GBD 2019 Antimicrobial Resistance Collaborators. Global mortality associated with 33 bacterial pathogens in 2019: a systematic analysis for the Global Burden of Disease Study 2019. Lancet. 2022;400:2221–48. DOIPubMedGoogle Scholar
Russo TA, Marr CM. Hypervirulent Klebsiella pneumoniae. Clin Microbiol Rev. 2019;32:e00001–00019. DOIPubMedGoogle Scholar
World Health Organization. Antimicrobial resistance, hypervirulent Klebsiella pneumoniae—global situation. 2024 Jul 31 [cited 2024 Aug 3]. https://www.who.int/emergencies/disease-outbreak-news/item/2024-DON527
European Centre for Disease Prevention and Control. Rapid risk assessment—emergence of hypervirulent Klebsiella pneumoniae ST23 carrying carbapenemase genes in EU/EEA countries—first update. 2024 Feb 14 [cited 2026 Mar 13]. https://www.ecdc.europa.eu/en/publications-data/risk-assessment-emergence-hypervirulent-Klebsiella-pneumoniae-eu-eea
Russo TA, Olson R, Fang CT, Stoesser N, Miller M, MacDonald U, et al. Identification of biomarkers for differentiation of hypervirulent Klebsiella pneumoniae from classical K. pneumoniae. J Clin Microbiol. 2018;56:e00776–18. DOIPubMedGoogle Scholar
Russo TA, Alvarado CL, Davies CJ, Drayer ZJ, Carlino-MacDonald U, Hutson A, et al. Differentiation of hypervirulent and classical Klebsiella pneumoniae with acquired drug resistance. MBio. 2024;15:e0286723. DOIPubMedGoogle Scholar
Russo TA, Lebreton F, McGann PT. A step forward in hypervirulent Klebsiella pneumoniae diagnostics. Emerg Infect Dis. 2025;31:1–3. DOIPubMedGoogle Scholar
Roach DJ, Sridhar S, Oliver E, Rao SR, Slater DM, Hwang W, et al. Clinical and genomic characterization of a cohort of patients with Klebsiella pneumoniae bloodstream infection. Clin Infect Dis. 2024;78:31–9. DOIPubMedGoogle Scholar
Fostervold A, Raffelsberger N, Hetland MAK, Bakksjø R, Bernhoff E, Samuelsen Ø, et al. Assoc. on behalf of The Norwegian Study Group on Klebsiella pneumoniae. Risk of death in Klebsiella pneumoniae bloodstream infections is associated with specific phylogenetic lineages. J Infect. 2024;88:106155. DOIPubMedGoogle Scholar
Harada S, Aoki K, Yamamoto S, Ishii Y, Sekiya N, Kurai H, et al. Clinical and molecular characteristics of Klebsiella pneumoniae isolates causing bloodstream infections in Japan: occurrence of hypervirulent infections in health care. J Clin Microbiol. 2019;57:e01206–19. DOIPubMedGoogle Scholar
Barrios-Camacho H, Silva-Sánchez J, Cercas-Ayala E, Lozano-Aguirre L, Duran-Bedolla J, Aguilar-Vera A, et al. PCR system for the correct differentiation of the main bacterial species of the Klebsiella pneumoniae complex. Arch Microbiol. 2022;204:73. DOIPubMedGoogle Scholar
Clinical and Laboratory Standards Institute. Performance standards for antimicrobial susceptibility testing, 34th edition (M100-S34). Wayne (PA): The Institute; 2024.
Magiorakos AP, Srinivasan A, Carey RB, Carmeli Y, Falagas ME, Giske CG, et al. Multidrug-resistant, extensively drug-resistant and pandrug-resistant bacteria: an international expert proposal for interim standard definitions for acquired resistance. Clin Microbiol Infect. 2012;18:268–81. DOIPubMedGoogle Scholar
Charlson ME, Pompei P, Ales KL, MacKenzie CR. A new method of classifying prognostic comorbidity in longitudinal studies: development and validation. J Chronic Dis. 1987;40:373–83. DOIPubMedGoogle Scholar
Wick RR, Judd LM, Gorrie CL, Holt KE. Unicycler: Resolving bacterial genome assemblies from short and long sequencing reads. PLOS Comput Biol. 2017;13:e1005595. DOIPubMedGoogle Scholar
Gurevich A, Saveliev V, Vyahhi N, Tesler G. QUAST: quality assessment tool for genome assemblies. Bioinformatics. 2013;29:1072–5. DOIPubMedGoogle Scholar
Chklovski A, Parks DH, Woodcroft BJ, Tyson GW. CheckM2: a rapid, scalable and accurate tool for assessing microbial genome quality using machine learning. Nat Methods. 2023;20:1203–12. DOIPubMedGoogle Scholar
Argimón S, David S, Underwood A, Abrudan M, Wheeler NE, Kekre M, et al.; NIHR Global Health Research Unit on Genomic Surveillance of Antimicrobial Resistance. Rapid genomic characterization and global surveillance of Klebsiella using Pathogenwatch. Clin Infect Dis. 2021;73:S325–35. DOIPubMedGoogle Scholar
Lam MMC, Wick RR, Watts SC, Cerdeira LT, Wyres KL, Holt KE. A genomic surveillance framework and genotyping tool for Klebsiella pneumoniae and its related species complex. Nat Commun. 2021;12:4188. DOIPubMedGoogle Scholar
Feldgarden M, Brover V, Gonzalez-Escalona N, Frye JG, Haendiges J, Haft DH, et al. AMRFinderPlus and the Reference Gene Catalog facilitate examination of the genomic links among antimicrobial resistance, stress response, and virulence. Sci Rep. 2021;11:12728. DOIPubMedGoogle Scholar
Croucher NJ, Page AJ, Connor TR, Delaney AJ, Keane JA, Bentley SD, et al. Rapid phylogenetic analysis of large samples of recombinant bacterial whole genome sequences using Gubbins. Nucleic Acids Res. 2015;43:e15. DOIPubMedGoogle Scholar
Wong TKF, Ly-Trong N, Ren H, Demotte P, Baños H, Rojer AJ, et al. IQ-TREE 3: phylogenomic inference software using complex evolutionary models. Mol Biol Evol. 2026;43:msag117. DOIPubMedGoogle Scholar
Kanda Y. Investigation of the freely available easy-to-use software ‘EZR’ for medical statistics. Bone Marrow Transplant. 2013;48:452–8. DOIPubMedGoogle Scholar
Firth D. Bias reduction of maximum likelihood estimates. Biometrika. 1993;80:27–38. DOIGoogle Scholar
Kochan TJ, Nozick SH, Medernach RL, Cheung BH, Gatesy SWM, Lebrun-Corbin M, et al. Genomic surveillance for multidrug-resistant or hypervirulent Klebsiella pneumoniae among United States bloodstream isolates. BMC Infect Dis. 2022;22:603. DOIPubMedGoogle Scholar
Tang Y, Du P, Du C, Yang P, Shen N, Russo TA, et al. Genomically defined hypervirulent Klebsiella pneumoniae contributed to early-onset increased mortality. Nat Commun. 2025;16:2096. DOIPubMedGoogle Scholar
Yu F, Lv J, Niu S, Du H, Tang YW, Pitout JDD, et al. Multiplex PCR analysis for rapid detection of Klebsiella pneumoniae carbapenem-resistant (sequence type 258 [ST258] and ST11) and hypervirulent (ST23, ST65, ST86, and ST375) strains. J Clin Microbiol. 2018;56:e00731–18. DOIPubMedGoogle Scholar
Jiang J, Long T, Porter AR, Lovey A, Lee A, Jacob JT, et al. Carbapenem-resistant, virulence plasmid–harboring Klebsiella pneumoniae, United States. Emerg Infect Dis. 2025;31:761–71. DOIPubMedGoogle Scholar






