Current Management Strategies for Hypervirulent Klebsiella

Abi Manesh S

doi:10.1016/j.idc.2025.11.005

Current Management Strategies for Hypervirulent Klebsiella

Infect Dis Clin North Am. 2025 Dec 22:S0891-5520(25)00099-6. doi: 10.1016/j.idc.2025.11.005. Online ahead of print.

Author

Abi Manesh S¹

Affiliation

¹ Department of Infectious Diseases, Christian Medical College, Vellore, 632004, India; Saw Swee Hock Schooll of Public Health, National University of Singapore, Tahir Foundation Building, 12 Science Drive 2, #10-01, 117549, Singapore. Electronic address: abimanesh@gmail.com.

PMID: 41436293
DOI: 10.1016/j.idc.2025.11.005

Abstract

Hypervirulent Klebsiella pneumoniae (HvKp) is a highly invasive pathotype causing severe, community-acquired infections, unlike nosocomial classic K pneumoniae. First reported in 1986, HvKp is linked to liver abscess, bacteremia, and endophthalmitis, driven by K1/K2 polysaccharide capsule, hypermucoviscous capsule production and siderophores. It colonizes the gut, with high prevalence in the Asia-Pacific, but is emerging globally, including in Europe and the United States. The convergence of hypervirulence and multidrug resistance, notably carbapenem resistance, limits treatment options, prompting a World Health Organization alert in 2024. Management includes source control (percutaneous drainage) and antibiotics. Evidence-based treatment strategies are urgently needed.

Keywords: Convergence in hypervirulence; Hypervirulent Klebsiella; Metastatic infections; Virulence plasmid.

Publication types

Review