Mucoviscous characteristics of Klebsiella pneumoniae strains: A factor of clinical severity?

Prognosis and Characteristics of Hypermucoviscous Klebsiella pneumoniae Infection in Critically Ill Patients: A Case Series

Introduction Hypermucoviscous Klebsiella pneumoniae (hvKP) is related to invasive infections; however, there have been very few comprehensive reports on the clinical features and prognosis of critically ill patients with the infection. Methods We conducted a retrospective case series in a general intensive care unit in Japan. Patients with positive blood cultures for KP between January 1, 2020 and December 31, 2022 were included. hvKP was defined by the positivity in the string test. We analyzed the patient's characteristics at baseline, including comorbidities, abscess formation, Sequential Organ Failure Assessment (SOFA) score, Acute Physiology and Chronic Health Evaluation (APACHE) II score, septic shock, duration of hospitalization, 30-day mortality, and infection site. Results A total of 24 patients had a positive blood culture for KP; nine patients (37.5%) were positive for the string test (hvKP) while 15 (62.5%) were negative (non-hvKP). In both groups, the patients were old (mean age, hvKP 80.4 vs. non-hvKP 75.7 years) and more often male (five patients (55.6%) vs. 12 patients (80.0%)). No statistically significant difference was found between the two groups in terms of comorbidities, such as diabetes mellitus, chronic obstructive pulmonary disease, chronic kidney disease, and malignancy. No statistical difference was seen in abscess formation (two patients [22.2%] vs. one patient (6.7%)), SOFA score (5.2±4.8 vs. 4.7±3.4), APACHE II score (19.6 (15.0-20.0) vs. 17.0 (11.2-20.8)), septic shock (five patients (55.6%) vs. four patient (26.7%)), duration of hospitalization (37.2 (12.0-51.0) vs. 32.3 (9.5-21.0)), and 30-day mortality (two patients (22.2%) vs. two patients (13.3%)). Two cases with hvKP died within 24 h. No significant difference was seen in the infection sources; respiratory infection (2 (22.2%) vs. 1 (6.7%)), hepatobiliary infection (2 (22.2%) vs. 7 (46.7%)), and genitourinary infection (1 (11.1%) vs. 5 (33.3%)). Conclusions Critically ill patients with hvKP infection showed characteristics similar to those reported previously. However, the disease could rapidly become severe and have a poor prognostic outcome.

Fermented Carrot Pulp Regulates the Dysfunction of Murine Intestinal Microbiota

It was the focus of attention that probiotic control drink was packed with prebiotic nutrients and lactic acid bacteria. So, this study is aimed at revealing that the fermented carrot pulp regulation and protection function to the intestinal microecological disorders usually induced by antibiotic treatment. First, we study on lactobacillus fermentation conditions and effects on the secondary metabolism of fermented carrot juice, get its phenolic acids up, and get its flavonoids down. Then, establishment of the dysbacteriosis mouse model was used to validate the fermented carrot pulp prevention and treatment of intestinal microbiota imbalance. After the antibiotic treatment, the mice showed impotence, laziness, slow movement, weight loss, thin feces, dull hair, and anal redness, while the mice in the control group were all normal in terms of the mental state, diet, weight, and bowl movement. Along with the treatment, the abnormal conditions of the mice in the model group and natural recovery group improved in different degrees, indicating that the fermentation treatment is of help to the intestinal microbiota recovery. The fermentation-treated group of mice recovered close to normal that the diarrhea disappeared, and the weight gain, mental state, and the feces became normal. The serum antioxidant (SOD, GSH, and MDA) levels of the mice were checked. The superoxide dismutase (SOD) levels and glutathione (GSH) levels in the ordinary fermentation-treated group and probiotic fermentation-treated group were significantly increased compare to the natural recovery group. The malondialdehyde (MDA) levels showed great differences between the fermentation-treated groups and the blank group. At last, the 16sRNA analysis revealed that the microbiota richness and diversity in probiotic fermentation (J) are much higher than those in the model group (H), ordinary fermentation group (I), and blank group (G). Groups J and I are of significantly higher antioxidant level than group H; however, only the glutathione (GSH) level in group J increased dramatically but not those in the other three groups. Antibiotic treatment-induced mouse intestinal microecological disorder reduce the microbiota richness and diversity. Prebiotics fermented carrot pulp treatment can help in the recovery from the microbiota richness and diversity level prior to the antibiotic treatment, which suggests it can regulate and protect the murine intestinal microbiome.