“Superbugs” with hypervirulence and carbapenem resistance in Klebsiella pneumoniae: the rise of such emerging nosocomial pathogens in China

Science Bulletin, Journal Year: 2023, Volume and Issue: 68(21), P. 2658 - 2670

Published: Sept. 30, 2023

Although hypervirulent Klebsiella pneumoniae (hvKP) can produce community-acquired infections that are fatal in young and adult hosts, such as pyogenic liver abscess, endophthalmitis, meningitis, it has historically been susceptible to antibiotics. Carbapenem-resistant K. (CRKP) is usually associated with urinary tract acquired hospitals, pneumonia, septicemias, soft tissue infections. Outbreaks quick spread of CRKP hospitals have become a major challenge public health due the lack effective antibacterial treatments. In early stages development, HvKP first appear distinct routes. However, lines dividing two pathotypes vanishing currently, advent carbapenem-resistant (CR-hvKP) devastating simultaneously multidrug-resistant, hypervirulent, highly transmissible. Most CR-hvKP cases reported Asian clinical settings, particularly China. Typically, develops when hvKP or acquires plasmids carry either carbapenem-resistance gene virulence gene. Alternatively, classic (cKP) may acquire hybrid plasmid carrying both genes. this review, we provide an overview key antimicrobial resistance mechanisms, factors, presentations, outcomes infection. Additionally, discuss possible evolutionary processes prevalence Given wide occurrence CR-hvKP, continued surveillance control measures organisms should be assigned higher priority.

Language: Английский

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Expansion and transmission dynamics of high risk carbapenem-resistant Klebsiella pneumoniae subclones in China: An epidemiological, spatial, genomic analysis

Drug Resistance Updates, Journal Year: 2024, Volume and Issue: 74, P. 101083 - 101083

Published: March 29, 2024

Carbapenem-resistant Klebsiella pneumonia (CRKP) is a global threat that varies by region. The distribution, evolution, and clinical implications of the ST11 CRKP clone remain obscure. We conducted multicenter molecular epidemiological survey using isolates obtained from 28 provinces municipalities across China between 2011 2021. integrated sequences public databases performed genetic epidemiology analysis CRKP. Among CRKP, KL64 serotypes exhibited considerable expansion, increasing 1.54% to 46.08% Combining our data with databases, phylogenetic phylogeography analyses indicated appeared in Americas 1996 spread worldwide, key clones progressing China's southeastern coast inland 2010. Global showed has evolved virulent, resistant clade notable regional spread. Single-nucleotide polymorphism (SNP) identified BMPPS (bmr3, mltC, pyrB, ppsC, sdaC) as marker for this clade. SNP associated high mortality strong anti-phagocytic competitive traits vitro. high-risk subclone expansion potential survival advantages, probably owing factors.

Language: Английский

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Hypervirulent Klebsiella pneumoniae

Infection and Drug Resistance, Journal Year: 2023, Volume and Issue: Volume 16, P. 5243 - 5249

Published: Aug. 1, 2023

Abstract: Hypervirulent Klebsiella pneumoniae (hvKP), especially multidrug-resistant hvKP (MDR-hvKP) infections, are distributed globally, and lead to several outbreaks with high pathogenicity mortality in immunocompetent individuals. This is usually characterized by a rapidly metastatic spread resulting multiple pyogenic tissue abscesses. To date, even though the explanation of hypervirulent factors has been identified, it still remains be fully understood. The most common key virulence agents included (1) siderophore systems for iron acquisition, (2) increased capsule production, (3) colibactin toxin, (4) hypermucoviscosity, so on. Several hypervirulence have renewed, evolution MDR-hvKP deeply explored recently. We aim describe chain attributed lethality MDR-hvKP. In this review, recent advances renewed were summarized, potential therapeutic targets explored. Novel co-existence elements, superplasmid, was screened. Superplasmid simultaneously harbours genes can mobile autonomously its complete conjugative elements. Research into related immunity also gained traction, which may cause invasive infections higher rates than classical ones, such as neutrophil- complement-mediated activity. multidrug resistance accelerating. More reliable methods identifying or must investigated. Furthermore, critical investigate innovative treatment future. Keywords: , hypervirulence, resistant

Language: Английский

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Clinical and laboratory insights into the threat of hypervirulent Klebsiella pneumoniae

International Journal of Antimicrobial Agents, Journal Year: 2024, Volume and Issue: 64(3), P. 107275 - 107275

Published: July 14, 2024

Language: Английский

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Hypervirulent and carbapenem-resistant Klebsiella pneumoniae: A global public health threat

Microbiological Research, Journal Year: 2024, Volume and Issue: 288, P. 127839 - 127839

Published: Aug. 11, 2024

Language: Английский

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Emergence and clinical challenges of ST11-K64 carbapenem-resistant Klebsiella pneumoniae: molecular insights and implications for antimicrobial resistance and virulence in Southwest China

BMC Infectious Diseases, Journal Year: 2025, Volume and Issue: 25(1)

Published: Jan. 3, 2025

In clinical practice, the emergence of ST11-K64 carbapenem-resistant Klebsiella pneumoniae (ST11-K64 CRKP) has become increasingly alarming. Despite this trend, limited research been conducted to elucidate and molecular characteristics these strains. This study aimed comprehensively investigate characteristics, antimicrobial resistance patterns, virulence-associated genes, epidemiology CRKP in Southwest China. A retrospective analysis was performed on patients infected with (CRKP) a tertiary care hospital between July 2021 May 2022. total 69 strains were isolated, data collected for detailed analysis. Laboratory assessments included susceptibility testing, hypermucoviscosity string genotypic characterization virulence multi-locus sequence typing. Statistical analyses using SPSS, significance set at P < 0.05. Among isolates, 36 (52.2%) identified as CRKP. Hematological diseases less associated infection compared non-ST11-K64 (P = 0.012). However, central intravenous catheter use 0.001), mechanical ventilation 0.002), tracheal intubation 0.006), tracheotomy 0.041) significantly more common cases. Resistance rates amikacin gentamicin 0.004), tobramycin 0.034), sulfamethoxazole 0.001) higher Additionally, resistance-associated genes such blaKPC−2 including rmpA iucA rmpA2 iutA detected Furthermore, ST11-K47 CRKP, harbored 0.007), 0.003). Our findings underscore rising prevalence characterized by high levels presence potent genes. strain poses significant therapeutic challenge, necessitating heightened vigilance, stringent control measures, robust management strategies.

Language: Английский

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Hypervirulent Klebsiella pneumoniae have better clinical outcomes than classical Klebsiella pneumoniae for lower respiratory tract infection patients

BMC Microbiology, Journal Year: 2025, Volume and Issue: 25(1)

Published: Jan. 22, 2025

Language: Английский

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Therapeutic efficacy of a K5-specific phage and depolymerase against Klebsiella pneumoniae in a mouse model of infection

Veterinary Research, Journal Year: 2024, Volume and Issue: 55(1)

Published: May 7, 2024

Klebsiella pneumoniae has become one of the most intractable gram-negative pathogens infecting humans and animals due to its severe antibiotic resistance. Bacteriophages protein products derived from them are receiving increasing amounts attention as potential alternatives antibiotics. In this study, we isolated investigated characteristics a new lytic phage, P1011, which lyses K5 K. specifically among 26 serotypes. The K5-specific capsular polysaccharide-degrading depolymerase dep1011 was identified expressed. By establishing murine infection models using bovine strain B16 (capable supporting phage proliferation) human KP181 (incapable sustaining expansion), explored safety efficacy treatments against pneumoniae. Phage P1011 resulted in 60% survival rate mice challenged with multiplication, concurrently lowering bacterial burden their blood, liver, lungs. Unexpectedly, even when confronted bacteria impervious therapy markedly decreased number viable organisms. protective significantly better than that phage. achieved 100% both treatment groups regardless propagation compatibility. These findings indicated might be used antibacterial agents control infection.

Language: Английский

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Understanding carbapenem-resistant hypervirulent Klebsiella pneumoniae: Key virulence factors and evolutionary convergence

hLife, Journal Year: 2024, Volume and Issue: unknown

Published: June 1, 2024

The emergence of hypervirulence (hv) and carbapenem resistance (CR) as distinct evolutionary directions for Klebsiella pneumoniae presents a significant threat in clinical settings. However, recent years, there has been growing identification K. strains that integrate both phenotypes, resulting severe outcomes. Carbapenem-resistant hypervirulent (CRhvKP) typically emerges through the acquisition plasmids carrying either virulence or CR-encoded genes by carbapenem-resistant pneumoniae. Furthermore, hybrid plasmid can confer combination CR hv. CRhvKP cause variety infections, including pneumonia, urinary tract bloodstream liver abscesses, other related conditions. While sequence type 11 (ST11) dominates majority China, molecular factors responsible success ST11 largely remain unknown. Here, we provide an overview current understanding variation distribution crucial determinants, mechanisms driving merging hv CR, potential influencing epidemiological CRhvKP. This research aims to contribute comprehensive complexities surrounding It is imperative underscore development therapies, precision medicine, vaccine strategies pivotal approaches effectively combating Considering widespread prevalence CRhvKP, prioritized, multifaceted approach encompassing infection control, active surveillance, innovative therapeutics essential.

Language: Английский

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Emergence of KPC-2 and NDM-5-coproducing hypervirulent carbapenem-resistant Klebsiella pneumoniae with high-risk sequence types ST11 and ST15

mSphere, Journal Year: 2024, Volume and Issue: 9(1)

Published: Jan. 9, 2024

ABSTRACT The emergence of Klebsiella pneumoniae carbapenemase-2 (KPC-2) and New Delhi metallo-β-lactamase (NDM)-coproducing hypervirulent carbapenem-resistant (KPC-2-NDM-hv-CRKP) poses a certain threat to public health. Currently, only few sporadic reports such double-positive hv-CRKPs were available. In this study, we isolated two KPC-2-NDM-5-hv-CRKPs from elderly patients with serious underlying diseases poor prognoses. We found both FK3122 FK3127 typical multidrug-resistant (MDR) isolates, exhibiting high-level resistance carbapenems novel β-lactamase inhibitors ceftazidime/avibactam. Notably, is even resistant cefiderocol due multiple bla NDM-5 elements. Besides the MDR phenotype, A549 human lung epithelial cells Galleria mellonella infection model all indicated that highly pathogenic. According whole-genome sequencing analysis, observed over 10 elements, uncommon co-existence KPC-2 , virulence plasmids in isolates. Both identified shared high identity classical plasmid pK2044, harboring specific factors: rmpA iuc operon. also could not be transferred Escherichia coli EC600 independently but together as co-transfer, which was additionally confirmed by S1-pulsed-field gel electrophoresis profile. Moreover, polymorphic mobile genetic elements surrounding genes, may stimulate mobilization genes result duplication these Considering combination pathogenicity, limited therapy options, easy transmission KPC-2-NDM-5-hv-CRKP, our study emphasizes need for underscores imperative ongoing surveillance pathogens. IMPORTANCE Hypervirulent drug has increased gradually K. (hv-CRKP). However, little information available on characteristics (NDM) co-producing strains. obtained KPC-2-NDM-hv-CRKPs patients, each distinct capsule types sequence types: ST11-KL64 ST15-KL24; ST-type lineages are recognized . including ceftazidime/avibactam cefiderocol, displayed exceptionally levels pathogenicity. addition, high-risk factors can other Consequently, isolates their heightened therapeutic potential transmission.

Language: Английский

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