		Metastatic infection	0	0
Treatment		Treatment
Third-generation cephalosporins	Yes	Third-generation cephalosporins	7	70
Other	–	Other	2	20
Unknown	–	Unknown	1	10
Outcome		Outcome
Mortality	Survived	Mortality	5	50
Microbiological characteristics		Microbiological characteristics
String test		String test
	Positive	Positive	10	100
Serotype		Serotype
	K2	K1	1	10
		K2	8	80
		K-nontypable	1	10
MLST		MLST
	ST86	K-nontypable-ST11	1	10
		K1-ST23	1	10
		K2-ST65	2	20
		K2-ST86	6	60
Virulence gene profiles		Virulence gene profiles (N = 9)
	iutA	magA	1	11.1
	rmpA	iutA (N = 8)	8	100
	entB	allS (N = 7)	0	0
	mrkD	kfu	0	0
		rmpA	8	88.8
		entB	7	77.7
		mrkD	9	100
		ybtS	8	88.8