Hypervirulent Klebsiella pneumoniae – clinical and molecular perspectives
Year: 2019
Type: review
Abstract: Hypervirulent Klebsiella pneumoniae (hvKp) has emerged as a concerning global pathogen. hvKp is more virulent than classical K. pneumoniae (cKp) and capable of causing community-acquired infections, often in healthy individuals. hvKp is carried in the gastrointestinal tract, which contributes to its spread in the community and healthcare settings. First recognized in Asia, hvKp arose as a leading cause of pyogenic liver abscesses. In the decades since, hvKp has spread globally and causes a variety of infections. In addition to liver abscesses, hvKp is distinct from cKp in its ability to metastasize to distant sites, including most commonly the eye, lung and central nervous system (CNS). hvKp has also been implicated in primary extrahepatic infections including bacteremia, pneumonia and soft tissue infections. The genetic determinants of hypervirulence are often found on large virulence plasmids as well as chromosomal mobile genetic elements which can be used as biomarkers to distinguish hvKp from cKp clinical isolates. These distinct virulence determinants of hvKp include up to four siderophore systems for iron acquisition, increased capsule production, K1 and K2 capsule types, and the colibactin toxin. Additionally, hvKp strains demonstrate hypermucoviscosity, a phenotypic description of hvKp in laboratory conditions that has become a distinguishing feature of many hypervirulent isolates. Alarmingly, multidrug-resistant hypervirulent strains have emerged, creating a new challenge in combating this already dangerous pathogen.
Source: Journal of Internal Medicine
DOI: 10.1111/joim.13007
Authors: J. E. Choby, J. Howard‐Anderson, D. S. Weiss
Language: English
Subfield: Microbiology (medical)
Field: Medicine
Domain: Health Sciences
Open Access status: green
Funders: U.S. Department of Veterans Affairs, Burroughs Wellcome Fund, Division of Intramural Research, National Institute of Allergy and Infectious Diseases, Health Services Research and Development, National Institutes of Health, National Institute of Allergy and Infectious Diseases, National Institute of Diabetes and Digestive and Kidney Diseases, National Center for Advancing Translational Sciences
Awards: G1183338040, G1284115699, G3573657424, G4225459209, G4855239928, Mechanisms of phenotypic antibiotic resistance in Gram-negative bacteria, G574410863, G8389053815, Georgia Clinical & Translational Science Alliance (Georgia CTSA), Research Training in Translational Gastroenterology and Hepatology, Emory National Primate Research Center, J. NRSA Training Core
OpenAlex ID: W2987013299