Skip to main content
Clinical and Diagnostic Laboratory Immunology logoLink to Clinical and Diagnostic Laboratory Immunology
. 1997 Sep;4(5):550–555. doi: 10.1128/cdli.4.5.550-555.1997

O-antigen seroepidemiology of Klebsiella clinical isolates and implications for immunoprophylaxis of Klebsiella infections.

M Trautmann 1, M Ruhnke 1, T Rukavina 1, T K Held 1, A S Cross 1, R Marre 1, C Whitfield 1
PMCID: PMC170594  PMID: 9302204

Abstract

To provide a database for the development of an O-antigen-polysaccharide-containing vaccine against Klebsiella spp., we examined the O-antigen seroepidemiology of 378 Klebsiella clinical isolates collected prospectively in two university centers. Strains were typed by competitive enzyme-linked immunosorbent assay with rabbit antisera specific for serogroups O1 to O12 and monoclonal antibodies (MAbs) specific for serogroups O1, O2ab, O2ac, and the genus-specific core antigen. The numbers of isolates (percentages) of individual O serogroups were as follows: 148 (39.2) for serogroup O1, 40 (10.6) for serogroup O2ab, 4 (1.1) for serogroup O2ac, 89 (23.6) for serogroup O3, 2 (0.5) for serogroup O4, 32 (8.5) for serogroup O5, none for serogroups O7, O9, and O12, and 21 (5.6) for serogroup O11. Forty-two (11.1) of the strains were non-O-typeable. O-serogroup distributions were virtually identical between isolates from invasive infections and those from noninvasive infections or colonizations. A vaccine containing the O-specific polysaccharides of serogroups O1, O2ab, O3, and O5 would cover 82% of clinically occurring O-antigen specificities. Three hundred thirty-eight of 378 isolates (89.4%) reacted with the genus-specific MAb V/9-5, which recognizes an epitope of the outer core region of Klebsiella lipopolysaccharide. Antibodies directed against this epitope may represent a further alternative for O-antigen-targeted immunoprophylaxis of Klebsiella infections. These data support further experimental investigations on the protective potential of O-antigen-based vaccines and/or hyperimmune globulins in Klebsiella infection.

Full Text

The Full Text of this article is available as a PDF (642.0 KB).

Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Albertí S., Hernández-Allés S., Gil J., Reina J., Martínez-Beltrán J., Camprubí S., Tomás J. M., Benedí V. J. Development of an enzyme-linked immunosorbent assay method for typing and quantitation of Klebsiella pneumoniae lipopolysaccharide: application to serotype O1. J Clin Microbiol. 1993 May;31(5):1379–1381. doi: 10.1128/jcm.31.5.1379-1381.1993. [DOI] [PMC free article] [PubMed] [Google Scholar]
  2. Ansaruzzaman M., Albert M. J., Holme T., Jansson P. E., Rahman M. M., Widmalm G. A Klebsiella pneumoniae strain that shares a type-specific antigen with Shigella flexneri serotype 6. Characterization of the strain and strain and structural studies of the O-antigenic polysaccharide. Eur J Biochem. 1996 May 1;237(3):786–791. doi: 10.1111/j.1432-1033.1996.0786p.x. [DOI] [PubMed] [Google Scholar]
  3. BAER H., EHRENWORTH L. The pathogenicity of Klebsiella pneumoniae for mice: the relationship to the quantity and rate of production of type-specific capsular polysaccharide. J Bacteriol. 1956 Nov;72(5):713–717. doi: 10.1128/jb.72.5.713-717.1956. [DOI] [PMC free article] [PubMed] [Google Scholar]
  4. Carpenter J. L. Klebsiella pulmonary infections: occurrence at one medical center and review. Rev Infect Dis. 1990 Jul-Aug;12(4):672–682. doi: 10.1093/clinids/12.4.672. [DOI] [PubMed] [Google Scholar]
  5. Clarke B. R., Whitfield C. Molecular cloning of the rfb region of Klebsiella pneumoniae serotype O1:K20: the rfb gene cluster is responsible for synthesis of the D-galactan I O polysaccharide. J Bacteriol. 1992 Jul;174(14):4614–4621. doi: 10.1128/jb.174.14.4614-4621.1992. [DOI] [PMC free article] [PubMed] [Google Scholar]
  6. Cross A. S., Gemski P., Sadoff J. C., Orskov F., Orskov I. The importance of the K1 capsule in invasive infections caused by Escherichia coli. J Infect Dis. 1984 Feb;149(2):184–193. doi: 10.1093/infdis/149.2.184. [DOI] [PubMed] [Google Scholar]
  7. Cryz S. J., Jr, Fürer E., Germanier R. Purification and vaccine potential of Klebsiella capsular polysaccharides. Infect Immun. 1985 Oct;50(1):225–230. doi: 10.1128/iai.50.1.225-230.1985. [DOI] [PMC free article] [PubMed] [Google Scholar]
  8. Cryz S. J., Jr, Mortimer P. M., Mansfield V., Germanier R. Seroepidemiology of Klebsiella bacteremic isolates and implications for vaccine development. J Clin Microbiol. 1986 Apr;23(4):687–690. doi: 10.1128/jcm.23.4.687-690.1986. [DOI] [PMC free article] [PubMed] [Google Scholar]
  9. Donta S. T., Peduzzi P., Cross A. S., Sadoff J., Haakenson C., Cryz S. J., Jr, Kauffman C., Bradley S., Gafford G., Elliston D. Immunoprophylaxis against klebsiella and pseudomonas aeruginosa infections. The Federal Hyperimmune Immunoglobulin Trial Study Group. J Infect Dis. 1996 Sep;174(3):537–543. doi: 10.1093/infdis/174.3.537. [DOI] [PubMed] [Google Scholar]
  10. Fujita S., Matsubara F. Latex agglutination text for O serogrouping of Klebsiella species. Microbiol Immunol. 1984;28(6):731–734. doi: 10.1111/j.1348-0421.1984.tb00728.x. [DOI] [PubMed] [Google Scholar]
  11. Gransden W. R., Eykyn S. J., Phillips I., Rowe B. Bacteremia due to Escherichia coli: a study of 861 episodes. Rev Infect Dis. 1990 Nov-Dec;12(6):1008–1018. doi: 10.1093/clinids/12.6.1008. [DOI] [PubMed] [Google Scholar]
  12. Granström M., Wretlind B., Markman B., Cryz S. Enzyme-linked immunosorbent assay to evaluate the immunogenicity of a polyvalent Klebsiella capsular polysaccharide vaccine in humans. J Clin Microbiol. 1988 Nov;26(11):2257–2261. doi: 10.1128/jcm.26.11.2257-2261.1988. [DOI] [PMC free article] [PubMed] [Google Scholar]
  13. Held T. K., Trautmann M., Mielke M. E., Neudeck H., Cryz S. J., Jr, Cross A. S. Monoclonal antibody against Klebsiella capsular polysaccharide reduces severity and hematogenic spread of experimental Klebsiella pneumoniae pneumonia. Infect Immun. 1992 May;60(5):1771–1778. doi: 10.1128/iai.60.5.1771-1778.1992. [DOI] [PMC free article] [PubMed] [Google Scholar]
  14. Jarvis W. R., Munn V. P., Highsmith A. K., Culver D. H., Hughes J. M. The epidemiology of nosocomial infections caused by Klebsiella pneumoniae. Infect Control. 1985 Feb;6(2):68–74. doi: 10.1017/s0195941700062639. [DOI] [PubMed] [Google Scholar]
  15. Kaluzewski S. Antygeny somatyczne szczepów Klebsiella K 63-K 72. Med Dosw Mikrobiol. 1965;17(4):283–290. [PubMed] [Google Scholar]
  16. Kelly R. F., Severn W. B., Richards J. C., Perry M. B., MacLean L. L., Tomás J. M., Merino S., Whitfield C. Structural variation in the O-specific polysaccharides of Klebsiella pneumoniae serotype O1 and O8 lipopolysaccharide: evidence for clonal diversity in rfb genes. Mol Microbiol. 1993 Nov;10(3):615–625. doi: 10.1111/j.1365-2958.1993.tb00933.x. [DOI] [PubMed] [Google Scholar]
  17. Kelly R. F., Whitfield C. Clonally diverse rfb gene clusters are involved in expression of a family of related D-galactan O antigens in Klebsiella species. J Bacteriol. 1996 Sep;178(17):5205–5214. doi: 10.1128/jb.178.17.5205-5214.1996. [DOI] [PMC free article] [PubMed] [Google Scholar]
  18. Kol O., Wieruszeski J. M., Strecker G., Fournet B., Zalisz R., Smets P. Structure of the O-specific polysaccharide chain of Klebsiella pneumoniae O1K2 (NCTC 5055) lipopolysaccharide. A complementary elucidation. Carbohydr Res. 1992 Dec 15;236:339–344. doi: 10.1016/0008-6215(92)85028-x. [DOI] [PubMed] [Google Scholar]
  19. Korvick J. A., Bryan C. S., Farber B., Beam T. R., Jr, Schenfeld L., Muder R. R., Weinbaum D., Lumish R., Gerding D. N., Wagener M. M. Prospective observational study of Klebsiella bacteremia in 230 patients: outcome for antibiotic combinations versus monotherapy. Antimicrob Agents Chemother. 1992 Dec;36(12):2639–2644. doi: 10.1128/aac.36.12.2639. [DOI] [PMC free article] [PubMed] [Google Scholar]
  20. MacLean L. L., Whitfield C., Perry M. B. Characterization of the polysaccharide antigen of Klebsiella pneumoniae O:9 lipopolysaccharide. Carbohydr Res. 1993 Feb 1;239:325–328. doi: 10.1016/0008-6215(93)84231-t. [DOI] [PubMed] [Google Scholar]
  21. McCabe W. R., Kaijser B., Olling S., Uwaydah M., Hanson L. A. Escherichia coli in bacteremia: K and O antigens and serum sensitivity of strains from adults and neonates. J Infect Dis. 1978 Jul;138(1):33–41. doi: 10.1093/infdis/138.1.33. [DOI] [PubMed] [Google Scholar]
  22. McCallum K. L., Schoenhals G., Laakso D., Clarke B., Whitfield C. A high-molecular-weight fraction of smooth lipopolysaccharide in Klebsiella serotype O1:K20 contains a unique O-antigen epitope and determines resistance to nonspecific serum killing. Infect Immun. 1989 Dec;57(12):3816–3822. doi: 10.1128/iai.57.12.3816-3822.1989. [DOI] [PMC free article] [PubMed] [Google Scholar]
  23. Mizuta K., Ohta M., Mori M., Hasegawa T., Nakashima I., Kato N. Virulence for mice of Klebsiella strains belonging to the O1 group: relationship to their capsular (K) types. Infect Immun. 1983 Apr;40(1):56–61. doi: 10.1128/iai.40.1.56-61.1983. [DOI] [PMC free article] [PubMed] [Google Scholar]
  24. Montgomerie J. Z. Epidemiology of Klebsiella and hospital-associated infections. Rev Infect Dis. 1979 Sep-Oct;1(5):736–753. doi: 10.1093/clinids/1.5.736. [DOI] [PubMed] [Google Scholar]
  25. Nimmich W., Korten G. Die chemische Zusammensetzung der Klebsiella-Lipopolysaccharide (O-Antigene) Pathol Microbiol (Basel) 1970;36(3):179–190. [PubMed] [Google Scholar]
  26. Olesen B., Kolmos H. J., Orskov F., Orskov I. A comparative study of nosocomial and community-acquired strains of Escherichia coli causing bacteraemia in a Danish University Hospital. J Hosp Infect. 1995 Dec;31(4):295–304. doi: 10.1016/0195-6701(95)90208-2. [DOI] [PubMed] [Google Scholar]
  27. Rukavina T., Tícac B., Susa M., Jendrike N., Jonjíc S., Lucin P., Marre R., Doríc M., Trautmann M. Protective effect of antilipopolysaccharide monoclonal antibody in experimental Klebsiella infection. Infect Immun. 1997 May;65(5):1754–1760. doi: 10.1128/iai.65.5.1754-1760.1997. [DOI] [PMC free article] [PubMed] [Google Scholar]
  28. Severn W. B., Kelly R. F., Richards J. C., Whitfield C. Structure of the core oligosaccharide in the serotype O8 lipopolysaccharide from Klebsiella pneumoniae. J Bacteriol. 1996 Mar;178(6):1731–1741. doi: 10.1128/jb.178.6.1731-1741.1996. [DOI] [PMC free article] [PubMed] [Google Scholar]
  29. Simoons-Smit A. M., Verweij-van Vught A. M., MacLaren D. M. The role of K antigens as virulence factors in Klebsiella. J Med Microbiol. 1986 Mar;21(2):133–137. doi: 10.1099/00222615-21-2-133. [DOI] [PubMed] [Google Scholar]
  30. Straus D. C., Atkisson D. L., Garner C. W. Importance of a lipopolysaccharide-containing extracellular toxic complex in infections produced by Klebsiella pneumoniae. Infect Immun. 1985 Dec;50(3):787–795. doi: 10.1128/iai.50.3.787-795.1985. [DOI] [PMC free article] [PubMed] [Google Scholar]
  31. Straus D. C. Production of an extracellular toxic complex by various strains of Klebsiella pneumoniae. Infect Immun. 1987 Jan;55(1):44–48. doi: 10.1128/iai.55.1.44-48.1987. [DOI] [PMC free article] [PubMed] [Google Scholar]
  32. Süsskind M., Müller-Loennies S., Nimmich W., Brade H., Holst O. Structural investigation on the carbohydrate backbone of the lipopolysaccharide from Klebsiella pneumoniae rough mutant R20/O1-. Carbohydr Res. 1995 Apr 3;269(1):C1–C7. doi: 10.1016/0008-6215(95)00002-b. [DOI] [PubMed] [Google Scholar]
  33. Trautmann M., Cross A. S., Reich G., Held H., Podschun R., Marre R. Evaluation of a competitive ELISA method for the determination of Klebsiella O antigens. J Med Microbiol. 1996 Jan;44(1):44–51. doi: 10.1099/00222615-44-1-44. [DOI] [PubMed] [Google Scholar]
  34. Trautmann M., Vogt K., Hammack C., Cross A. S. A murine monoclonal antibody defines a unique epitope shared by Klebsiella lipopolysaccharides. Infect Immun. 1994 Apr;62(4):1282–1288. doi: 10.1128/iai.62.4.1282-1288.1994. [DOI] [PMC free article] [PubMed] [Google Scholar]
  35. Tsai C. M., Frasch C. E. A sensitive silver stain for detecting lipopolysaccharides in polyacrylamide gels. Anal Biochem. 1982 Jan 1;119(1):115–119. doi: 10.1016/0003-2697(82)90673-x. [DOI] [PubMed] [Google Scholar]
  36. Whitfield C., Perry M. B., MacLean L. L., Yu S. H. Structural analysis of the O-antigen side chain polysaccharides in the lipopolysaccharides of Klebsiella serotypes O2(2a), O2(2a,2b), and O2(2a,2c). J Bacteriol. 1992 Aug;174(15):4913–4919. doi: 10.1128/jb.174.15.4913-4919.1992. [DOI] [PMC free article] [PubMed] [Google Scholar]
  37. Whitfield C., Richards J. C., Perry M. B., Clarke B. R., MacLean L. L. Expression of two structurally distinct D-galactan O antigens in the lipopolysaccharide of Klebsiella pneumoniae serotype O1. J Bacteriol. 1991 Feb;173(4):1420–1431. doi: 10.1128/jb.173.4.1420-1431.1991. [DOI] [PMC free article] [PubMed] [Google Scholar]
  38. ØRSKOV I. O antigens in the Klebsiella group. Acta Pathol Microbiol Scand. 1954;34(2):145–156. doi: 10.1111/j.1699-0463.1954.tb00811.x. [DOI] [PubMed] [Google Scholar]

Articles from Clinical and Diagnostic Laboratory Immunology are provided here courtesy of American Society for Microbiology (ASM)

RESOURCES