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Review
. 2022 Sep 12:13:1003783.
doi: 10.3389/fmicb.2022.1003783. eCollection 2022.

Epidemiological characteristics and molecular evolution mechanisms of carbapenem-resistant hypervirulent Klebsiella pneumoniae

Yu-Ling Han  1   2 , Xu-Hui Wen  1   2 , Wen Zhao  1 , Xi-Shan Cao  1 , Jian-Xun Wen  3 , Jun-Rui Wang  1 , Zhi-De Hu  1 , Wen-Qi Zheng  1   2
Affiliations
Review

Epidemiological characteristics and molecular evolution mechanisms of carbapenem-resistant hypervirulent Klebsiella pneumoniae

Yu-Ling Han et al. Front Microbiol. .

Abstract

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

Keywords: Klebsiella pneumoniae; carbapenem-resistant; evolution; hybrid plasmid; hypervirulent.

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Conflict of interest statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Figures

Figure 1
Figure 1
Global distribution of CR-hvKP (2015–2022). KPC, Klebsiella pneumoniae carbapenemase; NDM, New Delhi metallo-β-lactamase; VIM, Verona integron-encoded metallo-β-lactamase; IMP, imipenemase; OXA, oxacillinase.
Figure 2
Figure 2
The molecular evolution and carbapenem-resistance mechanism of CR-hvKP.
See this image and copyright information in PMC

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