Article
Public, Environmental & Occupational Health
Na Huang, Huaiyu Jia, Beibei Zhou, Cui Zhou, Jianming Cao, Wenli Liao, Shixing Liu, Lingbo Wang, Liqiong Chen, Lijiang Chen, Tieli Zhou, Jianzhong Ye
Summary: This study investigated the clinical and microbiological characteristics of Klebsiella pneumoniae meningitis, revealing an association between antimicrobial resistance, virulence, and patient prognosis. The high fatality of meningitis caused by hypervirulent carbapenem-resistant K. pneumoniae strains is particularly concerning.
FRONTIERS IN PUBLIC HEALTH
(2022)
Review
Infectious Diseases
Junjun Chen, Huan Zhang, Xuelian Liao
Summary: Hypervirulent Klebsiella pneumoniae (hvKP), including multidrug-resistant hvKP (MDR-hvKP), is a global concern due to its ability to cause outbreaks with high pathogenicity and mortality. Key virulence agents associated with hvKP and MDR-hvKP include iron acquisition systems, increased capsule production, colibactin toxin, and hypermu-coviscosity. Recent advances have identified new hypervirulence factors and explored the evolution of MDR-hvKP. Further research is needed to identify reliable methods for detection and investigate innovative treatment targets.
INFECTION AND DRUG RESISTANCE
(2023)
Review
Microbiology
Jie Zhu, Tao Wang, Liang Chen, Hong Du
Summary: The review summarizes the virulence factors associated with hypervirulent Klebsiella pneumoniae to understand its molecular pathogenesis and provide new strategies for improving the prevention, diagnosis, and treatment of infections caused by hvKP.
FRONTIERS IN MICROBIOLOGY
(2021)
Article
Immunology
Dakang Hu, Wenjie Chen, Qi Zhang, Meng Li, Zehua Yang, Yong Wang, Yunkun Huang, Gang Li, Dongxing Tian, Pan Fu, Weiwen Wang, Ping Ren, Qing Mu, Lianhua Yu, Xiaofei Jiang
Summary: This study investigated the epidemiology of carbapenem-resistant hypervirulent Klebsiella pneumoniae (CR-HvKP) and hypervirulent carbapenem-resistant Klebsiella pneumoniae (Hv-CRKP) in mainland China. Molecular determination of CR-HvKP and Hv-CRKP showed biases compared to mouse lethality test, with the exact prevalence of CR-HvKP being less than 1.0% and that of Hv-CRKP even lower.
FRONTIERS IN CELLULAR AND INFECTION MICROBIOLOGY
(2022)
Article
Immunology
Dakang Hu, Yuming Li, Ping Ren, Dongxing Tian, Wenjie Chen, Pan Fu, Weiwen Wang, Xiaobin Li, Xiaofei Jiang
Summary: The positive rates of virulence genes in Klebsiella pneumoniae vary significantly, with iucA, p-rmpA2, and p-rmpA being the primary genes leading to Hv-bla (KPC)(+)-KP. The formation of Hv-bla (KPC)(+)-KP is mostly due to bla (KPC)(+)-KP acquiring another plasmid carrying virulence genes.
FRONTIERS IN CELLULAR AND INFECTION MICROBIOLOGY
(2021)
Article
Infectious Diseases
Aurora Piazza, Matteo Perini, Carola Mauri, Francesco Comandatore, Elisa Meroni, Francesco Luzzaro, Luigi Principe
Summary: This study reports a hypermucoviscous K. pneumoniae strain causing recurrent meningitis and investigates its genomic features using whole-genome sequencing analysis. The strain is susceptible to most antibiotics despite the presence of some resistance genes and exhibits several virulence factors related to pathogenicity. Phylogenetic analysis shows high similarity between this strain and a Chinese isolate, suggesting a hidden circulation of this lineage.
Article
Microbiology
Otavio Hallal Ferreira Raro, Patrice Nordmann, Manuel Dominguez Pino, Jacqueline Findlay, Laurent Poirel
Summary: There is an increasing occurrence of multidrug-resistant (MDR) and hypervirulent (hv) Klebsiella pneumoniae (MDR-hvKp) convergent clones. These strains can cause difficult-to-treat infections and have a higher mortality rate in healthy adults. This study in Switzerland identified a rate of 9.0% K. pneumoniae with a virulence genotype, producing carbapenemase and recovered from rectal swabs, urine, and blood. The presence of alarming MDR-hvKp and MDR nonhypervirulent K. pneumoniae (MDR-nhv-Kp) isolates highlights the need for surveillance networks to track and monitor their spread.
ANTIMICROBIAL AGENTS AND CHEMOTHERAPY
(2023)
Article
Biotechnology & Applied Microbiology
Dongjie Chen, Yingrui Zhang, Jiafang Wu, Jun Li, Han Chen, Xiaoguang Zhang, Xinlan Hu, Falin Chen, Rongguo Yu
Summary: This study evaluates the clinical and genetic virulence characteristics of critically ill patients with hypervirulent Klebsiella pneumoniae (hvKP) and classic KP (cKP) infection. It found a high rate of hvKP infection in the Chinese population, with a higher probability of septic shock in hvKP-infected patients compared to cKP-infected patients. However, survival and length of hospital stay were similar between the two groups. Risk factors for hvKP infection included hospital-acquired infection and renal insufficiency.
JOURNAL OF APPLIED MICROBIOLOGY
(2022)
Article
Gastroenterology & Hepatology
Jing Yang, Yi Li, Na Tang, Juan Li, Juan Zhou, Shan Lu, Gui Zhang, Yuqin Song, Chao Wang, Jin Zhong, Jianguo Xu, Jie Feng
Summary: This study investigated the colonization of hypervirulent Klebsiella pneumoniae (hvKp) in the healthy population and its relationship with clinically important strains. The results showed that the human gut may serve as a reservoir of hvKp and that hvKp in the gut can play a role in infection of other body parts, highlighting the importance of understanding the transmission and controlling the infection of hvKp.
Article
Immunology
Xuemei Yang, Qiaoling Sun, Jiaping Li, Yu Jiang, Yi Li, Jianping Lin, Kaichao Chen, Edward Wai-Chi Chan, Rong Zhang, Sheng Chen
Summary: The epidemiological features and potential threat to human health of the newly emerged carbapenem-resistant hypervirulent Klebsiella pneumoniae (CR-HvKP) are currently unknown. This study analyzed 784 CRKP strains collected from three hospitals in China and found that the proportion of CRKP strains among clinical K. pneumoniae strains increased sharply. A significant number of these CRKP strains carried a virulence-encoding plasmid, but only a small percentage exhibited a hypervirulent phenotype. Genetic markers were not strongly correlated with hypervirulent phenotypes, indicating that additional factors may contribute to the hypervirulence of CRKP. The transmission of these CRKP strains in China likely involved multiple clones of ST11 and the major mechanism of carbapenem resistance was the carriage of IncFII pSWU01-like, bla (KPC-2)-bearing plasmids. These findings highlight the rapid increase in prevalence of CRKP strains carrying virulence plasmids in China and the need for better definition and screening of truly hypervirulent CR-HvKP strains in clinical settings.
EMERGING MICROBES & INFECTIONS
(2022)
Review
Microbiology
Gabriel Mendes, Maria Leonor Santos, Joao F. Ramalho, Aida Duarte, Catia Caneiras
Summary: Hypervirulent and carbapenem-resistant pathotypes of Klebsiella pneumoniae have emerged as distinct evolutionary types with significant impact on public health. However, there is concern over the convergence of high-risk clones that pose a challenge to available therapeutic options. This review aims to describe the worldwide distribution of virulence factors among carbapenem-resistant highly virulent or hypervirulent K. pneumoniae strains and their interactions with carbapenemase production and sequence types. Urgent understanding of these strains is necessary for effective response as they increasingly replace classical strains in healthcare settings.
FRONTIERS IN MICROBIOLOGY
(2023)
Article
Immunology
Xiaoyu Liu, Yarong Wu, Ying Zhu, Peiyao Jia, Xue Li, Xinmiao Jia, Wei Yu, Yujun Cui, Ruifu Yang, Wei Xia, Yingchun Xu, Qiwen Yang
Summary: This study retrospectively screened 14 colistin-resistant Klebsiella pneumoniae strains, of which 6 were multidrug-resistant strains. The study revealed that the up-regulated expression of certain genes was associated with colistin resistance, and mgrB mutation was found to be the most common molecular mechanism of colistin resistance. In addition, the presence of hypervirulence genes and biofilm-producing genes was also identified. This suggests that colistin-resistant and hypervirulent multidrug-resistant Klebsiella pneumoniae could pose a severe challenge to public health.
EMERGING MICROBES & INFECTIONS
(2022)
Article
Biochemistry & Molecular Biology
Elias Eger, Stefan E. Heiden, Karsten Becker, Andrea Rau, Katharina Geisenhainer, Evgeny A. Idelevich, Katharina Schaufler
Summary: This study conducted both genomic and phenotypic experiments to analyze two K. pneumoniae isolates causing severe multiple site infection in a human patient. It revealed that the isolates belong to sequence type 420, suggesting they are of the hypervirulent pathotype, and identified the insertion of a hypervirulence plasmid in the bacterial chromosome mediated by a new IS5 family sub-group IS903 insertion sequence.
INTERNATIONAL JOURNAL OF MOLECULAR SCIENCES
(2021)
Article
Genetics & Heredity
Yanping Xu, Jianfeng Zhang, Meng Wang, Meng Liu, Guitian Liu, Hongping Qu, Jialin Liu, Zixin Deng, Jingyong Sun, Hong-Yu Ou, Jieming Qu
Summary: This study revealed that a nonconjugative virulence plasmid in ST11 CRKP strains can potentially be mobilized from hvKP or E. coli intermediates with the assistance of conjugative IncF plasmids. The virulence plasmid can be mobilized in four modes, and most putative helper plasmids and virulence plasmids carry a specific 28-bp fusion site. This highlights the rapid dissemination of virulence plasmids and the continuous emergence of hypervirulent carbapenem-resistant K. pneumoniae (hv-CRKP) strains.
Article
Infectious Diseases
Jose Joao Sumbana, Antonella Santona, Nader Abdelmalek, Maura Fiamma, Massimo Deligios, Alice Manjate, Jahit Sacarlal, Salvatore Rubino, Bianca Paglietti
Summary: Globally, antibiotic-resistant Klebsiella spp. cause healthcare-associated infections with high mortality rates. The study investigated the phenotypic and genetic features of Klebsiella isolates from invasive infections in Mozambique. The majority of isolates displayed multidrug resistance, with ESBL-producing strains carrying various beta-lactamase genes. The study also identified susceptible hypervirulent Klebsiella pneumoniae isolates associated with severe infections. The findings highlight the importance of surveillance strategies to prevent the emergence of multidrug-resistant hypervirulent Klebsiella pneumoniae.
