Five-Biomarker Definition for Hypervirulent Klebsiella pneumoniae Bloodstream Infection and Abscess Complications, Japan, 2022–2024
Abstract
Hypervirulent Klebsiella pneumoniae (hvKp) is an emerging cause of invasive infection, but clinical relevance of a 5-biomarker genotypic definition remains unclear. We analyzed 207 episodes of K. pneumoniae bloodstream infection at a tertiary hospital in Japan during 2022–2024. We defined hvKp by PCR detection of all 5 biomarkers: rmpA, rmpA2, iucA, iroB, and peg-344. Overall, hvKp accounted for 14% (28/207) of episodes. Abscess complications occurred in 61% (17/28) of hvKp episodes and 13% (23/179) of classical K. pneumoniae episodes. hvKp case-patients had longer median hospitalization (28 vs. 14 days) and duration of antimicrobial drug treatment (43 vs. 14 days) than those with classical K. pneumoniae. Most (9/10) sequence type 23 hvKp episodes involved abscesses. Short-read whole-genome sequencing detected CTX-M–type extended-spectrum β-lactamase genes in 11% (3/28) of hvKp isolates, representing 1.4% (3/207) of all K. pneumoniae episodes. The 5-biomarker definition delineated a clinically distinct subgroup, demonstrating its value for genomic surveillance of emerging hvKp.
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BibTeX
@article{watanabe2026fivebiomarker,
title = {{Five-Biomarker Definition for Hypervirulent Klebsiella pneumoniae Bloodstream Infection and Abscess Complications, Japan, 2022–2024}},
author = {Naoki Watanabe and Tomohisa Watari and Yoshihito Otsuka and Tomoh Matsumiya},
journal = {Emerging Infectious Diseases},
year = {2026},
month = oct,
doi = {10.3201/eid3211.260825},
url = {https://doi.org/10.3201/eid3211.260825},
note = {CC BY 4.0},
}
RIS
TY - JOUR
TI - Five-Biomarker Definition for Hypervirulent Klebsiella pneumoniae Bloodstream Infection and Abscess Complications, Japan, 2022–2024
AU - Naoki Watanabe
AU - Tomohisa Watari
AU - Yoshihito Otsuka
AU - Tomoh Matsumiya
PY - 2026
DA - 2026/10/30
JO - Emerging Infectious Diseases
DO - 10.3201/eid3211.260825
UR - https://doi.org/10.3201/eid3211.260825
AB - Hypervirulent Klebsiella pneumoniae (hvKp) is an emerging cause of invasive infection, but clinical relevance of a 5-biomarker genotypic definition remains unclear. We analyzed 207 episodes of K. pneumoniae bloodstream infection at a tertiary hospital in Japan during 2022–2024. We defined hvKp by PCR detection of all 5 biomarkers: rmpA, rmpA2, iucA, iroB, and peg-344. Overall, hvKp accounted for 14% (28/207) of episodes. Abscess complications occurred in 61% (17/28) of hvKp episodes and 13% (23/179) of classical K. pneumoniae episodes. hvKp case-patients had longer median hospitalization (28 vs. 14 days) and duration of antimicrobial drug treatment (43 vs. 14 days) than those with classical K. pneumoniae. Most (9/10) sequence type 23 hvKp episodes involved abscesses. Short-read whole-genome sequencing detected CTX-M–type extended-spectrum β-lactamase genes in 11% (3/28) of hvKp isolates, representing 1.4% (3/207) of all K. pneumoniae episodes. The 5-biomarker definition delineated a clinically distinct subgroup, demonstrating its value for genomic surveillance of emerging hvKp.
SN - 1080-6040
SN - 1080-6059
ER -