Hypervirulent Klebsiella pneumoniae (HVKp) infections have distinct clinical manifestations from classical K. pneumoniae infections. The hallmark of HVKp infections are liver abscess formation and metastatic infections. Due to the severe sequelae of these complications, method to identify patients at-risk of HVKp infections should be developed. A retrospective cohort study of 222 patients with K. pneumoniae bloodstream infections (BSIs) was performed. Patient demographics, clinical manifestations, and bacterial characteristics were investigated. Ten cases of liver abscesses were identified. Characteristics such as community-onset BSIs, hypermucoviscosity phenotype, and capsular serotype K1 were identified as risk factors for HVKp infections. A scoring system was developed based on the risk factors. The area under the receiver operating characteristic curve for the scoring system was 0.90. A score of ≥ 2 points provided sensitivity and specificity of 0.70 and 0.94, respectively. Simple scoring system was developed for the diagnosis of HVKp infections. The system allows early identification of patients with K. pneumoniae BSIs in whom hypervirulent infections should be evaluated. Prospective evaluation is expected.

中文翻译：

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开发用于检测高毒性肺炎克雷伯菌血流感染的基于风险因素的评分系统。

高毒力肺炎克雷伯菌 (HVKp) 感染具有与经典肺炎克雷伯菌感染不同的临床表现。HVKp 感染的标志是肝脓肿形成和转移性感染。由于这些并发症的严重后遗症，应开发识别有 HVKp 感染风险的患者的方法。对 222 名肺炎克雷伯菌血流感染 (BSI) 患者进行了一项回顾性队列研究。研究了患者的人口统计学、临床表现和细菌特征。确定了 10 例肝脓肿。社区发病的 BSI、高粘液性表型和包膜血清型 K1 等特征被确定为 HVKp 感染的危险因素。基于风险因素开发了评分系统。评分系统的受试者工作特征曲线下面积为 0.90。≥ 2 分的得分分别提供 0.70 和 0.94 的敏感性和特异性。为诊断 HVKp 感染开发了简单的评分系统。该系统允许及早识别应评估高毒性感染的肺炎克雷伯菌 BSI 患者。预期进行前瞻性评估。