Hypervirulent Klebsiella pneumoniae – clinical and molecular perspectives

Hypervirulent Klebsiella pneumoniae (hvKp) has emerged as a concerning global pathogen. hvKp is more virulent than classical K. pneumoniae (cKp) and capable of causing community‐acquired infections, often in healthy individuals. hvKp is carried in the gastrointestinal tract, which contributes to its...

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Vydané v:Journal of internal medicine Ročník 287; číslo 3; s. 283 - 300
Hlavní autori: Choby, J. E., Howard‐Anderson, J., Weiss, D. S.
Médium: Journal Article
Jazyk:English
Vydavateľské údaje: England Blackwell Publishing Ltd 01.03.2020
Predmet:
Abscesses
Anti-Bacterial Agents - pharmacology
Bacteremia
Biomarkers
capsule
Central nervous system
Clinical isolates
Community-Acquired Infections - epidemiology
Drug resistance
Drug Resistance, Bacterial
Gastrointestinal system
Gastrointestinal tract
Humans
hypermucoviscous
hypervirulent
Infections
Klebsiella
Klebsiella Infections - drug therapy
Klebsiella Infections - epidemiology
Klebsiella Infections - microbiology
Klebsiella pneumonia
Klebsiella pneumoniae
Klebsiella pneumoniae - drug effects
Klebsiella pneumoniae - pathogenicity
Liver
liver abscess
Pathogens
Plasmids
Pneumonia
siderophores
Soft tissues
Toxins
Virulence
Klebsiella pneumonia
capsule
liver abscess
hypermucoviscous
siderophores
hypervirulent
ISSN:0954-6820, 1365-2796, 1365-2796
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Shrnutí:Hypervirulent Klebsiella pneumoniae (hvKp) has emerged as a concerning global pathogen. hvKp is more virulent than classical K. pneumoniae (cKp) and capable of causing community‐acquired infections, often in healthy individuals. hvKp is carried in the gastrointestinal tract, which contributes to its spread in the community and healthcare settings. First recognized in Asia, hvKp arose as a leading cause of pyogenic liver abscesses. In the decades since, hvKp has spread globally and causes a variety of infections. In addition to liver abscesses, hvKp is distinct from cKp in its ability to metastasize to distant sites, including most commonly the eye, lung and central nervous system (CNS). hvKp has also been implicated in primary extrahepatic infections including bacteremia, pneumonia and soft tissue infections. The genetic determinants of hypervirulence are often found on large virulence plasmids as well as chromosomal mobile genetic elements which can be used as biomarkers to distinguish hvKp from cKp clinical isolates. These distinct virulence determinants of hvKp include up to four siderophore systems for iron acquisition, increased capsule production, K1 and K2 capsule types, and the colibactin toxin. Additionally, hvKp strains demonstrate hypermucoviscosity, a phenotypic description of hvKp in laboratory conditions that has become a distinguishing feature of many hypervirulent isolates. Alarmingly, multidrug‐resistant hypervirulent strains have emerged, creating a new challenge in combating this already dangerous pathogen.
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ISSN:0954-6820
1365-2796
1365-2796
DOI:10.1111/joim.13007