Hypervirulent
Klebsiella pneumoniae
isolates have been increasingly reported worldwide
,
especially hypervirulent drug-resistant variants owing to the acquisition of a mobilizable virulence plasmid by a carbapenem-resistant strain. This pLVPK-like mobilizable plasmid encodes various virulence factors; however, information about its genetic stability is lacking. This study aimed to investigate the type II toxin-antitoxin (TA) modules that facilitate the virulence plasmid to remain stable in
K. pneumoniae
. More than 3,000 TA loci in 2,000
K. pneumoniae
plasmids were examined for their relationship with plasmid cargo genes. TA loci from the RES-Xre family were highly correlated with virulence plasmids of hypervirulent
K. pneumoniae
. Overexpression of the RES toxin KnaT, encoded by the virulence plasmid-carrying RES-Xre locus
knaAT,
halts the cell growth of
K. pneumoniae
and
E. coli
, whereas co-expression of the cognate Xre antitoxin KnaA neutralizes the toxicity of KnaT.
knaA
and
knaT
were co-transcribed, representing the characteristics of a type II TA module. The
knaAT
deletion mutation gradually lost its virulence plasmid in
K. pneumoniae,
whereas the stability of the plasmid in
E. coli
was enhanced by adding
knaAT
, which revealed that the
knaAT
operon maintained the genetic stability of the large virulence plasmid in
K. pneumoniae
. String tests and mouse lethality assays subsequently confirmed that a loss of the virulence plasmid resulted in reduced pathogenicity of
K. pneumoniae
. These findings provide important insights into the role of the RES-Xre TA pair in stabilizing virulence plasmids and disseminating virulence genes in
K. pneumonia
e.