Understanding carbapenem-resistant hypervirulent Klebsiella pneumoniae: Key virulence factors and evolutionary convergence
The emergence of hypervirulence (hv) and carbapenem resistance (CR) as distinct evolutionary directions for Klebsiella pneumoniae presents a significant threat in clinical settings. However, in recent years, there has been a growing identification of K. pneumoniae strains that integrate both phenoty...
Saved in:
| Main Authors: | , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Elsevier
2024-12-01
|
| Series: | hLife |
| Subjects: | |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S2949928324000543 |
| Tags: |
Add Tag
No Tags, Be the first to tag this record!
|
| _version_ | 1846111755756896256 |
|---|---|
| author | Tao Chen Liya Ying Luying Xiong Xueting Wang Ping Lu Yuan Wang Ping Shen Yonghong Xiao |
| author_facet | Tao Chen Liya Ying Luying Xiong Xueting Wang Ping Lu Yuan Wang Ping Shen Yonghong Xiao |
| author_sort | Tao Chen |
| collection | DOAJ |
| description | The emergence of hypervirulence (hv) and carbapenem resistance (CR) as distinct evolutionary directions for Klebsiella pneumoniae presents a significant threat in clinical settings. However, in recent years, there has been a growing identification of K. pneumoniae strains that integrate both phenotypes, resulting in severe clinical outcomes. Carbapenem-resistant hypervirulent K. pneumoniae (CRhvKP) typically emerges through the acquisition of plasmids carrying either virulence or CR-encoded genes by carbapenem-resistant K. pneumoniae or hypervirulent K. pneumoniae. Furthermore, the acquisition of a hybrid plasmid can confer a combination of CR and hv. CRhvKP can cause a variety of infections, including pneumonia, urinary tract infections, bloodstream infections, liver abscesses, and other related conditions. While the sequence type 11 (ST11) dominates the majority of CRhvKP strains in China, the molecular factors responsible for the success of ST11 CRhvKP largely remain unknown. Here, we provide an overview of the current understanding of the variation and distribution of crucial virulence determinants, the mechanisms driving the merging of hv and CR, and the potential molecular factors influencing the epidemiological success of ST11 CRhvKP. This research aims to contribute to a comprehensive understanding of the complexities surrounding CRhvKP. It is imperative to underscore the development of combination therapies, precision medicine, and vaccine strategies as pivotal approaches in effectively combating CRhvKP. Considering the widespread prevalence of CRhvKP, a prioritized, multifaceted approach encompassing infection control, active surveillance, and the development of innovative therapeutics is essential. |
| format | Article |
| id | doaj-art-506c2bd7c05f4103a9580d4eb9f8b4d6 |
| institution | Kabale University |
| issn | 2949-9283 |
| language | English |
| publishDate | 2024-12-01 |
| publisher | Elsevier |
| record_format | Article |
| series | hLife |
| spelling | doaj-art-506c2bd7c05f4103a9580d4eb9f8b4d62024-12-23T04:19:48ZengElsevierhLife2949-92832024-12-01212611624Understanding carbapenem-resistant hypervirulent Klebsiella pneumoniae: Key virulence factors and evolutionary convergenceTao Chen0Liya Ying1Luying Xiong2Xueting Wang3Ping Lu4Yuan Wang5Ping Shen6Yonghong Xiao7State Key Laboratory for Diagnosis and Treatment of Infectious Diseases, National Clinical Research Center for Infectious Diseases, Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, the First Affiliated Hospital, Zhejiang University School of Medicine, Zhejiang, ChinaHangzhou Stomatological Hospital, Zhejiang, ChinaState Key Laboratory for Diagnosis and Treatment of Infectious Diseases, National Clinical Research Center for Infectious Diseases, Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, the First Affiliated Hospital, Zhejiang University School of Medicine, Zhejiang, ChinaState Key Laboratory for Diagnosis and Treatment of Infectious Diseases, National Clinical Research Center for Infectious Diseases, Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, the First Affiliated Hospital, Zhejiang University School of Medicine, Zhejiang, ChinaState Key Laboratory for Diagnosis and Treatment of Infectious Diseases, National Clinical Research Center for Infectious Diseases, Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, the First Affiliated Hospital, Zhejiang University School of Medicine, Zhejiang, ChinaState Key Laboratory for Diagnosis and Treatment of Infectious Diseases, National Clinical Research Center for Infectious Diseases, Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, the First Affiliated Hospital, Zhejiang University School of Medicine, Zhejiang, ChinaState Key Laboratory for Diagnosis and Treatment of Infectious Diseases, National Clinical Research Center for Infectious Diseases, Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, the First Affiliated Hospital, Zhejiang University School of Medicine, Zhejiang, China; Jinan Microecological Biomedicine Shandong Laboratory, Shandong, ChinaState Key Laboratory for Diagnosis and Treatment of Infectious Diseases, National Clinical Research Center for Infectious Diseases, Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, the First Affiliated Hospital, Zhejiang University School of Medicine, Zhejiang, China; Jinan Microecological Biomedicine Shandong Laboratory, Shandong, China; Correspondence:The emergence of hypervirulence (hv) and carbapenem resistance (CR) as distinct evolutionary directions for Klebsiella pneumoniae presents a significant threat in clinical settings. However, in recent years, there has been a growing identification of K. pneumoniae strains that integrate both phenotypes, resulting in severe clinical outcomes. Carbapenem-resistant hypervirulent K. pneumoniae (CRhvKP) typically emerges through the acquisition of plasmids carrying either virulence or CR-encoded genes by carbapenem-resistant K. pneumoniae or hypervirulent K. pneumoniae. Furthermore, the acquisition of a hybrid plasmid can confer a combination of CR and hv. CRhvKP can cause a variety of infections, including pneumonia, urinary tract infections, bloodstream infections, liver abscesses, and other related conditions. While the sequence type 11 (ST11) dominates the majority of CRhvKP strains in China, the molecular factors responsible for the success of ST11 CRhvKP largely remain unknown. Here, we provide an overview of the current understanding of the variation and distribution of crucial virulence determinants, the mechanisms driving the merging of hv and CR, and the potential molecular factors influencing the epidemiological success of ST11 CRhvKP. This research aims to contribute to a comprehensive understanding of the complexities surrounding CRhvKP. It is imperative to underscore the development of combination therapies, precision medicine, and vaccine strategies as pivotal approaches in effectively combating CRhvKP. Considering the widespread prevalence of CRhvKP, a prioritized, multifaceted approach encompassing infection control, active surveillance, and the development of innovative therapeutics is essential.http://www.sciencedirect.com/science/article/pii/S2949928324000543Klebsiella pneumoniaecarbapenem-resistancehypervirulencevirulence factorsevolutiongenome |
| spellingShingle | Tao Chen Liya Ying Luying Xiong Xueting Wang Ping Lu Yuan Wang Ping Shen Yonghong Xiao Understanding carbapenem-resistant hypervirulent Klebsiella pneumoniae: Key virulence factors and evolutionary convergence hLife Klebsiella pneumoniae carbapenem-resistance hypervirulence virulence factors evolution genome |
| title | Understanding carbapenem-resistant hypervirulent Klebsiella pneumoniae: Key virulence factors and evolutionary convergence |
| title_full | Understanding carbapenem-resistant hypervirulent Klebsiella pneumoniae: Key virulence factors and evolutionary convergence |
| title_fullStr | Understanding carbapenem-resistant hypervirulent Klebsiella pneumoniae: Key virulence factors and evolutionary convergence |
| title_full_unstemmed | Understanding carbapenem-resistant hypervirulent Klebsiella pneumoniae: Key virulence factors and evolutionary convergence |
| title_short | Understanding carbapenem-resistant hypervirulent Klebsiella pneumoniae: Key virulence factors and evolutionary convergence |
| title_sort | understanding carbapenem resistant hypervirulent klebsiella pneumoniae key virulence factors and evolutionary convergence |
| topic | Klebsiella pneumoniae carbapenem-resistance hypervirulence virulence factors evolution genome |
| url | http://www.sciencedirect.com/science/article/pii/S2949928324000543 |
| work_keys_str_mv | AT taochen understandingcarbapenemresistanthypervirulentklebsiellapneumoniaekeyvirulencefactorsandevolutionaryconvergence AT liyaying understandingcarbapenemresistanthypervirulentklebsiellapneumoniaekeyvirulencefactorsandevolutionaryconvergence AT luyingxiong understandingcarbapenemresistanthypervirulentklebsiellapneumoniaekeyvirulencefactorsandevolutionaryconvergence AT xuetingwang understandingcarbapenemresistanthypervirulentklebsiellapneumoniaekeyvirulencefactorsandevolutionaryconvergence AT pinglu understandingcarbapenemresistanthypervirulentklebsiellapneumoniaekeyvirulencefactorsandevolutionaryconvergence AT yuanwang understandingcarbapenemresistanthypervirulentklebsiellapneumoniaekeyvirulencefactorsandevolutionaryconvergence AT pingshen understandingcarbapenemresistanthypervirulentklebsiellapneumoniaekeyvirulencefactorsandevolutionaryconvergence AT yonghongxiao understandingcarbapenemresistanthypervirulentklebsiellapneumoniaekeyvirulencefactorsandevolutionaryconvergence |