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Bacteriology

Genotypes of Klebsiella oxytoca Isolates from Patients with Nosocomial Pneumonia Are Distinct from Those of Isolates from Patients with Antibiotic-Associated Hemorrhagic Colitis

Kathrin A. T. Herzog, Georg Schneditz, Eva Leitner, Gebhard Feierl, Karl Martin Hoffmann, Ines Zollner-Schwetz, Robert Krause, Gregor Gorkiewicz, Ellen L. Zechner, Christoph Högenauer
W. M. Dunne Jr., Editor
Kathrin A. T. Herzog
aDivision of Gastroenterology and Hepatology, Department of Internal Medicine, Medical University of Graz, Graz, Austria
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Georg Schneditz
bInstitute of Molecular Biosciences, University of Graz, Graz, Austria
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Eva Leitner
cInstitute of Hygiene, Microbiology and Environmental Medicine, Medical University of Graz, Graz, Austria
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Gebhard Feierl
cInstitute of Hygiene, Microbiology and Environmental Medicine, Medical University of Graz, Graz, Austria
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Karl Martin Hoffmann
dDivision of General Pediatrics, Department of Pediatrics and Adolescent Medicine, Medical University of Graz, Graz, Austria
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Ines Zollner-Schwetz
eSection of Infectious Diseases and Tropical Medicine, Department of Internal Medicine, Medical University of Graz, Graz, Austria
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Robert Krause
eSection of Infectious Diseases and Tropical Medicine, Department of Internal Medicine, Medical University of Graz, Graz, Austria
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Gregor Gorkiewicz
fInstitute of Pathology, Medical University of Graz, Graz, Austria
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Ellen L. Zechner
bInstitute of Molecular Biosciences, University of Graz, Graz, Austria
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Christoph Högenauer
aDivision of Gastroenterology and Hepatology, Department of Internal Medicine, Medical University of Graz, Graz, Austria
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W. M. Dunne Jr.
Roles: Editor
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DOI: 10.1128/JCM.03373-13
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ABSTRACT

Klebsiella oxytoca acts as a pathobiont in the dysbiotic human intestinal microbiota, causing antibiotic-associated hemorrhagic colitis (AAHC), but it also infects other organs, resulting in pneumonia and urinary tract and skin infections. The virulence of K. oxytoca is still poorly understood. The production of a specific cytotoxin has been linked to AAHC pathogenesis. To investigate the clonal relationships of K. oxytoca with regard to clinical origin and virulence attributes, we established a multilocus sequence typing (MLST) method and analyzed 74 clinical K. oxytoca isolates from asymptomatic carriers and patients with AAHC, respiratory infections, and other infections. The isolates were phenotypically characterized, typed, and compared phylogenetically based on the sequences of seven housekeeping genes. MLST analysis yielded 60 sequence types, 12 of which were represented by more than one isolate. The phylogenetic tree distinguished clusters of K. oxytoca isolates between patients with AAHC and those with respiratory infections. Toxin-positive and -negative strains were observed within one sequence type. Our findings indicate that AAHC isolates share a genetic background. Interestingly, K. oxytoca isolates from nosocomial pneumonia showed a different genetic clustering, suggesting that these strains do not originate from the intestines or that they are specialized for respiratory tract colonization. Our results further indicate a polyphyletic origin and possible horizontal transfer of the genes involved in K. oxytoca cytotoxin production. This work provides evidence that K. oxytoca isolates colonizing the two main clinically relevant habitats (lower gastrointestinal [GI] tract and respiratory tract) of the human host are genetically distinct. Applications of this MLST analysis should help clarify the sources of nosocomial infections.

FOOTNOTES

    • Received 5 December 2013.
    • Returned for modification 10 January 2014.
    • Accepted 22 February 2014.
    • Accepted manuscript posted online 5 March 2014.
  • Supplemental material for this article may be found at http://dx.doi.org/10.1128/JCM.03373-13.

  • Copyright © 2014, American Society for Microbiology. All Rights Reserved.
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Genotypes of Klebsiella oxytoca Isolates from Patients with Nosocomial Pneumonia Are Distinct from Those of Isolates from Patients with Antibiotic-Associated Hemorrhagic Colitis
Kathrin A. T. Herzog, Georg Schneditz, Eva Leitner, Gebhard Feierl, Karl Martin Hoffmann, Ines Zollner-Schwetz, Robert Krause, Gregor Gorkiewicz, Ellen L. Zechner, Christoph Högenauer
Journal of Clinical Microbiology Apr 2014, 52 (5) 1607-1616; DOI: 10.1128/JCM.03373-13

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Genotypes of Klebsiella oxytoca Isolates from Patients with Nosocomial Pneumonia Are Distinct from Those of Isolates from Patients with Antibiotic-Associated Hemorrhagic Colitis
Kathrin A. T. Herzog, Georg Schneditz, Eva Leitner, Gebhard Feierl, Karl Martin Hoffmann, Ines Zollner-Schwetz, Robert Krause, Gregor Gorkiewicz, Ellen L. Zechner, Christoph Högenauer
Journal of Clinical Microbiology Apr 2014, 52 (5) 1607-1616; DOI: 10.1128/JCM.03373-13
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