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

Bibliographic Details
Title: Understanding carbapenem-resistant hypervirulent Klebsiella pneumoniae: Key virulence factors and evolutionary convergence
Authors: Tao Chen, Liya Ying, Luying Xiong, Xueting Wang, Ping Lu, Yuan Wang, Ping Shen, Yonghong Xiao
Source: hLife, Vol 2, Iss 12, Pp 611-624 (2024)
Publisher Information: Elsevier, 2024.
Publication Year: 2024
Collection: LCC:Medicine
Subject Terms: Klebsiella pneumoniae, carbapenem-resistance, hypervirulence, virulence factors, evolution, genome, Medicine
More Details: The emergence of hypervirulence (hv) and carbapenem resistance (CR) as distinct evolutionary directions for Klebsiella pneumoniae presents a significant threat in clinical settings. However, in recent years, there has been a growing identification of K. pneumoniae strains that integrate both phenotypes, resulting in severe clinical outcomes. Carbapenem-resistant hypervirulent K. pneumoniae (CRhvKP) typically emerges through the acquisition of plasmids carrying either virulence or CR-encoded genes by carbapenem-resistant K. pneumoniae or hypervirulent K. pneumoniae. Furthermore, the acquisition of a hybrid plasmid can confer a combination of CR and hv. CRhvKP can cause a variety of infections, including pneumonia, urinary tract infections, bloodstream infections, liver abscesses, and other related conditions. While the sequence type 11 (ST11) dominates the majority of CRhvKP strains in China, the molecular factors responsible for the success of ST11 CRhvKP largely remain unknown. Here, we provide an overview of the current understanding of the variation and distribution of crucial virulence determinants, the mechanisms driving the merging of hv and CR, and the potential molecular factors influencing the epidemiological success of ST11 CRhvKP. This research aims to contribute to a comprehensive understanding of the complexities surrounding CRhvKP. It is imperative to underscore the development of combination therapies, precision medicine, and vaccine strategies as pivotal approaches in effectively combating CRhvKP. Considering the widespread prevalence of CRhvKP, a prioritized, multifaceted approach encompassing infection control, active surveillance, and the development of innovative therapeutics is essential.
Document Type: article
File Description: electronic resource
Language: English
ISSN: 2949-9283
Relation: http://www.sciencedirect.com/science/article/pii/S2949928324000543; https://doaj.org/toc/2949-9283
DOI: 10.1016/j.hlife.2024.06.005
Access URL: https://doaj.org/article/506c2bd7c05f4103a9580d4eb9f8b4d6
Accession Number: edsdoj.506c2bd7c05f4103a9580d4eb9f8b4d6
Database: Directory of Open Access Journals
More Details
ISSN:29499283
DOI:10.1016/j.hlife.2024.06.005
Published in:hLife
Language:English