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Hypervirulent Klebsiella pneumoniae (hvKP) can cause severe invasive infections in healthy and immunocompromised individuals. It is an important clinical pathogen, with the recent identification of highly invasive community-acquired K. pneumoniae that produce purulent liver abscess. Herein, the frequency, clinical characteristics, and molecular epidemiology of K. pneumoniae isolates obtained from January to October 2016 in Wenzhou, China, were examined. In the present study, 33 isolates (68.8%, 33/48) had a positive string test and were identified as hvKP. Both age and sex were associated with a positive string test (p < 0.05). Univariate analysis revealed that liver abscess (odds ratio = 10.154) was a significant risk factor for hvKP. Among the hvKP isolates, K1 was the most common capsular serotype, followed by K2 (p < 0.05). The prevalence of K1 and K2 was significantly higher in hvKP than non-hvKP isolates. The rates of virulence-associated genes, rmpA, iroB, fib, and hib, were significantly higher for hvKP than for non-hvKP (p < 0.05). In this study, kfuB, ybtA, and wcaG were associated with K1 isolates. ST23 was the predominant hvKP type, which belonged to serotype K1. Pulsed-field gel electrophoresis showed that two clusters had >75% similarity and each accounted for >3 isolates. The homology of the 48 clinical isolates was diverse. In conclusion, hvKP isolates had a high frequency of virulence factors and a wide variety of homologs. These results suggest that, because of the toxicity associated with K. pneumoniae, increased clinical understanding of the disease is important to prevent larger, severe outbreaks. [ABSTRACT FROM AUTHOR]

Background: Staphylococcus epidermidis has emerged as an often encountered pathogen responsible for hospital-acquired infections. The aim of present study is to investigate the microbiological characteristic of S. epidermidis isolates isolated from sterile specimens and skin in a Chinese tertiary hospital. Methods: A total of 223 non-duplicate S. epidermidis were collected from various sterile specimens of inpatients among 10 years in Wenzhou, China. 106 S. epidermidis obtained from the skin (urethral orifices) of healthy volunteers. All isolates were tested for antimicrobial susceptibility. PCR was used to detect the virulence- and resistance-associated genes and 7 housekeeping genes to determine the sequence types (STs) of selected isolates. Results: The resistance rates to antimicrobials tested except linezolid and vancomycin and the prevalence of methicillin-resistant S. epidermidis (MRSE) of S. epidermidis clinical isolates were significantly higher than those among colonized isolates (P < 0.05). The positive rates of virulence-associated genes including aap, sesI, ACME-arcA, IS256, bhp, altE, aae and gehD for S. epidermidis clinical isolates were significantly higher than those for colonized isolate (P < 0.05). A total of 60 STs including 28 from clinical isolates and 32 from colonized isolates were identified by MLST. A novel, rarely encountered clone, ST466, was found to be the second prevalent clone among clinical isolates. The great majority of the S. epidermidis isolates tested (73.86%) belonged to clone complex 2 (CC2). Compared with ST2, ST130, ST20 and ST59 clones, ST466 clone had the highest resistance rate to tetracycline (50.00%), the second highest prevalence of ACME-arcA (65.00%), bhp (30.00%) and qacA/B (65.00%), very low prevalence of carriage of icaA (0.00%) and biofilm formation (0.00%), the lack of sesI and high prevalence of aap, altE and aae (> 90%), which was similar to the characteristics of ST59 clone with one locus difference from ST466. ST466 clone competence with Staphylococcus aureus was relatively stronger, relative to ST2, ST20, ST130 and ST59 clones. Conclusion: Taken together, a high-level of genetic diversity was found between clinical and colonized S. epidermidis isolates. A novel ST466 clone with distinct and similar characteristics relative to other prevalent clones, emerging as a prevalent clone in China, should be of major concern. [ABSTRACT FROM AUTHOR]