Hypervirulent Klebsiella Pneumoniae, an Emerging Cause of Endogenous Endophthalmitis in A French Center: A Comparative Cohort Study

ABSTRACT

Introduction

Klebsiella pneumoniae (KP) is the most common cause of endogenous endophthalmitis (EE) in Asia, but data in Europe are scarce. We describe eight cases of KP EE compared to a cohort of EE in a French center.

Methods

EE cases were retrospectively studied between January 2014 and January 2021. KP EE cases were analyzed to assess clinical, microbiological features, and outcome.

Results

Among the 33 EE cases identified, the first causative agent (24%, n = 8) was KP, mainly (7/8) with hypervirulent phenotype (hvKP). All but one of these cases occurred from December 2019 to January 2021. Contrary to non-KP patients, KP patients had multiple extraocular infective foci (p = .006), all presented with liver abscesses (p < .001), 50% had cerebral involvement (p = .13). Visual outcome was poor in both groups.

Conclusion

KP is an emerging cause of EE in a French center, consistently associated with liver abscesses, frequent cerebral involvement, and predominance of hvKP strains.

KEYWORDS:

• Endophtalmitis
• hypervirulent
• Klebsiella pneumoniae
• liver abscess

Acknowledgments

We thank all physicians involved in the follow-up of EE patients in the ophthalmology, internal medicine and infectious diseases units. A special thanks to Dr Adrien Contejean and Dr Philippe Blanche for their precious help in collecting data. We also thank all patients who accepted to give their medical data for analysis. We thank Jeffrey Arsham for his proofreading.

Disclosure statement

No potential conflict of interest was reported by the author(s).

Additional information

Funding

The author(s) reported that there is no funding associated with the work featured in this article.