Klebsiella pneumoniae clinical isolates with features of both multidrug-resistance and hypervirulence have unexpectedly low virulence

• Published in: Nature communications Vol. 14; no. 1; p. 7962
• Main Authors: Kochan, Travis J., Nozick, Sophia H., Valdes, Aliki, Mitra, Sumitra D., Cheung, Bettina H., Lebrun-Corbin, Marine, Medernach, Rachel L., Vessely, Madeleine B., Mills, Jori O., Axline, Christopher M. R., Nelson, Julia A., VanGosen, Ethan M., Ward, Timothy J., Ozer, Egon A., van Duin, David, Chen, Liang, Kreiswirth, Barry N., Long, S. Wesley, Musser, James M., Bulman, Zackery P., Wunderink, Richard G., Hauser, Alan R.
• Format: Journal Article
• Language: English
• Published: London Nature Publishing Group UK 02.12.2023; Nature Publishing Group; Nature Portfolio
• Subjects: 45/23; 631/326/107; 631/326/1320; 631/326/22/1434; 631/326/41/2529; 64/60; Aerobactin; Antibiotic resistance; Antibiotics; Antimicrobial resistance; Biosynthesis; Clinical isolates; Convergence; Drug resistance; Humanities and Social Sciences; Klebsiella; Klebsiella pneumoniae; multidisciplinary; Multidrug resistance; Multidrug resistant organisms; Nosocomial infection; Nosocomial infections; Pathogenicity; Pathogens; Phenotypes; Plasmids; Pneumonia; Public health; Science; Science (multidisciplinary); Siderophores; Virulence; United States > US
• ISSN: 2041-1723; 2041-1723
• DOI: 10.1038/s41467-023-43802-1

Klebsiella pneumoniae has been classified into two types, classical K. pneumoniae (cKP) and hypervirulent K. pneumoniae (hvKP). cKP isolates are highly diverse and important causes of nosocomial infections; they include globally disseminated antibiotic-resistant clones. hvKP isolates are sensitive to most antibiotics but are highly virulent, causing community-acquired infections in healthy individuals. The virulence phenotype of hvKP is associated with pathogenicity loci responsible for siderophore and hypermucoid capsule production. Recently, convergent strains of K. pneumoniae , which possess features of both cKP and hvKP, have emerged and are cause of much concern. Here, we screen the genomes of 2,608 multidrug-resistant K. pneumoniae isolates from the United States and identify 47 convergent isolates. We perform phenotypic and genomic characterization of 12 representative isolates. These 12 convergent isolates contain a variety of antimicrobial resistance plasmids and virulence plasmids. Most convergent isolates contain aerobactin biosynthesis genes and produce more siderophores than cKP isolates but not more capsule. Unexpectedly, only 1 of the 12 tested convergent isolates has a level of virulence consistent with hvKP isolates in a murine pneumonia model. These findings suggest that additional studies should be performed to clarify whether convergent strains are indeed more virulent than cKP in mouse and human infections. Convergent strains, those containing characteristics of both multidrug-resistant & hypervirulent Klebsiella pneumoniae , are a global threat to public health. In this work, authors analyse convergent isolates from the United States and reveal unexpectantly low virulence.