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Review
. 2023 Nov 30:14:1325077.
doi: 10.3389/fmicb.2023.1325077. eCollection 2023.

Virulence factors in carbapenem-resistant hypervirulent Klebsiella pneumoniae

Gabriel Mendes  1 , Maria Leonor Santos  1 , João F Ramalho  1 , Aida Duarte  2   3 , Cátia Caneiras  1   3   4
Affiliations
Review

Virulence factors in carbapenem-resistant hypervirulent Klebsiella pneumoniae

Gabriel Mendes et al. Front Microbiol. .

Abstract

Hypervirulence and carbapenem-resistant have emerged as two distinct evolutionary pathotypes of Klebsiella pneumoniae, with both reaching their epidemic success and posing a great threat to public health. However, as the boundaries separating these two pathotypes fade, we assist a worrisome convergence in certain high-risk clones, causing hospital outbreaks and challenging every therapeutic option available. To better understand the basic biology of these pathogens, this review aimed to describe the virulence factors and their distribution worldwide among carbapenem-resistant highly virulent or hypervirulent K. pneumoniae strains, as well as to understand the interplay of these virulence strains with the carbapenemase produced and the sequence type of such strains. As we witness a shift in healthcare settings where carbapenem-resistant highly virulent or hypervirulent K. pneumoniae are beginning to emerge and replace classical K. pneumoniae strains, a better understanding of these strains is urgently needed for immediate and appropriate response.

Keywords: KPC-variants; Klebsiella pneumoniae; ST11; ST13; ST23; high-risk clones; siderophores; treatment.

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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
Carbapenem resistance mechanisms and virulence factors of carbapenem-resistant highly virulent or hypervirulent K. pneumoniae.
Figure 2
Figure 2
Distribution of virulence genes of carbapenem-resistant highly virulent or hypervirulent Klebsiella pneumoniae by region.
Figure 3
Figure 3
Distribution of virulence genes according to carbapenemase produced in carbapenem-resistant highly virulent or hypervirulent Klebsiella pneumoniae.
Figure 4
Figure 4
Distribution of virulence genes among ST11, ST23 and other clones (ST13, 14, 15, 16, 29, 35, 36, 65, 86, 101, 147, 258, 268, 375, 383, 392, 395, 420, 437, 464, 592, 859, 893, 1,265, 1,399, 1,660, 2,193 and 2,230) of carbapenem-resistant highly virulent or hypervirulent Klebsiella pneumoniae. ST11 and ST23 clones are also differentiated by region.
See this image and copyright information in PMC

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