Klebsiella pneumoniae: A major worldwide source and shuttle for antibiotic resistance

Shiri Navon-Venezia, Kira Kondratyeva, Alessandra Carattoli

Research output: Contribution to journalReview articlepeer-review

Abstract

Klebsiella pneumoniae is an important multidrug-resistant (MDR) pathogen affecting humans and a major source for hospital infections associated with high morbidity and mortality due to limited treatment options. We summarize the wide resistome of this pathogen, which encompasses plentiful chromosomal and plasmid-encoded antibiotic resistance genes (ARGs). Under antibiotic selective pressure, K. pneumoniae continuously accumulates ARGs, by de novo mutations, and via acquisition of plasmids and transferable genetic elements, leading to extremely drug resistant (XDR) strains harboring a 'super resistome'. In the last two decades, numerous high-risk (HiR) MDR and XDR K. pneumoniae sequence types have emerged showing superior ability to cause multicontinent outbreaks, and continuous global dissemination. The data highlight the complex evolution of MDR and XDR K. pneumoniae, involving transfer and spread of ARGs, and epidemic plasmids in highly disseminating successful clones. With the worldwide catastrophe of antibiotic resistance and the urgent need to identify the main pathogens that pose a threat on the future of infectious diseases, further studies are warranted to determine the epidemic traits and plasmid acquisition in K. pneumoniae. There is a need for future genomic and translational studies to decipher specific targets in HiR clones to design targeted prevention and treatment.

Original languageEnglish
Pages (from-to)252-275
Number of pages24
JournalFEMS Microbiology Reviews
Volume41
Issue number3
DOIs
Publication statusPublished - May 1 2017

Keywords

  • Antibiotic resistance
  • Epidemic plasmids
  • Extremely drug resistant (XDR)
  • High-risk clones
  • Mobile genetic elements (MGEs)
  • Resistome

ASJC Scopus subject areas

  • Microbiology
  • Infectious Diseases

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