AUTHOR=Tang Miran , Kong Xin , Hao Jingchen , Liu Jinbo 

TITLE=Epidemiological Characteristics and Formation Mechanisms of Multidrug-Resistant Hypervirulent Klebsiella pneumoniae

JOURNAL=Frontiers in Microbiology

VOLUME=11

YEAR=2020

URL=https://www.frontiersin.org/journals/microbiology/articles/10.3389/fmicb.2020.581543

DOI=10.3389/fmicb.2020.581543

ISSN=1664-302X

ABSTRACT=<p>Multi-drug resistance (MDR) and hypervirulence (hv) were exhibited by different well-separated <italic>Klebsiella pneumoniae</italic> lineages in the past, but their convergence clones—MDR-hypervirulent <italic>K. pneumoniae</italic> (HvKPs)—both highly pathogenic and resistant to most available antibiotics, have increasingly been reported. In light of the clonal lineages and molecular characteristics of the studied MDR-HvKP strains found in the literature since 2014, this review discusses the epidemiology of MDR-HvKPs, in particular summarizing the three general aspects of plasmids-associated mechanisms underlying the formation of MDR-HvKPs clones: MDR-classic <italic>K. pneumoniae</italic> (cKPs) acquiring hv plasmids, hvKPs obtaining MDR plasmids, and the acquisition of hybrid plasmids harboring virulence and resistance determinants. A deeper understanding of epidemiological characteristics and possible formation mechanisms of MDR-HvKPs is greatly needed for the proper surveillance and management of this potential threat.</p>