SynthesisInfection2026
Definitional ambiguity and the dual threat of Hypervirulent Klebsiella pneumoniae infections: a systematic review and meta-analysis.
Synthesis in Infection, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.
What it found
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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.
The trial behind it
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Who cites it
4 citing papers in PubMed.
- Comparative genomics of carbapenem resistance and virulence associated with respiratory tract and bloodstream infections in carbapenem-resistantVirulence · 2026Article
- Rifampicin as an antivirulence adjunct in hypervirulent/hypermucoviscous Klebsiella pneumoniae infections: a scoping review.BMC infectious diseases · 2026Article
- Co-evolution of resistance and virulence inFrontiers in cellular and infection microbiology · 2026Review
- O2a O-antigen type and sepsis in invasiveFrontiers in cellular and infection microbiology · 2026Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
9 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundHypervirulent Klebsiella pneumoniae (HvKp) causes severe invasive infections, but the lack of a standardized definition complicates surveillance. The emergence of carbapenem-resistant HvKp (CR-HvKp) poses a "dual-risk" threat whose impact is poorly quantified. This meta-analysis aimed to determine pooled proportions of severe outcomes stratified by diagnostic criteria and quantify the mortality risk associated with CR-HvKp.
methodsFollowing PRISMA guidelines, we systematically searched five databases for studies published up to July 2025 reporting clinical outcomes of HvKp infection. A random-effects model was used to calculate pooled proportions of liver abscess, metastatic spread, septic shock, microbiological failure and mortality, with subgroup analyses by HvKp definition (phenotypic, molecular, combined, or clinical). Odds ratios (OR) for mortality in CR-HvKp versus carbapenem-susceptible (CS)-HvKp were pooled.
resultsFrom 4413 records, 79 studies involving 4240 patients were included. The pooled proportion of liver abscess was 24% (95% CI 17-32%) and metastatic spread was 22% (95% CI 12-32%), both significantly influenced by the diagnostic criteria used (p < 0.0001). Pooled mortality for HvKp was 21% (95% CI 15-27%). In stark contrast, pooled mortality for CR-HvKp was 57% (95% CI 35-78%). The frequency of microbiological failure among HvKp infected patients was reported to be 39%. A meta-analysis of six studies revealed CR-HvKp infection was associated with over 12-fold higher odds of death compared to CS-HvKp infection.
conclusionHvKp continues to cause severe invasive infections, though outcome estimates vary due to inconsistent definitions. Mortality increases markedly when carbapenem resistance co-exists with virulence, indicating that poor outcomes are driven by both pathogenic and resistance mechanisms. Standardized diagnostic criteria and expanded genomic surveillance are essential to improve epidemiological comparability and guide early detection and containment of high-risk HvKp strains.
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