Understanding carbapenem-resistant hypervirulent Klebsiella pneumoniae: Key virulence factors and evolutionary convergence DOI Creative Commons
Tao Chen,

Liya Ying,

Luying Xiong

et al.

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

Mechanisms of Antibiotic Resistance in Important Gram-Positive and Gram-Negative Pathogens and Novel Antibiotic Solutions DOI Creative Commons
Loukas Kakoullis, Eleni Papachristodoulou, Paraskevi Chra

et al.

Antibiotics, Journal Year: 2021, Volume and Issue: 10(4), P. 415 - 415

Published: April 10, 2021

Multidrug-resistant bacteria have on overwhelming impact human health, as they cause over 670,000 infections and 33,000 deaths annually in the European Union alone. Of these, vast majority of are caused by only a handful species-multi-drug resistant

Language: Английский

Citations

161
Carbapenem-Resistant Klebsiella pneumoniae: Virulence Factors, Molecular Epidemiology and Latest Updates in Treatment Options DOI Creative Commons
Theodoros Karampatakis, Katerina Tsergouli, Payam Behzadi

et al.

Antibiotics, Journal Year: 2023, Volume and Issue: 12(2), P. 234 - 234

Published: Jan. 21, 2023

Klebsiella pneumoniae is a Gram-negative opportunistic pathogen responsible for variety of community and hospital infections. Infections caused by carbapenem-resistant K. (CRKP) constitute major threat public health are strongly associated with high rates mortality, especially in immunocompromised critically ill patients. Adhesive fimbriae, capsule, lipopolysaccharide (LPS), siderophores or iron carriers the main virulence factors which contribute to pathogenicity pneumoniae. Colistin tigecycline some last resorts treatment CRKP Carbapenemase production, carbapenemase (KPC) metallo-β-lactamase (MBL), constitutes basic molecular mechanism emergence. Knowledge appearance crucial, as it can determine selection most suitable antimicrobial agent among those recently launched. Plazomicin, eravacycline, cefiderocol, temocillin, ceftolozane–tazobactam, imipenem–cilastatin/relebactam, meropenem–vaborbactam, ceftazidime–avibactam aztreonam–avibactam potent alternatives treating The aim current review highlight pathogenesis provide recent updates on epidemiology options.

Language: Английский

Citations

152
Prevalence of hypervirulent and carbapenem-resistant Klebsiella pneumoniae under divergent evolutionary patterns DOI Creative Commons
Dongxing Tian, Xiao Liu, Wenjie Chen

et al.

Emerging Microbes & Infections, Journal Year: 2022, Volume and Issue: 11(1), P. 1936 - 1949

Published: July 18, 2022

K1/K2 hvKP strains acquire carbapenem-resistance plasmids, known as CR-hvKp, and carbapenem-resistant Klebsiella pneumoniae (CRKP) obtain virulence recognized hv-CRKP. The two different evolution patterns of hypervirulent combined may lead to their prevalence in hospitals. Our study aimed investigate the hv-CRKP CR-hvKp analyze factors influencing prevalence. We collected 890 K. genomes from GenBank 530 clinical isolates nine found that were more prevalent than both dominated by blaKPC-2 gene. blaKPC-2-carrying plasmids could mobilize non-conjugative hvKp CRKP strains. conserved oriT widespread conjugative helper potential for mobilization plasmids. HvKp with KPC plasmid hardly simultaneously exhibit hypervirulence carbapenem resistance plasmid, we rfaH mutation reduced capsular synthesis increased strain. In summary, this revealed suitable survival hospital settings KPC-producing contributed emergence

Language: Английский

Citations

79
Increase in antioxidant capacity associated with the successful subclone of hypervirulent carbapenem-resistant Klebsiella pneumoniae ST11-KL64 DOI Creative Commons
Ruobing Wang, Anru R. Zhang, Shijun Sun

et al.

Nature Communications, Journal Year: 2024, Volume and Issue: 15(1)

Published: Jan. 2, 2024

The acquisition of exogenous mobile genetic material imposes an adaptive burden on bacteria, whereas the adaptational evolution virulence plasmids upon entry into carbapenem-resistant Klebsiella pneumoniae (CRKP) and its impact remains unclear. To better understand in CRKP, we characterize utilizing a large genomic data containing 1219 K. from our long-term surveillance publicly accessible databases. Phylogenetic evaluation unveils associations between distinct serotypes. sub-lineage ST11-KL64 CRKP acquires pK2044-like plasmid ST23-KL1 hypervirulent pneumoniae, with 2698 bp region deletion all ST11-KL64. is observed to regulate methionine metabolism, enhance antioxidant capacity, further improve survival macrophages. discards certain sequences ST11-KL64, thereby conferring evolutionary advantage. This work contributes multifaceted understanding provides insight potential causes behind low fitness costs bacteria.

Language: Английский

Citations

22
Interplay between the cell envelope and mobile genetic elements shapes gene flow in populations of the nosocomial pathogen Klebsiella pneumoniae DOI Creative Commons
Matthieu Haudiquet, Amandine Nucci, Olaya Rendueles

et al.

PLoS Biology, Journal Year: 2021, Volume and Issue: 19(7), P. e3001276 - e3001276

Published: July 6, 2021

Mobile genetic elements (MGEs) drive transfers between bacteria using mechanisms that require a physical interaction with the cellular envelope. In high-priority multidrug-resistant nosocomial pathogens (ESKAPE), first point of contact cell and virions or conjugative pili is capsule. While capsule can be barrier to MGEs, it also evolves rapidly by horizontal gene transfer (HGT). Here, we aim at understanding this apparent contradiction studying covariation repertoire genes MGEs in approximately 4,000 genomes Klebsiella pneumoniae (Kpn). We show capsules phage-mediated flow closely related serotypes. Such serotype-specific phage predation explains frequent inactivation genes, observed more than 3% genomes. Inactivation strongly epistatic, recapitulating biosynthetic pathway. plasmids are acquired higher rates natural isolates lacking functional capsular locus confirmed experimentally result mutants. This suggests pressure facilitates its subsequent reacquisition conjugation. Accordingly, leaves long recombination tracts around locus. The loss regain process rewires toward other lineages whenever leads serotype swaps. changes happen preferentially chemically serotypes, hinting fitness serotype-swapped strains depends on host background. These results enlighten bases trade-offs evolution virulence multidrug resistance caution some alternatives antibiotics selecting for may facilitate acquisition antibiotic (ARGs).

Language: Английский

Citations

63
Epidemiological characteristics and molecular evolution mechanisms of carbapenem-resistant hypervirulent Klebsiella pneumoniae DOI Creative Commons

Yu‐Ling Han,

Xu‐Hui Wen,

Wen Zhao

et al.

Frontiers in Microbiology, Journal Year: 2022, Volume and Issue: 13

Published: Sept. 12, 2022

Carbapenem-resistant hypervirulent Klebsiella pneumoniae (CR-hvKP), a type of (KP) that exhibits hypervirulence and carbapenem resistance phenotypes, can cause severe infections, both hospital- community-acquired infections. CR-hvKP has brought great challenges to global public health is associated with significant morbidity mortality. There are many mechanisms responsible for the evolution such as horizontal transfer plasmid carrying gene (hvKP) or carbapenemase-producing (CRKP) acquiring virulence-encoding gene. Notably, KP evolve into by hybrid genes. In this review, we summarize evolutionary plasmid-borne virulence well prevalence CR-hvKP.

Language: Английский

Citations

55
Global spread and evolutionary convergence of multidrug-resistant and hypervirulent Klebsiella pneumoniae high-risk clones DOI Creative Commons
Gabriele Arcari, Alessandra Carattoli

Pathogens and Global Health, Journal Year: 2022, Volume and Issue: 117(4), P. 328 - 341

Published: Sept. 11, 2022

For people living in developed countries life span is growing at a faster pace than ever. One of the main reasons for such success attributable to introduction and extensive use clinical practice antibiotics over course last seven decades. In hospital settings, Klebsiella pneumoniae represents well-known commonly described opportunistic pathogen, typically characterized by resistance several antibiotic classes. On other hand, broad wedge population Low and/or Middle Income Countries increasing rapidly, allowing spread commensal bacteria which are transmitted via human contact. Community transmission has been original milieu K. isolates an outstanding virulence (hypervirulent). These two characteristics, also defined as "pathotypes", originally emerged different pathways evolutionary history pneumoniae. long time, Sequence Type (ST), combination alleles 7 housekeeping genes Multi-Locus Typing, reliable marker pathotype: multidrug-resistant clones (e.g. ST258, ST147, ST101) Western world hypervirulent ST23, ST65, ST86) Eastern. Currently, boundaries separating pathotypes fading away due factors, we witnessing worrisome convergence certain high-risk clones. Here review evidence available on confluence multidrug-resistance hypervirulence specific

Language: Английский

Citations

54
The making of hypervirulent Klebsiella pneumoniae DOI Creative Commons

Piaopiao Dai,

Dakang Hu

Journal of Clinical Laboratory Analysis, Journal Year: 2022, Volume and Issue: 36(12)

Published: Nov. 8, 2022

Abstract Klebsiella pneumoniae is a notorious bacterium in clinical practice. Virulence, carbapenem‐resistance and their convergence among K. are extensively discussed this article. Hypervirulent (HvKP) has spread from the Asian Pacific Rim to world, inducing various invasive infections, such as pyogenic liver abscess, endophthalmitis, meningitis. Furthermore, HvKP acquired more drug resistance. Among multidrug‐resistant HvKP, hypervirulent carbapenem‐resistant (Hv‐CRKP), (CR‐HvKP) both devastating for extreme resistance virulence. The hypervirulence of primarily attributed hypercapsule, macromolecular exopolysaccharides, or excessive siderophores, although it many other factors, example, lipopolysaccharides, fimbriae, porins. In contrast with classical determination that is, animal lethality test, molecular could be an optional practical method after improvement. including Hv‐CRKP CR‐HvKP, been progressing. R‐M CRISPR‐Cas systems may play pivotal roles evolutions. particular former, should severe concern due being prevalent.

Language: Английский

Citations

45
Characterization difference of typical KL1, KL2 and ST11-KL64 hypervirulent and carbapenem-resistant Klebsiella pneumoniae DOI
Ying Zhou,

Chunyang Wu,

Bingjie Wang

et al.

Drug Resistance Updates, Journal Year: 2023, Volume and Issue: 67, P. 100918 - 100918

Published: Jan. 3, 2023

Language: Английский

Citations

37
Antibiotic-Resistant ESKAPE Pathogens and COVID-19: The Pandemic beyond the Pandemic DOI Creative Commons
Alessia Catalano, Domenico Iacopetta, Jessica Ceramella

et al.

Viruses, Journal Year: 2023, Volume and Issue: 15(9), P. 1843 - 1843

Published: Aug. 30, 2023

Antibacterial resistance is a renewed public health plague in modern times, and the COVID-19 pandemic has rekindled this problem. Changes antibiotic prescribing behavior, misinformation, financial hardship, environmental impact, governance gaps have generally enhanced misuse improper access to antibiotics during pandemic. These determinants, intersected with antibacterial current pandemic, may amplify potential for future The occurrence of infections multidrug-resistant (MDR), extensively drug-resistant (XDR), difficult-to-treat (DTR), carbapenem-resistant (CR), pan-drug-resistant (PDR) bacteria still increasing. aim review highlight state art worldwide, focusing on most important pathogens, namely Enterobacterales, Acinetobacter baumannii, Klebsiella pneumoniae, their common antibiotics.

Language: Английский

Citations

27