Identification of a hypervirulent extensively drug-resistant ST383 Klebsiella pneumoniae sub-lineage carrying ICEKp5 in Lebanon
- 1Biological Sciences, Lebanese American University, Byblos, Lebanon
- 2Biological Sciences, Lebanese American University, Beirut, Lebanon
- 3Department of Pathology and Laboratory Medicine, Faculty of Medicine, American University of Beirut Medical Center, Beirut, Lebanon
Abstract
Klebsiella pneumoniae ST383 has emerged as a high-risk clone, characterized by carbapenem resistance and increasing detection of hypervirulence determinants. We describe a phylogenetically distinct ST383 sub-lineage in Lebanon, defined by the acquisition of ICEKp5, which carries the yersiniabactin locus. Three ST383 K. pneumoniae clinical isolates (LBN_CAKp91, LBN_CTKp3, and LBN_CTKp11) recovered from a Lebanese medical center were subjected to whole-genome sequencing. Comparative genomic analysis included regional ST383 strains and previously characterized Lebanese isolates. The study isolates formed a tight, monophyletic cluster (three to nine single-nucleotide polymorphisms [SNPs]) that is phylogenetically distinct from the previously reported Lebanese ST383 clone (>164 SNPs) and grouped most closely to an Egyptian ST383 strain (59–65 SNPs). All three isolates carried ICEKp5 with yersiniabactin lineage ybt14, a feature absent in the earlier Lebanese ST383 clone. The isolates were the only ST383 strains to harbor the full spectrum of hypervirulence determinants to date, including capsule regulators (rmpA and rmpA2), aerobactin (iucABCD and iutA), yersiniabactin, and the hypervirulence biomarker peg-344. All isolates carried dual carbapenemases (blaOXA-48 and blaNDM-5) in addition to blaCTX-M-15 and blaCTX-M-14b. The genetic environments of blaOXA-48 and blaNDM-5 were highly conserved across geographically diverse ST383 isolates, indicating common plasmid origins. This study describes a phylogenetically distinct hypervirulent extensively drug-resistant (XDR) ST383 K. pneumoniae sub-lineage in Lebanon. The acquisition of ICEKp5, combined with plasmid-borne hypervirulence and resistance determinants, reveals the concerning convergence of hypervirulence and XDR. Enhanced surveillance and infection control measures are urgently needed to monitor this emerging high-risk clone.
Related
- L-histidine metabolic reprogramming is associated with imipenem-relebactam resistance in carbapenem-resistant hypervirulent Klebsiella pneumoniae
- Prevalence, mortality, risk factors, and treatment of carbapenem-resistant hypervirulent Klebsiella pneumoniae: an evidence map
- Hypervirulent Klebsiella pneumoniae Infections in Vancouver, Canada: A Clinical, Microbiological, and Genetic Retrospective Investigation
- Five-Biomarker Definition for Hypervirulent Klebsiella pneumoniae Bloodstream Infection and Abscess Complications, Japan, 2022–2024
- ISKpn28 transposition and genomic alterations in λ-Red recombinants of hypervirulent Klebsiella pneumoniae: Whole-genome sequencing and phenotypic analysis
BibTeX
@article{abboud2026identification,
title = {{Identification of a hypervirulent extensively drug-resistant ST383 Klebsiella pneumoniae sub-lineage carrying ICEKp5 in Lebanon}},
author = {Martine Abboud and Tia Clara Chaaya and Yara Daccache and Nour El Alam and Theresa Gerges and Lea Haddad and Leon Kassabian and Jame Tannous and Yara Ghanem and Judy Nabbout and Kevin Chaar and Toni Nmeir and Anthony Haddad and Charbel Al Khoury and George F. Araj and Sima Tokajian},
journal = {Antimicrobial Agents and Chemotherapy},
year = {2026},
month = aug,
doi = {10.1128/aac.00384-26},
url = {https://doi.org/10.1128/aac.00384-26},
note = {CC BY 4.0},
}
RIS
TY - JOUR
TI - Identification of a hypervirulent extensively drug-resistant ST383 Klebsiella pneumoniae sub-lineage carrying ICEKp5 in Lebanon
AU - Martine Abboud
AU - Tia Clara Chaaya
AU - Yara Daccache
AU - Nour El Alam
AU - Theresa Gerges
AU - Lea Haddad
AU - Leon Kassabian
AU - Jame Tannous
AU - Yara Ghanem
AU - Judy Nabbout
AU - Kevin Chaar
AU - Toni Nmeir
AU - Anthony Haddad
AU - Charbel Al Khoury
AU - George F. Araj
AU - Sima Tokajian
PY - 2026
DA - 2026/08/05
JO - Antimicrobial Agents and Chemotherapy
DO - 10.1128/aac.00384-26
UR - https://doi.org/10.1128/aac.00384-26
AB - Klebsiella pneumoniae ST383 has emerged as a high-risk clone, characterized by carbapenem resistance and increasing detection of hypervirulence determinants. We describe a phylogenetically distinct ST383 sub-lineage in Lebanon, defined by the acquisition of ICEKp5, which carries the yersiniabactin locus. Three ST383 K. pneumoniae clinical isolates (LBN_CAKp91, LBN_CTKp3, and LBN_CTKp11) recovered from a Lebanese medical center were subjected to whole-genome sequencing. Comparative genomic analysis included regional ST383 strains and previously characterized Lebanese isolates. The study isolates formed a tight, monophyletic cluster (three to nine single-nucleotide polymorphisms [SNPs]) that is phylogenetically distinct from the previously reported Lebanese ST383 clone (>164 SNPs) and grouped most closely to an Egyptian ST383 strain (59–65 SNPs). All three isolates carried ICEKp5 with yersiniabactin lineage ybt14, a feature absent in the earlier Lebanese ST383 clone. The isolates were the only ST383 strains to harbor the full spectrum of hypervirulence determinants to date, including capsule regulators (rmpA and rmpA2), aerobactin (iucABCD and iutA), yersiniabactin, and the hypervirulence biomarker peg-344. All isolates carried dual carbapenemases (blaOXA-48 and blaNDM-5) in addition to blaCTX-M-15 and blaCTX-M-14b. The genetic environments of blaOXA-48 and blaNDM-5 were highly conserved across geographically diverse ST383 isolates, indicating common plasmid origins. This study describes a phylogenetically distinct hypervirulent extensively drug-resistant (XDR) ST383 K. pneumoniae sub-lineage in Lebanon. The acquisition of ICEKp5, combined with plasmid-borne hypervirulence and resistance determinants, reveals the concerning convergence of hypervirulence and XDR. Enhanced surveillance and infection control measures are urgently needed to monitor this emerging high-risk clone.
SN - 0066-4804
SN - 1098-6596
ER -