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Article: Epidemiology of Klebsiella oxytoca-associated diarrhea detected by simmons citrate agar supplemented with inositol, tryptophan, and bile salts

TitleEpidemiology of Klebsiella oxytoca-associated diarrhea detected by simmons citrate agar supplemented with inositol, tryptophan, and bile salts
Authors
Issue Date2012
PublisherAmerican Society for Microbiology.
Citation
Journal Of Clinical Microbiology, 2012, v. 50 n. 5, p. 1571-1579 How to Cite?
AbstractWe studied the clinical and epidemiological characteristics of Klebsiella oxytoca-associated diarrhea in hospitalized patients in Hong Kong. Between 1 November 2009 and 30 April 2011, all inositol-fermenting colonies found on Simmons citrate agar supplemented with inositol, tryptophan, and bile salts (SCITB agar) used for the culturing of diarrheal stool samples were screened by a spot indole test for K. oxytoca. The overall sensitivity of SCITB agar plus the spot indole test (93.3%) for the detection of K. oxytoca in stool samples was superior to that of MacConkey agar (63.3%), while the specificities were 100% and 60.4%, respectively. The former achieved a 23-fold reduction in the workload and cost of subsequent standard biochemical identifications. Cytotoxin production and the clonality of K. oxytoca were determined by a cell culture cytotoxicity neutralization assay using HEp-2 cells and pulsed-field gel electrophoresis (PFGE), respectively. Of 5,581 stool samples from 3,537 patients, K. oxytoca was cultured from 117/5,581 (2.1%) stool samples from 104/3,537 (2.9%) patients. Seventy-six of 104 (73.1%) patients with K. oxytoca had no copathogens in their diarrheal stool samples. Twenty-four (31.6%) of 76 patients carried cytotoxin-producing strains, which were significantly associated with antibiotic therapy after hospital admission (50% versus 21.2%; P = 0.01). Health care-associated diarrhea was found in 44 (42%) of 104 patients with K. oxytoca, but there was no epidemiological linkage suggestive of a nosocomial outbreak, and PFGE showed a diverse pattern. None of the patients with cytotoxin-producing K. oxytoca developed antibiotic-associated hemorrhagic colitis, suggesting that K. oxytoca can cause a mild disease manifesting as uncomplicated antibiotic-associated diarrhea with winter seasonality. Copyright © 2012, American Society for Microbiology. All Rights Reserved.
Persistent Identifierhttp://hdl.handle.net/10722/157691
ISSN
2015 Impact Factor: 3.631
2015 SCImago Journal Rankings: 2.151
PubMed Central ID
ISI Accession Number ID
Funding AgencyGrant Number
Food and Health Bureau of the Hong Kong Special Administrative Region Government
Funding Information:

The work was supported by the Research Fund for the Control of Infectious Diseases of the Food and Health Bureau of the Hong Kong Special Administrative Region Government.

References

 

DC FieldValueLanguage
dc.contributor.authorCheng, VCCen_HK
dc.contributor.authorYam, WCen_HK
dc.contributor.authorTsang, LLen_HK
dc.contributor.authorYau, MCYen_HK
dc.contributor.authorSiu, GKHen_HK
dc.contributor.authorWong, SCYen_HK
dc.contributor.authorChan, JFWen_HK
dc.contributor.authorTo, KKWen_HK
dc.contributor.authorTse, Hen_HK
dc.contributor.authorHung, IFNen_HK
dc.contributor.authorTai, JWMen_HK
dc.contributor.authorHo, PLen_HK
dc.contributor.authorYuen, KYen_HK
dc.date.accessioned2012-08-08T08:52:18Z-
dc.date.available2012-08-08T08:52:18Z-
dc.date.issued2012en_HK
dc.identifier.citationJournal Of Clinical Microbiology, 2012, v. 50 n. 5, p. 1571-1579en_HK
dc.identifier.issn0095-1137en_HK
dc.identifier.urihttp://hdl.handle.net/10722/157691-
dc.description.abstractWe studied the clinical and epidemiological characteristics of Klebsiella oxytoca-associated diarrhea in hospitalized patients in Hong Kong. Between 1 November 2009 and 30 April 2011, all inositol-fermenting colonies found on Simmons citrate agar supplemented with inositol, tryptophan, and bile salts (SCITB agar) used for the culturing of diarrheal stool samples were screened by a spot indole test for K. oxytoca. The overall sensitivity of SCITB agar plus the spot indole test (93.3%) for the detection of K. oxytoca in stool samples was superior to that of MacConkey agar (63.3%), while the specificities were 100% and 60.4%, respectively. The former achieved a 23-fold reduction in the workload and cost of subsequent standard biochemical identifications. Cytotoxin production and the clonality of K. oxytoca were determined by a cell culture cytotoxicity neutralization assay using HEp-2 cells and pulsed-field gel electrophoresis (PFGE), respectively. Of 5,581 stool samples from 3,537 patients, K. oxytoca was cultured from 117/5,581 (2.1%) stool samples from 104/3,537 (2.9%) patients. Seventy-six of 104 (73.1%) patients with K. oxytoca had no copathogens in their diarrheal stool samples. Twenty-four (31.6%) of 76 patients carried cytotoxin-producing strains, which were significantly associated with antibiotic therapy after hospital admission (50% versus 21.2%; P = 0.01). Health care-associated diarrhea was found in 44 (42%) of 104 patients with K. oxytoca, but there was no epidemiological linkage suggestive of a nosocomial outbreak, and PFGE showed a diverse pattern. None of the patients with cytotoxin-producing K. oxytoca developed antibiotic-associated hemorrhagic colitis, suggesting that K. oxytoca can cause a mild disease manifesting as uncomplicated antibiotic-associated diarrhea with winter seasonality. Copyright © 2012, American Society for Microbiology. All Rights Reserved.en_HK
dc.languageengen_US
dc.publisherAmerican Society for Microbiology.-
dc.relation.ispartofJournal of Clinical Microbiologyen_HK
dc.rightsJournal of Clinical Microbiology. Copyright © American Society for Microbiology.-
dc.rightsCopyright © American Society for Microbiology, [Journal of Clinical Microbiology, 2012, v. 50 n. 5, p. 1571-1579]-
dc.subject.meshBacteriological Techniques - methods-
dc.subject.meshCulture Media - chemistry-
dc.subject.meshDiarrhea - epidemiology - microbiology-
dc.subject.meshKlebsiella Infections - epidemiology - microbiology-
dc.subject.meshKlebsiella oxytoca - classification - genetics - isolation and purification - pathogenicity-
dc.titleEpidemiology of Klebsiella oxytoca-associated diarrhea detected by simmons citrate agar supplemented with inositol, tryptophan, and bile saltsen_HK
dc.typeArticleen_HK
dc.identifier.emailYam, WC: wcyam@hkucc.hku.hken_HK
dc.identifier.emailChan, JFW: jfwchan@hku.hken_HK
dc.identifier.emailTo, KKW: kelvinto@hkucc.hku.hken_HK
dc.identifier.emailTse, H: htse@hkucc.hku.hken_HK
dc.identifier.emailHung, IFN: ivanhung@hkucc.hku.hken_HK
dc.identifier.emailHo, PL: plho@hkucc.hku.hken_HK
dc.identifier.emailYuen, KY: kyyuen@hkucc.hku.hken_HK
dc.identifier.authorityYam, WC=rp00313en_HK
dc.identifier.authorityChan, JFW=rp01736en_HK
dc.identifier.authorityTo, KKW=rp01384en_HK
dc.identifier.authorityTse, H=rp00519en_HK
dc.identifier.authorityHung, IFN=rp00508en_HK
dc.identifier.authorityHo, PL=rp00406en_HK
dc.identifier.authorityYuen, KY=rp00366en_HK
dc.description.naturelink_to_OA_fulltexten_US
dc.identifier.doi10.1128/JCM.00163-12en_HK
dc.identifier.pmid22357507-
dc.identifier.pmcidPMC3347154-
dc.identifier.scopuseid_2-s2.0-84859992625en_HK
dc.identifier.hkuros203196-
dc.identifier.hkuros204615-
dc.relation.referenceshttp://www.scopus.com/mlt/select.url?eid=2-s2.0-84859992625&selection=ref&src=s&origin=recordpageen_HK
dc.identifier.volume50en_HK
dc.identifier.issue5en_HK
dc.identifier.spage1571en_HK
dc.identifier.epage1579en_HK
dc.identifier.isiWOS:000302900500012-
dc.publisher.placeUnited Statesen_HK
dc.identifier.scopusauthoridCheng, VCC=23670479400en_HK
dc.identifier.scopusauthoridYam, WC=7004281720en_HK
dc.identifier.scopusauthoridTsang, LL=55193865300en_HK
dc.identifier.scopusauthoridYau, MCY=53664631800en_HK
dc.identifier.scopusauthoridSiu, GKH=35485473100en_HK
dc.identifier.scopusauthoridWong, SCY=55388445000en_HK
dc.identifier.scopusauthoridChan, JFW=24278817900en_HK
dc.identifier.scopusauthoridTo, KKW=14323807300en_HK
dc.identifier.scopusauthoridTse, H=7006070596en_HK
dc.identifier.scopusauthoridHung, IFN=7006103457en_HK
dc.identifier.scopusauthoridTai, JWM=7101993154en_HK
dc.identifier.scopusauthoridHo, PL=7402211363en_HK
dc.identifier.scopusauthoridYuen, KY=36078079100en_HK
dc.identifier.citeulike10777749-

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