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. 2022 Oct 14:13:1001169.
doi: 10.3389/fmicb.2022.1001169. eCollection 2022.

Clinical and genomic characterization of hypervirulent Klebsiella pneumoniae (hvKp) infections via passive surveillance in Southern California, 2020-2022

Edwin Kamau  1 , Elizabeth L Ranson  2 , Allison T Tsan  1 , Elke S Bergmann-Leitner  3 , Omai B Garner  1 , Shangxin Yang  1
Affiliations

Clinical and genomic characterization of hypervirulent Klebsiella pneumoniae (hvKp) infections via passive surveillance in Southern California, 2020-2022

Edwin Kamau et al. Front Microbiol. .

Abstract

Hypervirulent Klebsiella pneumoniae (hvKp) is more invasive and virulent than classical K. pneumoniae, and requires specialized treatment. To raise clinical awareness, this study determined the prevalence, clinical characteristics, and genomic epidemiology of hvKp infections in Southern California (SoCal) by conducting a passive surveillance in a single large academic medical center. We report here that hvKp infections were more common than expected, accounting for 2.6% of invasive K. pneumoniae infections, and presented with a wide disease spectrum, occasionally mimicking tumors, even co-infecting a COVID-19 patient. Most infections were community acquired with no recent international travel, suggesting hvKp strains are circulating in the community. Genomic analysis revealed genetic diversity, with the K1-ST23 lineage predominating but not clonal, and multiple sequence types of K2 including a SoCal unique K2-ST66 sublineage that had been unrecognized. Our findings highlight the urgency of heightened awareness of hvKp infection in the US, the need for rapid diagnosis of hvKp, and the necessity of implementing robust surveillance programs for hvKp at the institutional or local level.

Keywords: Southern California (United States); genomic epidemiology; hypervirulent Klebsiella pneumoniae (hvKP); invasive infections; surveillance.

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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
Genetic analysis of the study isolates. The first two columns show the MLST and K type for each isolate. Phylogenetic analysis using K-mer grouped isolates based on the K type and MLST. The gray shaded columns indicate the virulence genes present in each of the isolates.
Figure 2
Figure 2
Phylogenetic analysis of 20 K1-ST23 isolates from different geographical origins labeled with country of origin and year of sampling (Lin et al., 2012), 10 K1-ST23 isolates from our study population, and two references strains; K1 serotype (AP006725) and K2 serotype (F0834906).
Figure 3
Figure 3
SNP analysis of K1-ST23 isolates using NTUH-K2044 (GenBank accession AP006725) as the reference genome.
See this image and copyright information in PMC

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