Evidence map›Paper›PMID 42900364›Full record

ArticleNeurological sciences : official journal of the Italian Neurological Society and of the Italian Society of Clinical Neurophysiology2026

Clinical characteristics and prognosis of central nervous system Klebsiella pneumoniae infection: a focus on hypervirulent and classical strains.

Lu You, Jing Bai, Fan Meng, Xiang Yin

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Article in Neurological sciences : official journal of the Italian Neurological Society and of the Italian Society of Clinical Neurophysiology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

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5 · Who and what money

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4 authors.

Lu YouDepartment of Neurology, The First Hospital of Jilin University, No. 1 Xinmin Street, Changchun, Jilin Province, China.
Jing BaiDepartment of Neurology, The First Hospital of Jilin University, No. 1 Xinmin Street, Changchun, Jilin Province, China.
Fan MengDepartment of Neurology, The First Hospital of Jilin University, No. 1 Xinmin Street, Changchun, Jilin Province, China.
Xiang YinDepartment of Neurology, The First Hospital of Jilin University, No. 1 Xinmin Street, Changchun, Jilin Province, China. doc_yinxiang2016@jlu.edu.cn.ORCID http://orcid.org/0009-0008-4023-5505

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6 · The paper itself

Abstract

objectiveTo investigate the clinical characteristics, diagnosis, treatment, and prognosis of 20 cases of central nervous system (CNS) Klebsiella pneumoniae infection diagnosed by metagenomic next-generation sequencing (mNGS), and to compare the differences between classical Klebsiella pneumoniae (cKP) and hypervirulent Klebsiella pneumoniae (hvKP) in central nervous system infections.

methodsRetrospective single-center study of 20 mNGS-diagnosed CNS K. pneumoniae infections (January 2022 - March 2026). Univariate analysis compared hvKP and cKP groups.

resultsAmong 20 patients, 19 were diagnosed by CSF mNGS and 1 by abscess fluid mNGS. The cKP group had a higher proportion of tumor history (P = 0.029) and a marginally higher rate of neurosurgery history (P = 0.082). Type 2 diabetes was common in both groups (66.7% vs. 62.5%). The hvKP group had higher rates of focal neurological deficits (77.8% vs. 12.5%, P = 0.015) and bacteremia/sepsis (66.7% vs. 37.5%, P = 0.009), while the cKP group had more delirium (62.5% vs. 11.1%, P = 0.050). CSF mNGS positivity (95%) surpassed culture (23.5%, P < 0.001). Radiologically, hvKP showed more brain abscesses (P = 0.015). hvKP had worse modified Rankin Scale scores (P = 0.002) and higher mortality (44.4% vs. 0%, P = 0.002). No cKP deaths occurred.

conclusionhvKP and cKP CNS infections differ significantly. hvKP is associated with community-onset severe disease (multiple brain abscesses, pyoventricle, focal deficits) and high mortality, while cKP links to nosocomial factors and better outcomes. mNGS is key for diagnosis, offering high CSF positivity and concurrent virulence/resistance profiling. Potential prognostic factors identified include high CSF mNGS reads, resistance genes, early liver abscess drainage, timely intravitreal injection, and combination therapy.

Indexed as

Central Nervous System InfectionsKlebsiella InfectionsKlebsiella pneumoniaeAdultAgedFemaleHumansMaleMiddle AgedPrognosisRetrospective StudiesCentral nervous system infectionHypervirulent Klebsiella pneumoniaeInvasive Klebsiella pneumoniae pyogenic liver abscess syndromeKlebsiella pneumoniaeMetagenomic next-generation sequencing

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PMID42900364

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.