Evidence map›Paper›PMID 41507221›Full record

ArticleNature communications2026

Genomic dissection of the clonal background and global dissemination of hypervirulent Klebsiella pneumoniae CG23-KL57 lineage.

Shuangshuang Li, Yawen Yu, Siqi Liu, Menglu Zhang, Guoli Li, Qian Tong, Qingyang Sun, Huiqiong Jia, Zhiyu Wang, Yingying Kong and 6 more

Abstract read
In one paragraph

Article in Nature communications, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing 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

3 citing papers in PubMed.

  1. Article
  2. Article
  3. Characterization and pathogenic mechanisms of aFrontiers in microbiology · 2026
    Article
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

16 authors.

Shuangshuang Li *Department of Clinical Laboratory, Key Laboratory of Precision Medicine in Diagnosis and Monitoring Research of Zhejiang Province, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou, China.
Yawen Yu *Department of Clinical Laboratory, Key Laboratory of Precision Medicine in Diagnosis and Monitoring Research of Zhejiang Province, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou, China.
Siqi Liu *Shanghai Institute of Immunity and Infection of the Chinese Academy of Sciences, Shanghai, China.ORCID http://orcid.org/0009-0007-0916-3956
Menglu Zhang *Henan Province Hypertension Precision Prevention and Control Engineering Research Center, Henan Provincial People's Hospital, Zhengzhou University People's Hospital, Zhengzhou, Henan, China.
Guoli Li *Department of Clinical Laboratory, Key Laboratory of Precision Medicine in Diagnosis and Monitoring Research of Zhejiang Province, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou, China.
Qian TongLaboratory Medicine Center, Department of Transfusion Medicine, Zhejiang Provincial People's Hospital, Affiliated People's Hospital, Hangzhou Medical College, Hangzhou, Zhejiang, China.
Qingyang SunDepartment of Clinical Laboratory, No. 903 Hospital of PLA Joint Logistic Support Force, Hangzhou, China.
Huiqiong JiaDepartment of Laboratory Medicine, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China.
Zhiyu WangDepartment of Clinical Laboratory, Key Laboratory of Precision Medicine in Diagnosis and Monitoring Research of Zhejiang Province, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou, China.
Yingying KongDepartment of Clinical Laboratory, Key Laboratory of Precision Medicine in Diagnosis and Monitoring Research of Zhejiang Province, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou, China.
Yingying ZhangDepartment of Clinical Laboratory, Key Laboratory of Precision Medicine in Diagnosis and Monitoring Research of Zhejiang Province, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou, China.
João Pedro Rueda FurlanPaulista School of Medicine, Federal University of São Paulo, São Paulo, Brazil.ORCID http://orcid.org/0000-0003-2516-1129
Mohamed S DrazDepartment of Medicine, Case Western Reserve University School of Medicine, Cleveland, OH, USA.
Ning DongDepartment of Emergency Medicine, Second Affiliated Hospital, School of Public Health, The Key Laboratory of Intelligent Preventive Medicine of Zhejiang Province, Zhejiang University School of Medicine, Hangzhou, China. ningdong@zju.edu.cn.ORCID http://orcid.org/0000-0001-6515-4201
Yongchang XuZhejiang Key Laboratory of Medical Epigenetics, Department of Immunology and Pathogen Biology, School of Basic Medical Sciences, Hangzhou Normal University, Hangzhou, China. xuyc@zju.edu.cn.ORCID http://orcid.org/0000-0001-9554-7102
Zhi RuanDepartment of Clinical Laboratory, Key Laboratory of Precision Medicine in Diagnosis and Monitoring Research of Zhejiang Province, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou, China. r_z@zju.edu.cn.ORCID http://orcid.org/0000-0001-8648-4592

Funding

National Natural Science Foundation of China (National Science Foundation of China) 32300156National Natural Science Foundation of China (National Science Foundation of China) 82472335National Natural Science Foundation of China (National Science Foundation of China) 82572580Natural Science Foundation of Zhejiang Province (Zhejiang Provincial Natural Science Foundation) LR23H200001
6 · The paper itself

Abstract

The emergence of multidrug-resistant and hypervirulent Klebsiella pneumoniae represents a growing threat to global public health. Here we investigate the genomic epidemiology and evolutionary dynamics of emerging K. pneumoniae clonal group 23 (CG23) lineages, with a particular focus on ST218-KL57 (predominantly found in Asia) and ST23-KL57 (circulating in Europe) to understand how genomic recombination and adaptive evolution drive the convergence of hypervirulence and multidrug resistance in CG23. We analyzed 3,118 clinical isolates from China together with 75,954 publicly available genomes, encompassing 122 ST218-KL57 and 45 ST23-KL57 isolates; 13 ST218-KL57 isolates were newly sequenced. Phylogenetic analyses revealed that ST23-KL57 forms a distinct subclade within CG23, more closely related to ST218-KL57 than to the classical ST23-KL1 linage. Neither ST218-KL57 nor ST23-KL57 harbors the chromosomal virulence loci (GIE492 and all island), which are characteristic of hypervirulent ST23-KL1. ST23-KL57 simultaneously harbors dual carbapenemases and key virulence genes (peg-344, iucA, rmpADC, and rmpA2), reflecting its hybrid origin of approximately 80% Asian hypervirulent ST218-KL57 and 20% European multidrug-resistant ST395 linage. The genomic decay of the iroBCDN operon in ST23-KL57 suggests an adaptive trade-off between antimicrobial resistance and virulence. These findings underscore the importance of enhanced genomic surveillance and refined risk assessment for the evolving CG23-KL57 lineage.

Indexed as

Genome, BacterialKlebsiella InfectionsKlebsiella pneumoniaeBacterial ProteinsChinaDrug Resistance, Multiple, BacterialGenomicsHumansPhylogenyVirulenceBacterial Proteins

Identifiers

PMID41507221
PMCPMC12887077

What OpenQuestion holds

Textmetadata
LicenceCC BY-NC-ND
Read underepoch 390

Registered trials

None linked

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.