ArticleGenome medicine2023
Large-scale genomic analysis of global Klebsiella pneumoniae plasmids reveals multiple simultaneous clusters of carbapenem-resistant hypervirulent strains.
Article in Genome medicine, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 50 papers, 1 of them a synthesis that pooled it.
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Who cites it
50 citing papers in PubMed, 1 synthesis or guideline pooled it, 57 citations in OpenAlex.
- A systematic review of hypervirulentFrontiers in medicine · 2025Pooled it
- Emergence of carbapenem-resistant putative hypervirulentEmerging microbes & infections · 2026Article
- Comparative genomics of carbapenem resistance and virulence associated with respiratory tract and bloodstream infections in carbapenem-resistantVirulence · 2026Article
- Comparative genomics of hypervirulent Klebsiella pneumoniae isolates from Brazil.Archives of microbiology · 2026Article
- Emerging hypervirulent and extensively drug-resistant Klebsiella pneumoniae with potent biofilm formation as a new clinical challenge.Molecular biology reports · 2026Article
- Antimicrobial resistance and plasmidome of carbapenemase-resistant Klebsiella pneumoniae causing bloodstream infections between 2014 and 2024.BMC microbiology · 2026Article
- Characterization of Proline-Rich Antimicrobial Peptides with SbmA Transporter-Dependent and Independent Antimicrobial Activity towardACS infectious diseases · 2026Article
- Whole-genome sequencing of MDR K. pneumoniae circulating in Moroccan river ecosystems: a comprehensive genomic analysis of environmental isolates.BMC genomics · 2026Article
- Genome-Wide Association of ST, K-, and O-Locus Diversity with Virulence in Indian Klebsiella pneumoniae via Targeted Phenotypic Validation.Current microbiology · 2026Article
- Genomic analysis ofbioRxiv : the preprint server for biology · 2026Article
- Deciphering the genomic landscape of hypervirulent Klebsiella pneumoniae in South African tertiary hospitals.BMC microbiology · 2026Article
- Genomic epidemiology of multidrug-resistantAIMS microbiology · 2026Article
- Artificial Intelligence for Antimicrobial Resistance Detection and Prediction inInfection and drug resistance · 2026Review
- The oral cavity as a reservoir for resistance- and hypervirulence-associated genes ofFrontiers in microbiology · 2026Article
- Suspected community-acquisition of carbapenem-resistant hypervirulent Klebsiella pneumoniae (CRhvKp) in Germany: a case report and implications for infection control.GMS hygiene and infection control · 2026Article
- Clinical and molecular characteristics, antibiotic susceptibility, risk factors and predictors of mortality in carbapenem-resistant klebsiella pneumoniae bloodstream infections in Southern Sichuan, China: a 5-year multicenter study.Frontiers in cellular and infection microbiology · 2026Article
- Hypervirulent and Drug-ResistantInternational journal of general medicine · 2026Review
- Hybrid plasmids: genetic diversity and hypervirulent phenotype ofFrontiers in microbiology · 2026Article
- Molecular epidemiology of antimicrobial resistance and virulence of carbapenem-resistantFrontiers in microbiology · 2026Article
- Coexistence of carbapenemase and hypervirulence-associated genes amongFrontiers in microbiology · 2026Article
Corrections and comments
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Authors and funding
4 authors at 2 institutions in 2 countries.
Funding
Abstract
backgroundKlebsiella pneumoniae (Kp) Gram-negative bacteria cause nosocomial infections and rapidly acquire antimicrobial resistance (AMR), which makes it a global threat to human health. It also has a comparatively rare hypervirulent phenotype that can lead to severe disease in otherwise healthy individuals. Unlike classic Kp, canonical hypervirulent strains usually have limited AMR. However, after initial case reports in 2015, carbapenem-resistant hypervirulent Kp has increased in prevalence, including in China, but there is limited understanding of its burden in other geographical regions.
methodsHere, we examined the largest collection of publicly available sequenced Kp isolates (n=13,178), containing 1603 different sequence types (e.g. ST11 15.0%, ST258 9.5%), and 2174 (16.5%) hypervirulent strains. We analysed the plasmid replicons and carbapenemase and siderophore encoding genes to understand the movement of hypervirulence and AMR genes located on plasmids, and their convergence in carbapenem-resistant hypervirulent Kp.
resultsWe identified and analysed 3034 unique plasmid replicons to inform the epidemiology and transmission dynamics of carbapenem-resistant hypervirulent Kp (n=1028, 7.8%). We found several outbreaks globally, including one involving ST11 strains in China and another of ST231 in Asia centred on India, Thailand, and Pakistan. There was evidence of global flow of Kp, including across multiple continents. In most cases, clusters of Kp isolates are the result of hypervirulence genes entering classic strains, instead of carbapenem resistance genes entering canonical hypervirulent ones.
conclusionsOur analysis demonstrates the importance of plasmid analysis in the monitoring of carbapenem-resistant and hypervirulent strains of Kp. With the growing adoption of omics-based technologies for clinical and surveillance applications, including in geographical regions with gaps in data and knowledge (e.g. sub-Saharan Africa), the identification of the spread of AMR will inform infection control globally.
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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.