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Journal of Clinical Microbiology, February 2007, p. 466-471, Vol. 45, No. 2
0095-1137/07/$08.00+0     doi:10.1128/JCM.01150-06
Copyright © 2007, American Society for Microbiology. All Rights Reserved.

Capsular Serotype K1 or K2, Rather than magA and rmpA, Is a Major Virulence Determinant for Klebsiella pneumoniae Liver Abscess in Singapore and Taiwan{triangledown}

Kuo-Ming Yeh,1,2 A. Kurup,3 L. K. Siu,4 Y. L. Koh,3 Chang-Phone Fung,5 Jung-Chung Lin,2 Te-Li Chen,5 Feng-Yee Chang,2* and Tse-Hsien Koh6*

Graduate Institute of Medical Sciences, National Defense Medical Center,1 Division of Infectious Diseases and Tropical Medicine, Department of Internal Medicine, Tri-Service General Hospital,2 Unit of Infectious Diseases, Division of Clinical Research, National Health Research Institutes,4 Section of Infectious Diseases, Department of Medicine, Taipei Veterans General Hospital and National Yang-Ming University, Taipei, Taiwan,5 Infectious Diseases Unit, Department of Internal Medicine,3 Department of Pathology, Singapore General Hospital, Singapore6

Received 5 June 2006/ Returned for modification 22 August 2006/ Accepted 21 November 2006

Capsular serotypes, magA, and rmpA have been documented in high prevalence for Klebsiella pneumoniae liver abscess. To investigate the regional difference and the correlation of capsular serotype, magA, and rmpA with virulence, 73 isolates were collected in Singapore and Taiwan. Capsular serotypes were determined by countercurrent immunoelectrophoresis, the presence of magA and rmpA was determined by PCR, and virulence was determined by phagocytosis and mouse inoculation. Isolates from Singapore were similar to those from Taiwan in genomic heterogeneity, prevalence of serotype, and the presence of magA and rmpA. The most common serotype was K1 (34/73; 46.6%), followed by K2 (15/73; 20.5%). magA was restricted to serotype K1. All K1 or K2 isolates and 66.7% (16/24) of isolates that were neither serotype K1 nor serotype K2 (non-K1/K2) carried rmpA. Serotype K1 or K2 isolates demonstrated significantly more phagocytic resistance and virulence than did rmpA-positive and -negative groups of non-K1/K2 isolates. In the non-K1/K2 group, the virulence profiles of rmpA-positive strains from Taiwan and Singapore were different by phagocytosis assay and in the mouse model, indicating that factors other than rmpA contributed to virulence. The characteristics of K. pneumoniae liver abscess in Singapore and Taiwan are similar. Capsular serotype K1 or K2 plays a more important role than magA and rmpA in determining virulence in K. pneumoniae liver abscess.

* Corresponding author. Mailing address for T.-H. Koh: Department of Pathology, Singapore General Hospital, Singapore. Phone: 65-98259566. Fax: 65-62226826. E-mail: koh.tse.hsien{at}sgh.com.sg. Mailing address for F.-Y. Chang: Division of Infectious Diseases and Tropical Medicine, Department of Internal Medicine, Tri-Service General Hospital, Taipei 114, Taiwan. Phone: 886 2 87927257. Fax: 011-886-2 8792 7258. E-mail: fychang{at}ndmctsgh.edu.tw.

{triangledown} Published ahead of print on 6 December 2006.

Journal of Clinical Microbiology, February 2007, p. 466-471, Vol. 45, No. 2
0095-1137/07/$08.00+0     doi:10.1128/JCM.01150-06
Copyright © 2007, American Society for Microbiology. All Rights Reserved.



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