Abstract
Hypervirulent Klebsiella pneumoniae (hvKP) has raised grave concerns in recent years and can cause severe infections with diverse anatomic locations including liver abscess, meningitis, and endophthalmitis. However, there is limited data about neck abscess caused by hvKP. A K. pneumoniae strain Kp_whw was isolated from neck abscess. We characterized the genetic background, virulence determinates of the strain by genomic analysis and dertermined the virulence level by serum resistance assay. Kp_whw belonged to sequence type (ST) 1049 K locus (KL) 5. Kp_whw showed hypermucoviscosity phenotype and was resistant to ampicillin but susceptible to the majority of the other antimicrobial agents. A pLVPK-like virulence plasmid and a chromosomal ICEKp5-like mobile genetic element were carried by Kp_whw, resulting in the risk of dissemination of hypervirulence. The strain exhibited relative higher level of core genome allelic diversity than accessory genome profile, in comparison to hvKP of K1/K2 serotype. Kp_whw was finally demonstrated as virulent as the ST23 K1 serotype hvKP strain NTUH-K2044 in vitro. In conclusion, this work elaborates the genetic background of a clinical hvKP strain with an uncommon ST, reinforcing our understanding of virulence mechanisms of hvKP.
Highlights
Hypervirulent Klebsiella pneumoniae has raised grave concerns in recent years due to its extraordinary invasiveness and hypervirulence, resulting in considerable risks for morbidity and mortality (Shon et al, 2013)
We described a Hypervirulent Klebsiella pneumoniae (hvKP) strain of ST1049, which was rarely reported, causing neck abscess, and invasive infection. hvKP is usually characterized as hypermucoviscosity, positive for regulator of mucoid phenotype A (rmpA), aerobactin, or virulence plasmid, and these features are frequently used to define hvKP
Clinical definition of hvKP based on the invasive liver abscess syndrome hvKP Associated With Neck Abscess and microbiological definition of K1/K2 serotype have been accepted in recent years (Siu et al, 2012)
Summary
Hypervirulent Klebsiella pneumoniae (hvKP) has raised grave concerns in recent years due to its extraordinary invasiveness and hypervirulence, resulting in considerable risks for morbidity and mortality (Shon et al, 2013). Asia is the epidemic area for hvKP. K1/K2 accounted for 9.8% of all K. pneumoniae isolates in stools from healthy Chinese individuals in Asia countries (Lin et al, 2012). HvKP has been increasingly reported in other continents. The mortality of hvKP infections ranged from 29.2 to 55.1% (Lin Y.T. et al, 2010; Rafat et al, 2018; Namikawa et al, 2019). HvKp infection is often manifested as liver abscess (Liu et al, 1986; Siu et al, 2012; Joob and Wiwanitkit, 2017) The mortality of hvKP infections ranged from 29.2 to 55.1% (Lin Y.T. et al, 2010; Rafat et al, 2018; Namikawa et al, 2019). hvKp infection is often manifested as liver abscess (Liu et al, 1986; Siu et al, 2012; Joob and Wiwanitkit, 2017)
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