Molecular Epidemiology of Hypervirulent K. pneumoniae and Problems of Health-Care Associated Infections

Abstract

The review describes virulence factors of hypervirulent K. pneumoniae (hvKp) including genes determining its virulence and discusses their role in the development of health-care associated infections. The contribution of individual virulence factors and their combination to the development of the hypervirulence and the prospects of using these factors as biomarkers and therapeutic targets are described. Virulence factors of hvKp and “classical” K. pneumoniae strains (cKp) with no hypervirulence genes were compared. The mechanisms of biofilm formation by hvKp and high incidence of its antibiotic resistance are of particular importance for in health care institutions. Therefore, the development of methods for hvKp identification allowing early prevention of severe hvKp infection and novel approaches to abrogate its spreading are new challenges for epidemiology, infection diseases, and critical care medicine. New technologies including bacteriological and molecular studies make it possible to develop innovative strategies to diagnose and treat infection caused by hvKp. These include monitoring of both genetic biomarkers of hvKp and resistance plasmid that carry of virulence genes and antibiotic resistance genes, creation of immunological agents for the prevention and therapy of hvKp (vaccines, monoclonal antibodies) as well as personalized hvKp-specific phage therapies and pharmaceuticals enhancing the effect of antibiotics. A variety of approaches can reliably prepare our medicine for a new challenge: spreading of life-threatening health-care associated infections caused by antibiotic-resistant hvKp strains.

Occurrence and Molecular Study of Hypermucoviscous/Hypervirulence Trait in Gut Commensal K. pneumoniae from Healthy Subjects

“…Additionally, Nirwati et al (2019) reported that 85.63% of Kp isolates were biofilm producers, and 64.7% of these isolates were strong biofilm producers, according to a related study by Hassan et al (2011) [ 73 , 74 ]. Our data also showed no differences in the biofilm formation of hmvKp and non-hmvKp phenotypes among each strong, moderate, and weak biofilm-forming isolates; these results were consistent with clinical isolates investigated in Soto et al’s study [ 75 , 76 ].…”

Identification of hypervirulent Klebsiella pneumoniae carrying terW gene by MacConkey-potassium tellurite medium in the general population

“…In this study, most of the clinically isolated hvKPs were sensitive to commonly used clinical antibiotics, and the resistance rates were significantly lower than cKP, which was consistent with the previous studies ( 5 , 37 ). But in the past years, hvKP has become a clinical challenge in China ( 4 , 30 ), because the proportion of hvKP isolates increased from 25.5% to 54.5% within 2 years, and it resisted all testing resistant, except carbapenems and amikacin ( 32 ). Zhang et al ( 38 ) first reported the detection of carbapenem-resistant hypervirulent KP (CR-hvKP).…”