Hypervirulent Klebsiella pneumoniae have better clinical outcomes than classical Klebsiella pneumoniae for lower respiratory tract infection patients
Abstract Background The clinical outcomes and microbiological features of lower respiratory tract infections (LRTIs) caused by hypervirulent Klebsiella pneumoniae (hvKp) and classical Klebsiella pneumoniae (cKp) have not been well understood. Methods This study collected 287 non-repetitive Klebsiell...
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2025-01-01
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| Online Access: | https://doi.org/10.1186/s12866-024-03726-2 |
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| author | Xianxia Zhuo Zichen Lei Danni Pu Yongli Wu Jiankang Zhao Bin Cao |
| author_facet | Xianxia Zhuo Zichen Lei Danni Pu Yongli Wu Jiankang Zhao Bin Cao |
| author_sort | Xianxia Zhuo |
| collection | DOAJ |
| description | Abstract Background The clinical outcomes and microbiological features of lower respiratory tract infections (LRTIs) caused by hypervirulent Klebsiella pneumoniae (hvKp) and classical Klebsiella pneumoniae (cKp) have not been well understood. Methods This study collected 287 non-repetitive Klebsiella pneumoniae isolates from 287 LRTI patients. All these strains underwent annotation for resistance and virulence factors, with 141 strains undergoing mouse infection experiments to assess their virulence. The primary clinical outcomes of these patients were evaluated, including intensive care unit (ICU) admission and in-hospital mortality rates. Results A total of 46 capsule serotypes were identified. Among these isolates subjected to mouse infection experiments, the proportions of strains exhibiting hypervirulent phenotypes were 92.6% (25/27), 92.1% (35/38), 80% (4/5), 25% (1/4), 10.5% (2/19), and 7.1% (1/14) for K2, K1, K20, K54, K47, and K25, respectively. Therefore, K1, K2, and K20 K. pneumoniae were defined as hvKp. In addition, the rates of ICU admission and in-hospital mortality for hvKp-infected patients were significantly lower than those of cKp-infected patients (51.4% vs. 65.9%, χ2 = 4.722, p = 0.03 and 8.6% vs. 29%, χ2 = 12.133, p < 0.001). Notably, among the cKp group, the cKp-ST11 subgroup had higher rates of ICU admission (77% vs. 58.5%, χ2 = 7.981, p = 0.005) and in-hospital mortality (44.8% vs. 18.5%, χ2 = 17.585, p < 0.001) than cKp-nonST11 subgroup. Conclusions These findings suggest that capsule serotype is a more accurate factor for the prediction of the virulence phenotype, while hvKp have better clinical outcomes than cKp for LRTI patients. Furthermore, the cKp-ST11 subgroup has the worst prognosis than cKp-nonST11 subgroup. |
| format | Article |
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| institution | Kabale University |
| issn | 1471-2180 |
| language | English |
| publishDate | 2025-01-01 |
| publisher | BMC |
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| series | BMC Microbiology |
| spelling | doaj-art-7d6798fd9ccf4a3a9147624c3e815a032025-01-26T12:18:00ZengBMCBMC Microbiology1471-21802025-01-0125111110.1186/s12866-024-03726-2Hypervirulent Klebsiella pneumoniae have better clinical outcomes than classical Klebsiella pneumoniae for lower respiratory tract infection patientsXianxia Zhuo0Zichen Lei1Danni Pu2Yongli Wu3Jiankang Zhao4Bin Cao5Department of Respiratory Medicine, Capital Medical UniversityNational Center for Respiratory Medicine; State Key Laboratory of Respiratory Health and Multimorbidity; National Clinical Research Center for Respiratory Diseases; Institute of Respiratory Medicine, Chinese Academy of Medical Sciences; Department of Pulmonary and Critical Care Medicine, Center of Respiratory Medicine, China-Japan Friendship HospitalNational Center for Respiratory Medicine; State Key Laboratory of Respiratory Health and Multimorbidity; National Clinical Research Center for Respiratory Diseases; Institute of Respiratory Medicine, Chinese Academy of Medical Sciences; Department of Pulmonary and Critical Care Medicine, Center of Respiratory Medicine, China-Japan Friendship HospitalNational Center for Respiratory Medicine; State Key Laboratory of Respiratory Health and Multimorbidity; National Clinical Research Center for Respiratory Diseases; Institute of Respiratory Medicine, Chinese Academy of Medical Sciences; Department of Pulmonary and Critical Care Medicine, Center of Respiratory Medicine, China-Japan Friendship HospitalNational Center for Respiratory Medicine; State Key Laboratory of Respiratory Health and Multimorbidity; National Clinical Research Center for Respiratory Diseases; Institute of Respiratory Medicine, Chinese Academy of Medical Sciences; Department of Pulmonary and Critical Care Medicine, Center of Respiratory Medicine, China-Japan Friendship HospitalDepartment of Respiratory Medicine, Capital Medical UniversityAbstract Background The clinical outcomes and microbiological features of lower respiratory tract infections (LRTIs) caused by hypervirulent Klebsiella pneumoniae (hvKp) and classical Klebsiella pneumoniae (cKp) have not been well understood. Methods This study collected 287 non-repetitive Klebsiella pneumoniae isolates from 287 LRTI patients. All these strains underwent annotation for resistance and virulence factors, with 141 strains undergoing mouse infection experiments to assess their virulence. The primary clinical outcomes of these patients were evaluated, including intensive care unit (ICU) admission and in-hospital mortality rates. Results A total of 46 capsule serotypes were identified. Among these isolates subjected to mouse infection experiments, the proportions of strains exhibiting hypervirulent phenotypes were 92.6% (25/27), 92.1% (35/38), 80% (4/5), 25% (1/4), 10.5% (2/19), and 7.1% (1/14) for K2, K1, K20, K54, K47, and K25, respectively. Therefore, K1, K2, and K20 K. pneumoniae were defined as hvKp. In addition, the rates of ICU admission and in-hospital mortality for hvKp-infected patients were significantly lower than those of cKp-infected patients (51.4% vs. 65.9%, χ2 = 4.722, p = 0.03 and 8.6% vs. 29%, χ2 = 12.133, p < 0.001). Notably, among the cKp group, the cKp-ST11 subgroup had higher rates of ICU admission (77% vs. 58.5%, χ2 = 7.981, p = 0.005) and in-hospital mortality (44.8% vs. 18.5%, χ2 = 17.585, p < 0.001) than cKp-nonST11 subgroup. Conclusions These findings suggest that capsule serotype is a more accurate factor for the prediction of the virulence phenotype, while hvKp have better clinical outcomes than cKp for LRTI patients. Furthermore, the cKp-ST11 subgroup has the worst prognosis than cKp-nonST11 subgroup.https://doi.org/10.1186/s12866-024-03726-2Hypervirulent K. pneumoniaeLower respiratory tract infectionsClinical outcomesCapsule serotypesST11 |
| spellingShingle | Xianxia Zhuo Zichen Lei Danni Pu Yongli Wu Jiankang Zhao Bin Cao Hypervirulent Klebsiella pneumoniae have better clinical outcomes than classical Klebsiella pneumoniae for lower respiratory tract infection patients BMC Microbiology Hypervirulent K. pneumoniae Lower respiratory tract infections Clinical outcomes Capsule serotypes ST11 |
| title | Hypervirulent Klebsiella pneumoniae have better clinical outcomes than classical Klebsiella pneumoniae for lower respiratory tract infection patients |
| title_full | Hypervirulent Klebsiella pneumoniae have better clinical outcomes than classical Klebsiella pneumoniae for lower respiratory tract infection patients |
| title_fullStr | Hypervirulent Klebsiella pneumoniae have better clinical outcomes than classical Klebsiella pneumoniae for lower respiratory tract infection patients |
| title_full_unstemmed | Hypervirulent Klebsiella pneumoniae have better clinical outcomes than classical Klebsiella pneumoniae for lower respiratory tract infection patients |
| title_short | Hypervirulent Klebsiella pneumoniae have better clinical outcomes than classical Klebsiella pneumoniae for lower respiratory tract infection patients |
| title_sort | hypervirulent klebsiella pneumoniae have better clinical outcomes than classical klebsiella pneumoniae for lower respiratory tract infection patients |
| topic | Hypervirulent K. pneumoniae Lower respiratory tract infections Clinical outcomes Capsule serotypes ST11 |
| url | https://doi.org/10.1186/s12866-024-03726-2 |
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