ArticleVirulence2016
Impact of glycemic control on capsular polysaccharide biosynthesis and opsonophagocytosis of Klebsiella pneumoniae: Implications for invasive syndrome in patients with diabetes mellitus.
Article in Virulence, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 35 papers.
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35 citing papers in PubMed, 43 citations in OpenAlex.
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- Increased virulence and decreased antimicrobial resistance in Klebsiella pneumoniae in Beijing since 2020: a retrospective molecular epidemiology study.Science China. Life sciences · 2026Article
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- The dual threat of hypervirulent and multidrug-resistantFrontiers in microbiology · 2026Review
- Clinical and microbiological characteristics and prognosis of invasive infection caused byAnnals of medicine · 2025Article
- Severe Pyogenic Liver Abscess in a Diabetic Patient Presenting With Sepsis and Diabetic Ketoacidosis: A Case Report.Cureus · 2025Article
- Mechanisms governing bacterial capsular polysaccharide attachment and chain length.Annals of the New York Academy of Sciences · 2025Review
- Analysis of clinical and microbiological characteristics of invasive Klebsiella pneumoniae liver abscess syndrome.BMC infectious diseases · 2025Article
- Invasive Liver Abscess Syndrome in the Immunocompromised: A Case Report.Clinical case reports · 2025Article
- Incidence, Risk Factors, and Subsequent Health Outcomes of Pyogenic Liver Abscesses: A Scoping Review of Evidence From Population-Based Studies.Gastroenterology research and practice · 2025Review
- Correlation Between the Distribution of Virulence Genes and Drug Resistance Genes and Clinical Characteristics of Lower Respiratory Tract Infections withInfection and drug resistance · 2025Article
- Poor Glycemic Control in Carbapenem-ResistantInfection and drug resistance · 2025Article
- Anti-quorum sensing activity of essential oils against multidrug-resistant Klebsiella pneumoniae: a novel approach to control bacterial virulence.Brazilian journal of microbiology : [publication of the Brazilian Society for Microbiology] · 2024Article
- Diabetes and obesity and risk of pyogenic liver abscess.Scientific reports · 2023Article
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- Study on Virulence Genes, Drug Resistance and Molecular Epidemiology ofInfection and drug resistance · 2023Article
- Epidemiological Features and Impact of High Glucose Level on Virulence Gene Expression and Serum Resistance ofInfection and drug resistance · 2023Article
- Klebsiella invasive syndrome: a challenging diagnosis.BMJ case reports · 2022Article
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Authors and funding
7 authors at 2 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Klebsiella pneumoniae (KP), with production of abundant capsular polysaccharide (CPS), is capable of causing invasive syndrome. Environmental glucose stimuli may increase CPS biosynthesis. We aimed to investigate the relationship between glycemic control and KP-mediated invasive syndrome in diabetic patients and the effect of glucose on CPS biosynthesis. Diabetic patients with community-acquired KP bacteremia were included to study the risk factors of invasive syndrome. KP-M1, a serotype-K1 KP clinical isolate, was used to examine the CPS biosynthesis and cps gene expression, and the effect of exogenous glucose on bacterial phagocytosis and killing. We found that invasive syndrome was significantly more common in diabetic patients who were infected with strains expressing the K1 serotype (adjusted odds ratio [AOR], 8.32; 95% confidence interval [CI], 1.56-44.24; p=0.01), and had poor glycemic control (HbA1c ≥9%; AOR, 5.66; 95% CI, 2.01-15.92; p<0.01). Pre-incubation of KP-M1 in media containing different gradient glucose concentrations enhanced CPS biosynthesis and cps gene expression in high glucose (0.5%) concentration, which leads to increasing bacterial resistance to phagocytosis and killing. High glucose levels reflected by poor glycemic control may stimulate CPS biosynthesis and cps gene expression of highly virulent KP, which increase resistance to phagocytosis and contribute to development of invasive syndrome.
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