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Purpose of Review <p>This review aims to synthesize genomic evidence on the convergence of antimicrobial resistance and hypervirulence in <i>Klebsiella pneumoniae</i>, focusing on high-risk clones, plasmid dynamics, and global epidemiology.</p> Recent Findings <p>Whole-genome sequencing studies revealed that convergence is increasingly reported but remains unevenly distributed across lineages. ST11 represents a consistent example of stable MDR–hypervirulence convergence, whereas ST15 and ST147 show more limited and context-dependent evidence. Advances in long-read sequencing highlight the role of hybrid plasmids and mobile genetic elements in these evolutionary processes. One Health studies indicate that environmental and non-clinical reservoirs contribute to persistence and dissemination of resistance determinants.</p> Summary <p>Current evidence suggests that the success of K. pneumoniae is driven by a dynamic plasmidome and open pangenome. Although MDR–hypervirulent strains remain relatively uncommon, their clinical impact is significant. Integrating genomic surveillance with epidemiological data is essential for improving risk assessment, guiding infection control strategies, and informing future therapeutic development.</p>

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Plasmid-Mediated Convergence of Antimicrobial Resistance and Hypervirulence in Klebsiella pneumoniae: a PRISMA-Informed Narrative Review of High-Risk Clones and Global Genomic Epidemiology

  • 期刊论文

  • 发表日期：

    2026年5月22日

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  • Mohamed G. Seadawy,
  • Marym Saied Abo Al-khair,
  • Sherif M. Elnagdy

摘要

Purpose of Review

This review aims to synthesize genomic evidence on the convergence of antimicrobial resistance and hypervirulence in Klebsiella pneumoniae, focusing on high-risk clones, plasmid dynamics, and global epidemiology.

Recent Findings

Whole-genome sequencing studies revealed that convergence is increasingly reported but remains unevenly distributed across lineages. ST11 represents a consistent example of stable MDR–hypervirulence convergence, whereas ST15 and ST147 show more limited and context-dependent evidence. Advances in long-read sequencing highlight the role of hybrid plasmids and mobile genetic elements in these evolutionary processes. One Health studies indicate that environmental and non-clinical reservoirs contribute to persistence and dissemination of resistance determinants.

Summary

Current evidence suggests that the success of K. pneumoniae is driven by a dynamic plasmidome and open pangenome. Although MDR–hypervirulent strains remain relatively uncommon, their clinical impact is significant. Integrating genomic surveillance with epidemiological data is essential for improving risk assessment, guiding infection control strategies, and informing future therapeutic development.