"Superbugs" with hypervirulence and carbapenem resistance in Klebsiella pneumoniae : the rise of such emerging nosocomial pathogens in China

Copyright © 2023 Science China Press. Published by Elsevier B.V. All rights reserved..

Although hypervirulent Klebsiella pneumoniae (hvKP) can produce community-acquired infections that are fatal in young and adult hosts, such as pyogenic liver abscess, endophthalmitis, and meningitis, it has historically been susceptible to antibiotics. Carbapenem-resistant K. pneumoniae (CRKP) is usually associated with urinary tract infections acquired in hospitals, pneumonia, septicemias, and soft tissue infections. Outbreaks and quick spread of CRKP in hospitals have become a major challenge in public health due to the lack of effective antibacterial treatments. In the early stages of K. pneumoniae development, HvKP and CRKP first appear as distinct routes. However, the lines dividing the two pathotypes are vanishing currently, and the advent of carbapenem-resistant hypervirulent K. pneumoniae (CR-hvKP) is devastating as it is simultaneously multidrug-resistant, hypervirulent, and highly transmissible. Most CR-hvKP cases have been reported in Asian clinical settings, particularly in China. Typically, CR-hvKP develops when hvKP or CRKP acquires plasmids that carry either the carbapenem-resistance gene or the virulence gene. Alternatively, classic K. pneumoniae (cKP) may acquire a hybrid plasmid carrying both genes. In this review, we provide an overview of the key antimicrobial resistance mechanisms, virulence factors, clinical presentations, and outcomes associated with CR-hvKP infection. Additionally, we discuss the possible evolutionary processes and prevalence of CR-hvKP in China. Given the wide occurrence of CR-hvKP, continued surveillance and control measures of such organisms should be assigned a higher priority.

Medienart:

E-Artikel

Erscheinungsjahr:

2023

Erschienen:

2023

Enthalten in:

Zur Gesamtaufnahme - volume:68

Enthalten in:

Science bulletin - 68(2023), 21 vom: 15. Nov., Seite 2658-2670

Sprache:

Englisch

Beteiligte Personen:

Pu, Danni [VerfasserIn]
Zhao, Jiankang [VerfasserIn]
Chang, Kang [VerfasserIn]
Zhuo, Xianxia [VerfasserIn]
Cao, Bin [VerfasserIn]

Links:

Volltext

Themen:

Anti-Bacterial Agents
Carbapenem resistant
Carbapenems
Evolution
Hypervirulent
Journal Article
Klebsiella pneumonia
Nosocomial infection
Prevalence
Review

Anmerkungen:

Date Completed 14.11.2023

Date Revised 24.11.2023

published: Print-Electronic

Citation Status MEDLINE

doi:

10.1016/j.scib.2023.09.040

funding:

Förderinstitution / Projekttitel:

PPN (Katalog-ID):

NLM363143173