증례 : 소화기 ; Klebsiella oxytoca에 의한 간농양 1예

조현진 ( Hyun Chin Cho ),김현진 ( Hyun Jin Kim ),이재민 ( Jae Min Lee ),김수경 ( Soo Kyoung Kim ),강민경 ( Min Kyung Kang ),이옥재 ( Ok Jae Lee ),김선주 ( Sun Joo Kim ) 대한내과학회 2009 대한내과학회지 Vol.77 No.2

Klebsiella은 광범위한 기회감염의 원인균으로 대부분이 Klebsiella pneumoniae에 의한 것으로 Klebsiella oxytoca는 사람에서 동정되는 경우가 흔치 않고, 아직까지 균의 특성을 정확하게 알고 있지 못하다. 저자들은 원위부 총 담관암으로 유문부 보존 췌십이지장 절제술의 과거력이 있는 환자에서 간농양으로 내원하여 혈액에서 Klebsiella oxytoca가 동정되었고, 적절한 항생제로 교체 후에 증상이 호전되던 중에 혈액담즙증이 발생하여 농양 내 가성동맥류에 의한 출혈로 진단하고 방사선적 중제술로 성공적으로 치료한 예를 보고한다. Klebsiella are opportunistic pathogens that cause a wide spectrum of severe diseases, such as septicemia, pneumonia, urinary tract infection, and soft tissue infection. Klebsiella oxytoca is rarely isolated from human clinical specimens, and bacteremia due to Klebsiella oxytoca remains relatively uncommon. We experienced a case of liver abscess due to Klebsiella oxytoca in a 71-year-old male with a history of pylorus-preserving pan-creaticoduodenectomy (PPPD) 4 years earlier. The patient was diagnosed with hemobilia secondary to a pseudo-aneurysm at the lower pole of the abscess cavity during antibiotic treatment and was treated successfully with selective percutaneous transcatheter embolization. (Korean J 77:218-222, 2009)

분자학적 방법을 이용한 Carbapenemase-Producing Klebsiella oxytoca 검출

양병선,박지애 대한임상검사과학회 2019 대한임상검사과학회지(KJCLS) Vol.51 No.4

The rapid increase and dissemination of carbapene mases, such as Klebsiella pneumoniae carbapenemase (KPC), has become a major problem within the field of healthcare-related infection. There are few antibiotics to treat carbapenem-resistant Enterobacteriaceae (CRE) infections, so the identification of resistant bacterial mechanisms is critical to initiate infection control and conduct epidemiological research. A rapid and effective method for detecting KPC-producing bacteria is needed to avoid therapeutic failures and introduce measures to prevent and control the dissemination of these multi-resistant bacteria. During the study period, 31 isolates (seven isolates of Acinetobacter spp., six isolates of Morganella morganii, five isolates of Pseudomonas aeruginosa, five isolates of Proteus mirabilis, one isolate of Proteus vulgaris, two isolates of Enterobacter cloacae, one isolate of Enterobacter aerogenes, one isolate of Klebsiella pneumoniae, one isolate of Klebsiella oxytoca, one isolate of Serratia marcescens and one isolate of Escherichia coli) were identified by the VITEK. Gram negative rod bacteria were the most frequently isolated from urine (35.5%), blood (19.4%), sputum (16.1%), pus (9.7%), ascitic fluid (9.7%), tracheal aspirates (6.5%) and bile juice (3.2%). Analysis using the PCR method identified the blaKPC gene in the K. oxytoca1 strain, but the blaIMP, blaVIM and blaOXA-48 genes are not amplified. In conclusion, diagnosis using the PCR method can accurately and quickly diagnose KPC, thus establishing quick preventive measures to prevent the spread of KPC in hospitals. Klebsiella pneumoniae carbapenemase (KPC)와 같은carbapenem 분해효소의 급속한 증가와 보급은 의료 관련 감염 분야 내에서 주요한 문제가 되었다. Carbapenemresistant Enterobacteriaceae (CRE) 감염을 치료하기 위한항생제는 거의 없으므로 내성의 박테리아 메커니즘의 확인은 감염 통제와 역학 연구에 매우 중요하다. 그러므로 KPC 균주를 검출하는 신속하고 효과적인 방법은 치료상의 실패를 피하고, 이러한 다제 내성세균의 유통을 방지 및 통제하는 대책으로 도입할 필요가 있다. 분석에 이용한 31균주에서 Acinetobacter spp. 7균주, Morganella morganii 6균주, Pseudomonas aeruginosa 5균주, Proteus mirabilis 5균주, Proteus vulgaris 1균주, Enterobacter cloacae 2균주, Enterobacter aerogenes 1균주, Klebsiella pneumoniae 1균주, Klebsiella oxytoca 1균주, Serratia marcescens 1균주, Escherichia coli 1균주를 확인하였다. 그람음성 간균이 분리된 검체의 빈도는 urine (35.5%), blood (19.4%), sputum (16.1%), pus (9.7%), ascitic fluid (9.7%), tracheal aspirates (6.5%), bile juice (3.2%) 순으로 나타났다. PCR 방법을 이용한 유전자분석 결과blaIMP, blaVIM, blaOXA-48 에서는 증폭이 확인된 균주가 없었으나, Klebsiella oxytoca 1 균주에서 blaKPC 유전자를 확인하였다. 결론적으로, PCR 방법을 이용한 진단법은 KPC를 정확하고신속하게 진단할 수 있으며, 그로 인해 병원 내 KPC의 전파방지를 위한 신속한 예방대책 수립이 가능하다 할 수 있다.

Klebsiella oxytoca C302의 분리 동정 및 방향족 탄화수소물질의 분해특성

김기필,이정순,박송이,이문수,배경숙,김치경 한국미생물학회 2000 미생물학회지 Vol.36 No.1

공업단지 폐수로부터 benzoate에 대하여 분해능을 보이는 균주를 분리하여 생화학적 특성과 세포 지방산 분석을 실시하여 동정한 결과 Klebsiella oxytoca로 밝혀졌다. 따라서 이 균주를 Klebsiella oxytoca strain C3O2라 명명하였으며 여러 가지 방향족 탄화수소에 대한 분해특성을 알아본 결과, benzoate 외에 catechol, protocatechuate, 4-hydroxybenzoate에 대한 분해능이 우수하였으며, 특히 benzoate와 catechol에 대하여 높은 분해능을 보였다. Klebsiella oxytoca C3O2 균주의 catechol 분해능에 대한 환경요소의 영향을 실험한 결과, $30^{\circ}C$와 pH 7.0에서 그리고 0.5~1.0 mM의 농도에서 왕성한 생장과 분해능을 보였다. A bacterial isolate capable of degrading benzoate was selected from wastewater of Yocheon industrial complex and examined its biochemical characteristics and fatty acid composition. The isolate was identified as Klebsiella oxytoca strain C302. The strain C3O2 degraded catechol, protocatechuate, and 4-hydroxybenzoate as well as benzoate. The strain grew on and degraded 0.5 to 1.0 mM catechol most actively in MM2 medium at pH 7.0 and $30^{\circ}C$.

Identification of Klebsiella pneumoniae Carbapenemase-producing Klebsiella oxytoca in Clinical Isolates in Tehran Hospitals, Iran by Chromogenic Medium and Molecular Methods

Majid Validi,Mohammad Mehdi Soltan Dallal,Masoumeh Douraghi,Jalil Fallah Mehrabadi,Abbas Rahimi Foroushani 질병관리본부 2016 Osong Public Health and Research Persptectives Vol.7 No.5

Objectives: Production of carbapenemase, especially Klebsiella pneumoniae carbapenemases (KPC), is one of the antibiotic resistance mechanisms of Enterobacteriaceae such as Klebsiella oxytoca. This study aimed to investigate and identify KPC-producing K. oxytoca isolates using molecular and phenotypic methods. Methods: A total of 75 isolates of K. oxytoca were isolated from various clinical samples, and were verified as K. oxytoca after performing standard microbiological tests and using a polymerase chain reaction (PCR) method. An antibiotic susceptibility test was performed using a disc diffusion method according to the Clinical and Laboratory Standards Institute guidelines. CHROMagar KPC chromogenic culture media was used to examine and confirm the production of the carbapenemase enzyme in K. oxytoca isolates; in addition, PCR was used to evaluate the presence of blaKPC gene in K. oxytoca strains. Results: Of a total of 75 K. oxytoca isolates, one multidrug resistant strain was isolated from the urine of a hospitalized woman. This strain was examined to assess its ability to produce carbapenemase enzyme; it produced a colony with a blue metallic color on the CHROMagar KPC chromogenic culture media. In addition, the blaKPC gene was confirmed by PCR. After sequencing, it was confirmed and deposited in GenBank. Conclusion: To date, many cases of KPC-producing Enterobacteriaceae, in particular K. pneumoniae, have been reported in different countries; there are also some reports on the identification of KPC-producing K. oxytoca. Therefore, to prevent the outbreak of nosocomial infections, the early detection, control, and prevention of the spread of these strains are of great importance.

Pseudo-outbreak of Klebsiella oxytoca from Bronchial Washing Specimens

이자영,신정환,유성미,박은희,이희련,김재현,김혜란,문치숙,김영재,이정녀,이현경 대한임상미생물학회 2008 Annals of clinical microbiology Vol.11 No.1

배경: 2006년 5월부터 기관지 세척액 배양에서 Klebsiella oxytoca의 분리 빈도가 갑작스럽게 증가하였다. 이에 저자들은 K. oxytoca에 의한 돌발 감염을 의심하여 감염원을 찾기 위한 역학 조사 및 추가발생을 감소시키기 위한 감염활동을 실시 하였다. 방법: 총 18검체를 대상으로 하였다. K. oxytoca 14주는 기관지 내시경실 전용 기관지 내시경 장비에서, 나머지 4주는 내과 중환자실에서 사용했던 이동식 기관지 내시경 장비에서 검출되었다. 환자들의 병력과 미생물 검사 결과를 통해 감염 유무를 조사하였고, 기관지 내시경 기구 및 환경 검체에 대한 배양검사를 실시하였다. 분자역학적 연관성을 확인하기 위하여 보관이 가능하였던 10주를 대상으로 pulsed-field gel electrophoresis를 실시하였다. 결과: 환자들의 병력조사에서 기관지 내시경 시행 전후 K. oxytoca에 의한 호흡기 감염발생 증거는 없었다. 2대의 기관지 내시경 기구 및 환경 검체에 대한 배양검사 결과 K. oxytoca는 검출되지 않았다. Pulsed-field gel electrophoresis 유전자 형별분석 결과 8주에서 유사한 패턴이 관찰되었다. 가유행의 역학조사 기간 동안 기관지 내시경의 세척, 소독 강화 및 지속적인 감염관리 활동으로 이후 K. oxytoca 검출빈도는 점차 감소하였다. 결론: 기관지 세척액 배양에서 K. oxytoca 분리 빈도의 갑작스런 증가는 가유행으로 판명되었으며, 역학조사상 감염원은 기관지 내시경 검사 당시 해당 균을 상재하고 있던 환자로 추정하였다.

Engineering of <i>Klebsiella oxytoca</i> for production of 2,3-butanediol via simultaneous utilization of sugars from a <i>Golenkinia</i> sp. hydrolysate

Park, Jong Hyun,Choi, Min Ah,Kim, Yong Jae,Kim, Yeu-Chun,Chang, Yong Keun,Jeong, Ki Jun Elsevier Applied Science 2017 Bioresource technology Vol.245 No.2

<P><B>Abstract</B></P> <P>The <I>Klebsiella oxytoca</I> was engineered to produce 2,3-butanediol (2,3-BDO) simultaneously utilizing glucose and galactose obtained from a <I>Golenkinia</I> sp. hydrolysate. For efficient uptake of galactose at a high concentration of glucose, <I>Escherichia coli</I> galactose permease (GalP) was introduced, and the expression of <I>galP</I> under a weak-strength promoter resulted in simultaneous consumption of galactose and glucose. Next, to improve the sugar consumption, a gene encoding methylglyoxal synthase (MgsA) known as an inhibitor of multisugar metabolism was deleted, and the <I>mgsA</I>-null mutant showed much faster consumption of both sugars than the wild-type strain did. Finally, we demonstrated that the engineered <I>K. oxytoca</I> could utilize sugar extracts from a <I>Golenkinia</I> sp. hydrolysate and successfully produces 2,3-BDO.</P> <P><B>Highlights</B></P> <P> <UL> <LI> Production of 2,3-BDO by <I>Klebsiella oxytoca</I> using <I>Golenkinia</I> sp. hydrolysates. </LI> <LI> Engineering of <I>Klebsiella oxytoca</I> for simultaneous utilization of mixed sugars. </LI> <LI> Optimization of gene expression using synthetic promoters. </LI> </UL> </P>

Antibiotics-Associated Hemorrhagic Colitis Caused by Klebsiella oxytoca: Two Case Reports

Youngmin Youn,Sang Won Lee,Hyun-Hae Cho,Sanghui Park,Hae-Sun Chung,Jeong Wan Seo 대한소아소화기영양학회 2018 Pediatric gastroenterology, hepatology & nutrition Vol.21 No.2

Nowadays, Klebsiella oxytoca is described as a causative organism for antibiotic-associated hemorrhagic colitis (AAHC). Here we report two cases of pediatric AAHC, from which K. oxytoca was cultured after starting amox-icillin-clavulanate or amoxicillin treatment. The patients developed severe abdominal pain and a large amount of bloody diarrhea. K. oxytoca was obtained in intestinal fluid culture of a boy through the colonoscopy. On the other hand, colonic tissue culture and intestinal fluid culture were negative of the other patient. K. oxytoca was detected in stool culture when he was admitted. These cases showed characteristic endoscopic findings of segmental hemor-rhagic colitis, and both boys recovered spontaneously within 2-3 days after they stopped taking the antibiotics. Therefore, in children who develop relatively large amount of bloody diarrhea after antibiotic treatment, we should consider AAHC caused by K. oxytoca.

Antibiotics-Associated Hemorrhagic Colitis Caused by Klebsiella oxytoca: Two Case Reports

Youn, Youngmin,Lee, Sang Won,Cho, Hyun-Hae,Park, Sanghui,Chung, Hae-Sun,Seo, Jeong Wan The Korean Society of Pediatric Gastroenterology 2018 Pediatric gastroenterology, hepatology & nutrition Vol.21 No.2

Nowadays, Klebsiella oxytoca is described as a causative organism for antibiotic-associated hemorrhagic colitis (AAHC). Here we report two cases of pediatric AAHC, from which K. oxytoca was cultured after starting amoxicillin-clavulanate or amoxicillin treatment. The patients developed severe abdominal pain and a large amount of bloody diarrhea. K. oxytoca was obtained in intestinal fluid culture of a boy through the colonoscopy. On the other hand, colonic tissue culture and intestinal fluid culture were negative of the other patient. K. oxytoca was detected in stool culture when he was admitted. These cases showed characteristic endoscopic findings of segmental hemorrhagic colitis, and both boys recovered spontaneously within 2-3 days after they stopped taking the antibiotics. Therefore, in children who develop relatively large amount of bloody diarrhea after antibiotic treatment, we should consider AAHC caused by K. oxytoca.

Engineering of Klebsiella oxytoca for production of 2,3-butanediol from multiple sugars

Ki Jun Jeong 한국생물공학회 2021 한국생물공학회 학술대회 Vol.2021 No.10

Klebsiella oxytoca is one of promising microbes for production of 2,3-butanediol (2,3-BDO), which is a potentially valuable bulk chemical due to its extensive industry applications. As the demand for economic and ecologically friendly production of 2,3-BDO increases, the development of microorganisms consuming multiple sugars from cheaper biomass (lignocellulose, microalgae etc) is attracting attention. In general, hydrolysis of biomass generates multiple sugars including xylose, galactose, mannose as well as glucose, but due to higher preference to glucose than other sugars, the direct use of biomass hydrolysates does not allow the rapid cell growth and efficient production of target product. To tackle this limitation, we tried to engineer K. oxytoca using synthetic biology tools, adaptive laboratory evolution (ALE) and metabolic engineering, and the engineered strain showed improved sugar consumption rates with high productivity of 2,3-BDO during cultivation with multiple sugars. In addition to synthetic media, we also confirmed the efficient utilization of the real hydrolysates from sunflower and microalgae as carbon sources in cultivation. In this talk, I will present the progressive results for this engineering of K. oxytoca.

Isolation, Screening, and Selection of an L-glutaminase Producer from Soil and Media Optimization Using a Statistical Approach

Iyer Padma,Rekha Singhal 한국생물공학회 2010 Biotechnology and Bioprocess Engineering Vol.15 No.6

A culture isolated from garden soil was found to be a promising L-glutaminase producer. Biochemical identification tests and 16S rRNA sequencing identified this isolate to be Klebsiella oxytoca. Subsequently, media optimization using one-factor-at-a-time approach and response surface methodology was undertaken. A face centered central composite design was employed to investigate the interactive effects of four variables, viz. concentrations of maltose, yeast extract, beef extract, and ammonium acetate on glutaminase production. Almost all factors had significant interactive effects on glutaminase production. A medium containing (g/L): maltose, 23.31; yeast extract, 20.0; beef extract, 20.01; ammonium acetate, 10.0; mannitol, 10.0;KH2PO4, 0.4; Na2SO4, 0.4; and MgCl2, 0.4 was optimum for glutaminase production. The applied methodology was validated using this optimized media and enzyme activity of 458.91 ± 9.49 U/L and specific activity of 0.441 ± 0.04U/mg protein after 42 h of incubation at 33oC were obtained.