Evidence map›Paper›PMID 41353259›Full record

ArticleScientific reports2025

Comparative genomic insights into multidrug resistance in classical and hypervirulent K. pneumoniae clinical isolates.

Azra, Ihsan Ullah, Woranich Hinthong, Jody E Phelan, Susana Campino, Ihtisham Ul Haq, Zia Ud Din, Sajjad Ahmad, Gulab Fatima Rani, Aneeqa Naz and 4 more

Abstract readComparative Study
In one paragraph

Article in Scientific reports, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers.

0numbers the graph read from it
0cells of the map it votes in
5citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

5 citing papers in PubMed.

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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

14 authors.

AzraInstitute of Pathology and Diagnostic Medicine, IP&DM, Khyber Medical University Peshawar, Peshawar, Pakistan.
Ihsan UllahInstitute of Pathology and Diagnostic Medicine, IP&DM, Khyber Medical University Peshawar, Peshawar, Pakistan.
Woranich HinthongFaculty of Infectious and Tropical Diseases, London School of Hygiene and Tropical Medicine, London, UK.
Jody E PhelanFaculty of Infectious and Tropical Diseases, London School of Hygiene and Tropical Medicine, London, UK.
Susana CampinoFaculty of Infectious and Tropical Diseases, London School of Hygiene and Tropical Medicine, London, UK.
Ihtisham Ul HaqPost-Graduate Programme in Innovation in Technology, Federal University of Minas Gerais, Belo Horizonte, Minas Gerais, 30150-240, Brazil.
Zia Ud DinDepartment of Pharmacy, Kohat University of Science and Technology, Kohat, Pakistan.
Sajjad AhmadInstitute of Pathology and Diagnostic Medicine, IP&DM, Khyber Medical University Peshawar, Peshawar, Pakistan.
Gulab Fatima RaniInstitute of Pathology and Diagnostic Medicine, IP&DM, Khyber Medical University Peshawar, Peshawar, Pakistan.
Aneeqa NazDepartment of Pathology, Multan Medical and Dental College, Multan, Pakistan.
Otavio Cabral-MarquesDepartment of Immunology, Institute of Biomedical Sciences, University of São Paulo, São Paulo, 05508-220, Brazil.
Muhammad Zubair BhattiLady Reading Hospital, Peshawar, Pakistan.
Taj Ali KhanInstitute of Pathology and Diagnostic Medicine, IP&DM, Khyber Medical University Peshawar, Peshawar, Pakistan. Tajalikhan.ibms@kmu.edu.pk.
Taane G ClarkFaculty of Infectious and Tropical Diseases, London School of Hygiene and Tropical Medicine, London, UK. taane.clark@lshtm.ac.uk.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Klebsiella pneumoniae is a highly adaptable opportunistic pathogen responsible for various infections, particularly in immunocompromised individuals. The recent genetic evolution of K. pneumoniae has led to the emergence of strains exhibiting both hypervirulence and multidrug resistance (MDR). In this study, we compared the genomic characteristics of MDR in classical and hypervirulent K. pneumoniae clinical isolates. Sixty-four isolates were collected from two healthcare institutions in Khyber Pakhtunkhwa, Pakistan, and identified using standard microbiological techniques. Whole-genome sequencing (WGS) was performed on 30 selected isolates using an Illumina platform. The sequencing data were analysed with the Kleborate tool. WGS analysis identified sequence types ST147 (n = 7, 23%) and ST2629 (n = 5, 16.6%) as the most prevalent lineages. Additionally, 13 other ST were detected, including ST147-1LV (n = 1, 3.3%) and ST859 (n = 1, 3.3%), which exhibited hypervirulent MDR traits. Among K-loci-associated virulence determinants, KL64 was the most predominant (n = 7, 23%), while the O-serotype O1/O2v1 was found in 22 isolates. A diverse range of antimicrobial resistance (AMR) determinants was observed across isolates. Plasmid-mediated quinolone resistance (PMQR) genes (qnrS1, qnrB1, qnrB4, qepA2) and aminoglycoside-modifying enzymes (aac(3)-IIa, aac(6')-Ib-cr, strA, strB) were detected in both classical and hypervirulent strains. β-lactamase genes included bla-SHV variants (bla-SHV-1, bla-SHV-11, bla-SHV-25, bla-SHV-187), bla-CTX-M-15, bla-VEB-5, bla-OXA-1, bla-OXA-48, and bla-OXA-181. Additional resistance genes conferred resistance to macrolides (ermB, mphB), phenicols (catB4, catA1, floR), sulfonamides (sul1, sul2), tetracyclines (tetA, tetB, tetD), and trimethoprim (dfrA1, dfrA12, dfrA14). Acquired AmpC and other β-lactamases (DHA-1, TEM-1D, CMH-1, CMY-6, LAP-2, AmpC1) were also present. The most prevalent plasmid replicons were Col(pHAD28), IncFIB(K), and IncR, with the hypervirulent ST147-1LV isolate carrying the highest number. These findings underscore the significant public health threat posed by hypervirulent and MDR K. pneumoniae strains, highlighting the extensive burden of virulence and resistance genes that complicate treatment strategies.

Indexed as

Drug Resistance, Multiple, BacterialGenomicsKlebsiella pneumoniaeAnti-Bacterial AgentsGenome, BacterialHumansKlebsiella InfectionsMicrobial Sensitivity TestsPakistanVirulenceVirulence FactorsWhole Genome SequencingAnti-Bacterial AgentsVirulence FactorsAntimicrobial sequencingHybrid hvKp-MDRK pneumoniae. hypervirulenceResistance genesWGS

Identifiers

PMID41353259
PMCPMC12690147

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