Deng Zhang, Feng Gu, Xiaoyu Zhang, Xifan Zhang, Sufei Tian, Baiyi Chen, Yunzhuo Chu, Jingping Zhang, Xin Zhang
The incidence of EnE showed an increasing trend, primarily driven by hvKP ST23-K1. A comprehensive search for systemic infection foci, particularly liver abscesses, is essential. A negative string test result does not exclude hvKP. Timely intravitreal antimicrobial injection is a critical modifiable factor for improving visual prognosis.
OBJECTIVE: To explore the epidemiological characteristics of EnE and the molecular traits of the Klebsiella pneumoniae(KP).
METHODS: We revived 40 strains of the KP, utilized whole-genome sequencing technology to understand their molecular epidemiological characteristics.
RESULTS: Among 103 EnE patients (69.90% male, 56.31% left eye), vision loss was the chief complaint (96.12%). Extraocular infections were present in 63.11% of patients, most commonly liver abscess (45.00%). KP comprised 81.82% of culture-positive cases. Among 40 KP strains analyzed, 82.5% were hypervirulent KP (hvKP). Phylogenetic analysis revealed the dominance of ST23-K1 lineages. Intravitreal injection was associated with a significantly reduced risk of poor visual prognosis (RR = 0.061, 95%CI: 0.005-0.442) and emerged as an independent protective factor.
CONCLUSIONS: The incidence of EnE showed an increasing trend, primarily driven by hvKP ST23-K1. A comprehensive search for systemic infection foci, particularly liver abscesses, is essential. A negative string test result does not exclude hvKP. Timely intravitreal antimicrobial injection is a critical modifiable factor for improving visual prognosis.