ArticleBMC microbiology2024
Emergence of hypervirulent and carbapenem-resistant Klebsiella pneumoniae from 2014 - 2021 in Central and Eastern China: a molecular, biological, and epidemiological study.
Article in BMC microbiology, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 28 papers.
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Who cites it
28 citing papers in PubMed.
- Clinical and molecular characterizations of carbapenem-resistant Klebsiella pneumoniae among children with bloodstream infections in Beijing, China.BMC infectious diseases · 2026Article
- HypervirulentMicrobiology spectrum · 2026Article
- Bacterial profile and antimicrobial resistance in patients with pulmonary infection: a retrospective tertiary hospital-based study.BMC infectious diseases · 2026Article
- Increased virulence and decreased antimicrobial resistance in Klebsiella pneumoniae in Beijing since 2020: a retrospective molecular epidemiology study.Science China. Life sciences · 2026Article
- Genetic clusteringof KPC-2-producing carbapenem-resistant Klebsiella pneumoniae ST5422-KL19 in Shanghai, China.BMC microbiology · 2026Article
- Detection of hypervirulence genes in carbapenem resistant Klebsiella pneumoniae from cancer patients at a tertiary referral hospital in Nepal.BMC infectious diseases · 2026Article
- Carbapenem resistance and hypervirulence iniScience · 2026Review
- Plasmid-mediated convergence of multidrug resistance and hypervirulence in community-acquired Klebsiella pneumoniae in Tianjin, China.BMC microbiology · 2026Article
- <p>Molecular medicine reports · 2026Review
- Epidemiological and functional insights intoMicrobiology spectrum · 2026Article
- High-pathogenicity island enhances NDM-5 activity and drives global spread of Escherichia coli ST410.The ISME journal · 2026Article
- Fitness cost of ceftazidime-avibactam resistance acquisition in carbapenem-resistant hypervirulent Klebsiella pneumoniae.BMC microbiology · 2026Article
- Control efficacy and groundwater risk of antibiotic resistance genes in semi-arid landfill leachate treatment: seasonal insights and engineering implications.Frontiers in microbiology · 2026Article
- Molecular epidemiology of antimicrobial resistance and virulence of carbapenem-resistantFrontiers in microbiology · 2026Article
- Phenotypic characteristics and plasmid structure differences between ST11 carbapenem-resistantFrontiers in cellular and infection microbiology · 2026Article
- Genetic characterization of carbapenem-resistantFrontiers in cellular and infection microbiology · 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
- O2a O-antigen type and sepsis in invasiveFrontiers in cellular and infection microbiology · 2026Article
- Emergence and hospital dissemination of hypervirulent carbapenem-resistant Klebsiella pneumoniae lineages in eastern China.BMC microbiology · 2025Article
- Spread of ST11-O13/KL47 hypervirulent carbapenem-resistant Klebsiella pneumoniae isolates in China.Scientific reports · 2025Article
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10 authors.
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Abstract
backgroundIn recent years, the hypervirulent and carbapenem-resistant Klebsiella pneumoniae has been increasingly reported worldwide. The objective of this study was to compare the antibiotic resistance and virulence profiles of carbapenem-resistant hypervirulent K.pneumoniae (CR-hvKP) and hypervirulent carbapenem-resistant K.pneumoniae (hv-CRKP) and identify the prevailing strain in clinical settings.
methodsIn this study, hv-CRKP or CR-hvKP were identified based on the results of whole-genome analysis (WGS), multilocus sequence typing (MLST) and the antimicrobial susceptibility testing. We then compared antibiotic resistance and virulence profiles between CR-hvKP and hv-CRKP through the antimicrobial susceptibility testing and a series of virulence experiments including biofilm formation ability detection method, the resistance test against human serum, siderophore production test, neutrophil phagocytosis assay and Galleria mellonella infection model. Additionally, pathway enrichment analysis was conducted to assess the effect of SNPs on the phenotype.
resultsIn this study, we categorized 17.4% of hypervirulent and carbapenem-resistant K. pneumoniae strains as CR-hvKP and 82.6% as hv-CRKP. Among them, 84.2% (16/19) of CR-hvKP strains harboring carbapenemase genes exhibited lower imipenem and meropenem MIC values compared to hv-CRKP strains. The virulence potential of hv-CRKP and CR-hvKP was confirmed by using virulence experiments in vitro and in vivo, showing that virulence of the CR-hvKP strains was comparable to that of hv-CRKP strains. Notably, the 90 hv-CRKP strains were classified into 3 different ST types and 8 capsule types, each showing varying degrees of resistance and virulence. We observed that subclonal replacement was within the predominant hv-CRKP clone, with the ST11-KL64 strain, characterized by high-level resistance and virulence emerging as the currently prevailing subclone, replacing ST11-KL47. KEGG enrichment analysis showed that pathways associated with the citrate cycle (TCA cycle), glycolysis/gluconeogenesis, glutathione metabolism, two-component regulatory system, and folate metabolism were significantly enriched among the group expressing different levels of capsular polysaccharides.
conclusionsThe hv-CRKP strains exhibited a greater survival advantage in the hospital environment than CR-hvKP strains. Notably, the ST11-KL64 hv-CRKP strain which displayed a high level of resistance and hypervirulence, warrants the most clinical vigilance. CLINICAL TRIAL NUMBER: Not applicable.
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