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Review
. 2021 Jun;13(3):257-265.
doi: 10.18502/ijm.v13i3.6384.

Molecular epidemiology of hypervirulent Klebsiella pneumoniae: a systematic review and meta-analysis

Rahimeh Sanikhani  1 , Mohammad Moeinirad  2 , Fereshteh Shahcheraghi  1 , Arezou Lari  3 , Sepideh Fereshteh  1 , Amin Sepehr  1 , Afsaneh Salimi  1 , Farzad Badmasti  1
Affiliations
Review

Molecular epidemiology of hypervirulent Klebsiella pneumoniae: a systematic review and meta-analysis

Rahimeh Sanikhani et al. Iran J Microbiol. 2021 Jun.

Abstract

Classical (CKp) and hypervirulent (hvKp) Klebsiella pneumoniae are two different circulating pathotypes. The aim of this study was to assess the prevalence, epidemiology and molecular relatedness of hvKps using a systemic review and meta-analysis. The data extracted from Medline, Embase, and Web of Science and finally 14 studies met the eligible criteria. To combine prevalence proportions of all studies, we performed the metaprop command embedded in the Meta package software. Totally, of 1814 K. pneumoniae isolates, 21.7% (394/1814) were hvKp. The molecular typing showed that all hvKp isolates were grouped into 50 different sequence types (STs) of them ST23, ST11, ST65 and ST86 were common. K1, K2 and K64 were dominant capsule serotypes that strongly related to ST23, ST65 and ST11, respectively. It seems that clonal group 23 (CG23) is associated with liver abscess and CG11 related to various clinical sources.

Keywords: Hypervirulent Klebsiella pneumonia; Molecular typing; Pathotypesi genotypes; Virulence factors.

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Figures

Fig. 1.
Fig. 1.
The PRISMA flowchart of the study identification and selection criteria.
Fig. 2.
Fig. 2.
Forest plot of the meta-analysis on prevalence of (2A) common sequence type-23 (2B) common capsule serotype K1 and (2C) K2 among hvKp strains. P Value <0.01 and confidence interval (CI= 95%).
Fig. 3.
Fig. 3.
The proportion of STs among 394 hvKp isolates. The collections of STs which have the same frequency were considered in a graph bar. ST, Sequence Type; nt, non-typeable.
Fig. 4.
Fig. 4.
Minimum spanning tree (MST) analysis of multilocus sequence typing (MLST) data for hvKp isolates. Each circle corresponds to a sequence type (ST) that ST number is given inside each circle. The area of each circle is proportional to the number of isolates. The numbers on the connecting lines between STs correspond to the numbers of allelic differences. The circle was colored according to clinical source. The lines between STs indicate clonal relationships. MST is drawn based on the 3 allelic differences.
See this image and copyright information in PMC

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