Distinct evolutionary dynamics of horizontal gene transfer in drug resistant and virulent clones ofKlebsiella pneumoniae

Abstract

Klebsiella pneumoniae ( Kp ) has emerged as an important cause of two distinct public health threats: multidrug resistant (MDR) healthcare-associated infections 1 and community-acquired invasive infections, particularly pyogenic liver abscess 2 . The majority of MDR hospital outbreaks are caused by a subset of Kp clones with a high prevalence of acquired antimicrobial resistance (AMR) genes, while the majority of community-acquired invasive infections are caused by ‘hypervirulent’ clones that rarely harbour acquired AMR genes but have high prevalence of key virulence loci 3–5 . Worryingly, the last few years have seen increasing reports of convergence of MDR and the key virulence genes withi..