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Peer-reviewedCC BY 4.0IJID Regions

Clinical and molecular profile of Klebsiella pneumoniae bloodstream infections in a national referral hospital in the Philippines

  • Christian Francisco1,2
  • Angelo dela Tonga1
  • Stessi Marie Geganzo1
  • Joana Marie Gantuangco2
  • Jonnel Poblete2
  • Ia Marie Cruz2
  • Bryan Santiago2
  • Janet S. Lee3
  • Tatsunori Oyabu4
  • Masahiro Suzuki4
  • Sohei Harada5
  • Yohei Doi4,6
6 affiliations
  1. 1National Institutes of Health-University of the Philippines Manila, 623 Pedro Gil St. Ermita, Manila, 1000, Philippines
  2. 2Philippine General Hospital, Taft Ave, Ermita, Manila, 1000, Philippines
  3. 3Washington University in St. Louis, 660 S. Euclid Ave, St. Louis, MO, 63110, USA
  4. 4Fujita Health University, 1-98 Dengakugakubo, Kutsukake-cho, Toyoake, Aichi, 470-1192, Japan
  5. 5Toho University, 5 Chome 21-16 Omorinisihi, Ota City, Tokyo, 143-8540, Japan
  6. 6University of Pittsburgh, 4200 Fifth Ave., Pittsburgh, PA, 15260, USA
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Abstract

Objectives: Klebsiella pneumoniae (Kp) bloodstream infections (BSIs) are a major concern in the Philippines, but local clinical and molecular epidemiologic data are limited.

Methods: We conducted a cross-sectional study at a government hospital in Manila from April 2023 to January 2024, analyzing clinical data with whole genome sequencing of 39 cases.

Results: Most patients were male (mean age 53 years) and had diabetes or malignancy. The in-hospital mortality rate was 38.5%. Extended-spectrum β-lactamase and carbapenemase genes were identified in 41.0% and 33.3% of isolates, respectively, predominantly blaCTX-M-15, blaNDM, and blaKPC. The most frequent sequence type was ST437, followed by ST23, ST101, and ST17. Hypervirulence genes (rmpA/A2, iuc, and iro) were detected in 25.6% of isolates, defining 10 hypervirulent Kp (hvKp) strains, including one carbapenem-resistant hvKp strain carrying blaNDM-7. Compared with classic Kp infections, hvKp infections resulted in higher rates of septic shock and infection-attributable mortality despite having lower multidrug resistance.

Conclusion: These findings underscore the high mortality risk from Kp BSIs, driven by antimicrobial resistance and hypervirulence. The detection of hvKp and carbapenem-resistant hvKp is testament to the global spread of this critical priority pathogen.

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Cite

BibTeXRIS
BibTeX
@article{francisco2026clinical,
  title = {{Clinical and molecular profile of Klebsiella pneumoniae bloodstream infections in a national referral hospital in the Philippines}},
  author = {Christian Francisco and Angelo dela Tonga and Stessi Marie Geganzo and Joana Marie Gantuangco and Jonnel Poblete and Ia Marie Cruz and Bryan Santiago and Janet S. Lee and Tatsunori Oyabu and Masahiro Suzuki and Sohei Harada and Yohei Doi},
  journal = {IJID Regions},
  year = {2026},
  month = oct,
  doi = {10.1016/j.ijregi.2026.101039},
  url = {https://doi.org/10.1016/j.ijregi.2026.101039},
  note = {CC BY 4.0},
}
RIS
TY  - JOUR
TI  - Clinical and molecular profile of Klebsiella pneumoniae bloodstream infections in a national referral hospital in the Philippines
AU  - Christian Francisco
AU  - Angelo dela Tonga
AU  - Stessi Marie Geganzo
AU  - Joana Marie Gantuangco
AU  - Jonnel Poblete
AU  - Ia Marie Cruz
AU  - Bryan Santiago
AU  - Janet S. Lee
AU  - Tatsunori Oyabu
AU  - Masahiro Suzuki
AU  - Sohei Harada
AU  - Yohei Doi
PY  - 2026
DA  - 2026/10/15
JO  - IJID Regions
DO  - 10.1016/j.ijregi.2026.101039
UR  - https://doi.org/10.1016/j.ijregi.2026.101039
AB  - Objectives: Klebsiella pneumoniae (Kp) bloodstream infections (BSIs) are a major concern in the Philippines, but local clinical and molecular epidemiologic data are limited.  Methods: We conducted a cross-sectional study at a government hospital in Manila from April 2023 to January 2024, analyzing clinical data with whole genome sequencing of 39 cases.  Results: Most patients were male (mean age 53 years) and had diabetes or malignancy. The in-hospital mortality rate was 38.5%. Extended-spectrum β-lactamase and carbapenemase genes were identified in 41.0% and 33.3% of isolates, respectively, predominantly blaCTX-M-15, blaNDM, and blaKPC. The most frequent sequence type was ST437, followed by ST23, ST101, and ST17. Hypervirulence genes (rmpA/A2, iuc, and iro) were detected in 25.6% of isolates, defining 10 hypervirulent Kp (hvKp) strains, including one carbapenem-resistant hvKp strain carrying blaNDM-7. Compared with classic Kp infections, hvKp infections resulted in higher rates of septic shock and infection-attributable mortality despite having lower multidrug resistance.  Conclusion: These findings underscore the high mortality risk from Kp BSIs, driven by antimicrobial resistance and hypervirulence. The detection of hvKp and carbapenem-resistant hvKp is testament to the global spread of this critical priority pathogen.
SN  - 2772-7076
ER  -