Virulence and Resistance of Klebsiella pneumoniae, 2nd Edition

A special issue of Microorganisms (ISSN 2076-2607). This special issue belongs to the section "Medical Microbiology".

Deadline for manuscript submissions: 15 April 2025 | Viewed by 10450

Special Issue Editors


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Guest Editor
1. Faculdade de Farmacia, Universidade de Lisboa, Department of Microbiology and Immunology, Lisbon, Portugal
2. Centro de Investigação Interdisciplinar Egas Moniz (CiiEM), Instituto Universitário Egas Moniz (IUEM), Caparica, Portugal
Interests: biochemistry, environmental exposures; microbiology; antibiotics; bacterial virulence
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E-Mail Website
Guest Editor
1. Microbiology Research Laboratory in Environmental Health (EnviHealthMicro Lab), Institute of Environmental Health (ISAMB), Faculty of Medicine, University of Lisboa, 1649-026 Lisboa, Portugal
2. Institute of Preventive Medicine and Public Health (IMP&SP), University of Lisboa, 1649-026 Lisboa, Portugal
3. Microbiology and Immunology Department, Faculty of Pharmacy, University of Lisboa, 1649-033 Lisboa, Portugal
4. Centro de Investigação Interdisciplinar Egas Moniz (CiiEM), Instituto Universitário Egas Moniz (IUEM), Caparica, Portugal
Interests: klebsiella pneumoniae complex; gram-negative pathogens; enterobacteriacea; virulence factors; antimicrobial resistance; extended-spectrum β-lactamases (ESBL); carbapenemases; home care services; quality of health care; respiratory diseases; pulmonary rehabilitation; oxygen; non-invasive ventilation; sleep care; e-health
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues,

This Special Issue is the continuation of our previous special issue "Virulence and Resistance of Klebsiella pneumonia".

Klebsiella pneumoniae is an important opportunistic Gram-negative pathogen that belongs to the Enterobacteriaceae family, which is frequently associated with severe healthcare-associated infections (HAI) as well as community-acquired infections. It can cause different types of infection such as pneumonia, urinary tract infection, skin or soft tissue infection, meningitis, pyogenic liver abscess, and bacteremia potentially developing into sepsis. It is believed that the gastrointestinal tract is the most important reservoir for the transmission of K. pneumoniae. However, in contrast to many other bacterial pathogens, K. pneumoniae is ubiquitous in nature, and environmental reservoirs can also have a relevant role in human infections. Infections resulting from multidrug-resistant (MDR), extended-spectrum beta-lactamase (ESBL), and/or carbapenemase-producing K. pneumoniae strains are a challenge due to the lack of vaccines and therapeutic options. Several virulence factors, such as adherence and invasion factors, toxins, capsules, and siderophores, can be involved in the pathogenic mechanisms, namely, invasion of the host, disease induction, and the evasion of host defenses. The coexistence of antimicrobial resistance genes with other advantageous determinants such as virulence factors can have a significant impact on bacterial pathogenicity. Moreover, recent population diversity studies have shown that K. pneumoniae is in fact part of a complex of species. The aim of this Special Issue is to give an updated insight into K. pneumonia-complex resistance and virulence determinants, and the interplay of these factors. For this purpose, we welcome the submission of research articles, review articles, and short communications related to the various aspects of K. pneumonia-complex infection, with particular emphasis on antimicrobial resistance, its transmissibility, molecular pathways, the coexistence of virulence factors, biomarkers, clinical and environmental reservoirs, high-risk clones, whole genome sequencing characterization, in vivo infection models, and bacterial pathogenicity.

Dr. Aida Duarte
Dr. Cátia Caneiras
Guest Editors

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Published Papers (4 papers)

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Research

13 pages, 1421 KiB  
Article
The Association between Resistance and Virulence of Klebsiella pneumoniae in High-Risk Clonal Lineages ST86 and ST101
by Irina Pristas, Josip Ujevic, Kristian Bodulić, Natasa Andrijasevic, Branka Bedenic, Marina Payerl-Pal, Edita Susic, Karolina Dobrovic, Sien De Koster, Surbhi Malhotra-Kumar and Arjana Tambic Andrasevic
Microorganisms 2024, 12(10), 1997; https://doi.org/10.3390/microorganisms12101997 - 30 Sep 2024
Viewed by 803
Abstract
Klebsiella pneumoniae is an opportunistic pathogen known for two main pathotypes: classical K. pneumoniae (cKp), often multidrug-resistant and common in hospitals, and hypervirulent K. pneumoniae (hvKp), associated with severe community-acquired infections. The recent emergence of strains combining hypervirulence and resistance is alarming. This [...] Read more.
Klebsiella pneumoniae is an opportunistic pathogen known for two main pathotypes: classical K. pneumoniae (cKp), often multidrug-resistant and common in hospitals, and hypervirulent K. pneumoniae (hvKp), associated with severe community-acquired infections. The recent emergence of strains combining hypervirulence and resistance is alarming. This study investigates the distribution of sequence types (STs), resistance, and virulence factors in K. pneumoniae strains causing bloodstream and urinary tract infections in Croatia. In 2022, 200 consecutive K. pneumoniae isolates were collected from blood and urine samples across several Croatian hospitals. Whole genome sequencing was performed on 194 isolates. Within the analyzed K. pneumoniae population, the distribution of sequence types was determined with multi-locus sequence typing (MLST) and capsule loci, resistance, and virulence determinants were assessed with the bioinformatics tool Kleborate. The analysis identified 77 different STs, with ST101 (24.6%) being the most prevalent, predominantly linked to the K17 capsular type (CT), invasive device usage, high antimicrobial resistance, and low virulence scores. The highest virulence scores were recorded in ST86 isolates, which were predominantly linked to the K2 CT and included some strains with medium resistance scores. String tests were positive in 19 strains, but only four of those harbored hypermucoviscous genetic determinants. The most prevalent ST101 clone in Croatia demonstrated a diverging association between resistance and virulence. An alarming co-existence of resistance and virulence was recorded in the ST86 strains. Full article
(This article belongs to the Special Issue Virulence and Resistance of Klebsiella pneumoniae, 2nd Edition)
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15 pages, 1847 KiB  
Article
Clinical and Genomic Characterization of Carbapenem-Resistant Klebsiella pneumoniae with Concurrent Production of NDM and OXA-48-like Carbapenemases in Southern California, 2016–2022
by Stacey Cerón, Zackary Salem-Bango, Deisy A. Contreras, Elizabeth L. Ranson and Shangxin Yang
Microorganisms 2023, 11(7), 1717; https://doi.org/10.3390/microorganisms11071717 - 30 Jun 2023
Cited by 3 | Viewed by 2034
Abstract
The global emergence of carbapenem-resistant Klebsiella pneumoniae (CRKP) has become a critical public healthcare concern due to treatment challenges and high mortality. In recent years, there has been an increase in cases of CRKP co-producing New Delhi metallo-β-lactamases (NDM) and oxacillinase 48 (OXA-48)-like [...] Read more.
The global emergence of carbapenem-resistant Klebsiella pneumoniae (CRKP) has become a critical public healthcare concern due to treatment challenges and high mortality. In recent years, there has been an increase in cases of CRKP co-producing New Delhi metallo-β-lactamases (NDM) and oxacillinase 48 (OXA-48)-like carbapenemases in the US. The aim of this study was to correlate the clinical and genomic characteristics of CRKP co-producing NDM and OXA-48-like carbapenemases isolated from patients in Southern California since 2016. Whole-genome sequencing was performed on clinical isolates obtained from various sources, including blood, abdominal fluid, wounds, and urine. Genetic diversity was observed in these CRKP, including ST-14, ST-16, ST-167, ST-437, ST-2096, and ST-2497 lineages. Phylogenetic analysis revealed two closely related clusters (ST-14 and ST-2497), with single nucleotide polymorphism (SNP) differences ranging from 0 to 36, suggesting a possible local spread of these CRKP. Significant antimicrobial resistance (AMR) genes were identified in these CRKP, including blaNDM-1, blaNDM-5, blaOXA-232, blaOXA-181, blaCTX-M-15, armA, tet(A), and tet(D). Moreover, pColKP3-type and Inc-type plasmids known to harbor AMR genes were also detected in these isolates. Most of the patients infected with this rare type of CRKP died, although their severe comorbidities also played important roles in their demise. Our study highlighted the extremely limited treatment options and poor clinical outcomes associated with these dual-carbapenemase-producing CRKP. Real-time genomic surveillance of these unusual and deadly CRKP can provide critical information for infection prevention and treatment guidance. Full article
(This article belongs to the Special Issue Virulence and Resistance of Klebsiella pneumoniae, 2nd Edition)
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19 pages, 2723 KiB  
Article
Geno- and Phenotypic Characteristics of a Klebsiella pneumoniae ST20 Isolate with Unusual Colony Morphology
by Katharina Sydow, Elias Eger, Michael Schwabe, Stefan E. Heiden, Jürgen A. Bohnert, Sören Franzenburg, Christoph Jurischka, Peter Schierack and Katharina Schaufler
Microorganisms 2022, 10(10), 2063; https://doi.org/10.3390/microorganisms10102063 - 19 Oct 2022
Cited by 6 | Viewed by 4406
Abstract
Klebsiella pneumoniae is a common member of the intestinal flora of vertebrates. In addition to opportunistic representatives, hypervirulent (hvKp) and antibiotic-resistant K. pneumoniae (ABR-Kp) occur. While ABR-Kp isolates often cause difficult-to-treat diseases due to limited therapeutic options, hvKp is a pathotype that can [...] Read more.
Klebsiella pneumoniae is a common member of the intestinal flora of vertebrates. In addition to opportunistic representatives, hypervirulent (hvKp) and antibiotic-resistant K. pneumoniae (ABR-Kp) occur. While ABR-Kp isolates often cause difficult-to-treat diseases due to limited therapeutic options, hvKp is a pathotype that can infect healthy individuals often leading to recurrent infection. Here, we investigated the clinical K. pneumoniae isolate PBIO3459 obtained from a blood sample, which showed an unusual colony morphology. By combining whole-genome and RNA sequencing with multiple in vitro and in vivo virulence-associated assays, we aimed to define the respective Klebsiella subtype and explore the unusual phenotypic appearance. We demonstrate that PBIO3459 belongs to sequence type (ST)20 and carries no acquired resistance genes, consistent with phenotypic susceptibility tests. In addition, the isolate showed low-level virulence, both at genetic and phenotypic levels. We thus suggest that PBIO3459 is an opportunistic (commensal) K. pneumoniae isolate. Genomic comparison of PBIO3459 with closely related ABR-Kp ST20 isolates revealed that they differed only in resistance genes. Finally, the unusual colony morphology was mainly associated with carbohydrate and amino acid transport and metabolism. In conclusion, our study reveals the characteristics of a Klebsiella sepsis isolate and suggests that opportunistic representatives likely acquire and accumulate antibiotic resistances that subsequently enable their emergence as ABR-Kp pathogens. Full article
(This article belongs to the Special Issue Virulence and Resistance of Klebsiella pneumoniae, 2nd Edition)
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19 pages, 907 KiB  
Article
Hypervirulence and Multiresistance to Antibiotics in Klebsiella pneumoniae Strains Isolated from Patients with Hospital- and Community-Acquired Infections in a Mexican Medical Center
by Areli Bautista-Cerón, Eric Monroy-Pérez, Luis Rey García-Cortés, Ernesto Arturo Rojas-Jiménez, Felipe Vaca-Paniagua and Gloria Luz Paniagua-Contreras
Microorganisms 2022, 10(10), 2043; https://doi.org/10.3390/microorganisms10102043 - 16 Oct 2022
Cited by 7 | Viewed by 2008
Abstract
Klebsiella pneumoniae is a pathogenic bacterium associated with different infectious diseases. This study aimed to establish the different association profiles of virulence genes related to the hypermucoviscous phenotype (HM), capsular serotypes, biofilm formation, and multidrug resistance in K. pneumoniae strains from patients with [...] Read more.
Klebsiella pneumoniae is a pathogenic bacterium associated with different infectious diseases. This study aimed to establish the different association profiles of virulence genes related to the hypermucoviscous phenotype (HM), capsular serotypes, biofilm formation, and multidrug resistance in K. pneumoniae strains from patients with hospital- and community-acquired infections. K. pneumoniae virulence genes and capsular serotypes were identified by PCR, antibiotic susceptibility by the Kirby–Bauer method, HM by the string test, and biofilm formation by measurement in polystyrene microtiter plates. Of a total of 150 strains from patients with hospital- (n = 25) and community-acquired infections (n = 125), 53.3% (80/150) were HM-positive and 46.7% (70/150) were HM-negative. HM-positive (68/80) and HM-negative (67/70) strains were biofilm-forming. Moreover, 58.7% (47/80) HM-positive and 57.1% (40/70) HM-negative strains were multidrug-resistant. Among HM-positive, HM-negative, and serotypes K1 (25/150), K2 (48/150), and non-K1/K2 strains, (77/150) the frequently detected adhesion genes were fimH, mrkD, ycfM, and kpn; entB, irp2, irp1, and ybtS, for iron acquisition; and rmpA for protectins. The gene association pattern fimH/kpn/mrkD/ycfM/entB/irp1/irp2/ybtS/fyuA (18/150) was frequent among the strains. K. pneumoniae strains from patients with hospital- and community-acquired infections demonstrated a wide diversity of virulence gene profiles related to phenotype (hypermucoviscosity, multidrug resistance, and biofilm formation) and serotypes. Full article
(This article belongs to the Special Issue Virulence and Resistance of Klebsiella pneumoniae, 2nd Edition)
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