A Step Forward in Hypervirulent Klebsiella pneumoniae Diagnostics

Hypervirulent Klebsiella pneumoniae (hvKp) can cause life-threatening infections in healthy community members. HvKp infections often involve multiple sites, some of which are unusual for classical K. pneumoniae (cKp) infections, such as the central nervous system, eyes, and fascia. The acquisition of antimicrobial resistance by hvKp has resulted in concerns of an emerging superbug. This concern is magnified by increasing geographic dissemination and healthcare associated infections. Currently, diagnostic testing to differentiate hvKp from cKp is lacking, causing challenges for clinical care, surveillance, and research. Although imperfect, the detection of all 5 of the biomarkers iucA, iroB, peg-344, rmpA, and rmpA2 is the most accurate and pragmatic means to identify hvKp. We propose a working definition for hvKp that will enhance accuracy for diagnosis and surveillance, which will aid in preventing the spread of hvKp.