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PERSPECTIVE article
Front. Microbiol.
Sec. Infectious Agents and Disease
Volume 16 - 2025 |
doi: 10.3389/fmicb.2025.1535893
This article is part of the Research Topic Bacterial Pathogens and Virulence Factor Genes: Diversity and Evolution View all 14 articles
Prevalence of Hypervirulent Klebsiella pneumoniae Strains in COVID-19 Patients with Bacterial Co-infections
Provisionally accepted- 1 Shanxi Medical University, Taiyuan, China
- 2 First Hospital of Shanxi Medical University, Taiyuan, Shaanxi, China
Objective: A recent alarming report from the World Health Organization highlighted the rapid global spread of a hypervirulent, carbapenem-resistant strain of Klebsiella pneumoniae. The COVID-19 pandemic frequently led to bacterial co-infections, with K. pneumoniae being a common and highly pathogenic agent. This study aimed to assess KP characteristics via whole-genome sequencing and clarify its molecular epidemiology to guide standardized clinical treatment. Methods: Our retrospective analysis of clinical data from COVID-19 patients admitted to our hospital between December 7, 2022, and January 2, 2023-following China's policies changes, which led to a significant influx of patients-identified 17 K. pneumoniae isolates from sputum samples with bacterial co-infections. These isolates underwent whole-genome sequencing for ST typing, virulence gene annotation, plasmid profiling, and antimicrobial susceptibility testing. Results: Of the 17 K. pneumoniae isolates, 52.9% were hypermucoviscous. Whole genome sequencing identified eight sequence types (STs), with ST23/KL1 being the most prevalent at 35.3%. Virulence genes were present in 94.1% of strains, including Yersiniabactin (70.6%), Aerobactin (82.3%), and Salmochelin (88.2%). Plasmid analysis revealed common IncHI1B/FIBk or IncFIBk types. All isolates were highly sensitive to antibiotics, except for blaSHV resistance. The 17 patients had a median age of 71 years and significant comorbidities, such as hypertension (64.7%) and diabetes (41.2%). Conclusion: The ST types and virulence gene profiles indicate that most K. pneumoniae strains co-infecting COVID-19 patients are common, high-virulence strains prevalent in the Asia-Pacific region. Our findings suggest that COVID-19 may contribute to the spread of hypervirulent K. pneumoniae strains, potentially informing the ongoing WHO epidemic alert.
Keywords: hypervirulent Klebsiella pneumoniae, COVID-19, Bacterial co-infections, sequence type, virulence factor
Received: 28 Nov 2024; Accepted: 27 Jan 2025.
Copyright: © 2025 Zhang, Li, Liu, Fan, Shi and Yu. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence:
Yiwei Shi, First Hospital of Shanxi Medical University, Taiyuan, 030001, Shaanxi, China
Xiao Yu, First Hospital of Shanxi Medical University, Taiyuan, 030001, Shaanxi, China
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