Convergence of carbapenem-resistance and hypervirulence in Klebsiella pneumoniae

Klebsiella pneumoniae, first described in 1882, remains a common cause of community-acquired and hospital-acquired infections; but strikingly, the past three decades have witnessed the emergence of two largely non-overlapping K pneumoniae populations: one multidrug resistant (MDR) and one hypervirulent. These strains belong primarily to a few major clonal groups (CGs), such as the K pneumoniae carbapenemase (KPC)-producing CG258 strains, which cause about 50% mortality in high-risk patients admitted to hospitals; and CG23 strains, which are associated with community-acquired pyogenic liver abscess. A worrisome concern is that the virulence and resistance could converge, producing strains that are able to cause severe and untreatable invasive infections. 1 Shon AS Russo TA Hypervirulent Klebsiella pneumoniae: the next superbug?. Future Microbiol. 2012; 7: 669-671 Crossref PubMed Scopus (73) Google Scholar , 2 Holt KE Wertheim H Zadoks RN et al. Genomic analysis of diversity, population structure, virulence, and antimicrobial resistance in Klebsiella pneumoniae, an urgent threat to public health. Proc Natl Acad Sci U S A. 2015; 112: E3574-E3581 Crossref PubMed Scopus (632) Google Scholar A fatal outbreak of ST11 carbapenem-resistant hypervirulent Klebsiella pneumoniae in a Chinese hospital: a molecular epidemiological studyThe ST11 carbapenem-resistant hypervirulent K pneumoniae strains pose a substantial threat to human health because they are simultaneously hypervirulent, multidrug resistant, and highly transmissible. Control measures should be implemented to prevent further dissemination of such organisms in the hospital setting and the community. Full-Text PDF