Correlation between antimicrobial resistance and virulence in Klebsiella pneumoniae

Eur J Clin Microbiol Infect Dis. 2016 Mar;35(3):333-41. doi: 10.1007/s10096-015-2559-7. Epub 2015 Dec 30.


Klebsiella pneumoniae is responsible for a wide range of infections, including urinary tract infections, pneumonia, bacteremia, and liver abscesses. In addition to susceptible clinical isolates involved in nosocomial infections, multidrug-resistant (MDR) and hypervirulent (hvKP) strains have evolved separately in distinct clonal groups. The rapid geographic spread of these isolates is of particular concern. However, we still know little about the virulence of K. pneumoniae except for hvKP, whose secrets are beginning to be revealed. The treatment of K. pneumoniae infections is threatened by the emergence of antimicrobial resistance. The dissemination of resistance is associated with genetic mobile elements, such as plasmids that may also carry virulence determinants. A proficient pathogen should be virulent, resistant to antibiotics, and epidemic. However, the interplay between resistance and virulence is poorly understood. Here, we review current knowledge on the topic.

Publication types

  • Review

MeSH terms

  • Anti-Infective Agents / pharmacology*
  • Anti-Infective Agents / therapeutic use
  • Bacterial Outer Membrane Proteins / genetics
  • Bacterial Outer Membrane Proteins / metabolism
  • Cephalosporinase / genetics
  • Cephalosporinase / metabolism
  • Drug Resistance, Bacterial*
  • Drug Resistance, Multiple, Bacterial / genetics
  • Gene Expression
  • Genome, Bacterial
  • Genome-Wide Association Study
  • High-Throughput Nucleotide Sequencing
  • Humans
  • Klebsiella Infections / drug therapy
  • Klebsiella Infections / microbiology*
  • Klebsiella pneumoniae / drug effects*
  • Klebsiella pneumoniae / genetics
  • Klebsiella pneumoniae / metabolism
  • Klebsiella pneumoniae / pathogenicity*
  • Plasmids / genetics
  • Virulence / genetics
  • beta-Lactam Resistance
  • beta-Lactamases / genetics
  • beta-Lactams / pharmacology
  • beta-Lactams / therapeutic use


  • Anti-Infective Agents
  • Bacterial Outer Membrane Proteins
  • beta-Lactams
  • Cephalosporinase
  • beta-Lactamases