String test as a diagnostic tool for hypervirulent Klebsiella pneumoniae

Abstract

Klebsiella pneumoniae is an emerging pathogen capable of causing severe soft tissue infections including skin and wound infections, especially in immunocompromised individuals. The common organism causing soft tissue infection is gram positive bacteria, however Klebsiella is seen as an emerging virulent pathogen. These hypervirulent strains of Klebsiella can be detected easily by the “string test.” We present two diabetic elderly males with facial soft tissue infections which tested positive on the string test. They were successfully managed with surgical drainage, debridement, and intravenous antibiotics (ceftriaxone and metronidazole), tailored to sensitivity reports. This report highlights the value of the string test in early detection of the hypervirulent strain of Klebsiella guiding prompt, prolonged aggressive treatment to ensure complete disease clearance.