{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,3]],"date-time":"2026-10-03T19:59:07Z","timestamp":1791057547288,"version":"4.1.0"},"reference-count":56,"publisher":"American Society for Microbiology","issue":"4","license":[{"start":{"date-parts":[[2025,4,22]],"date-time":"2025-04-22T00:00:00Z","timestamp":1745280000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2025,4,22]],"date-time":"2025-04-22T00:00:00Z","timestamp":1745280000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.asm.org\/non-commercial-tdm-license"}],"funder":[{"DOI":"10.13039\/501100002920","name":"Research Grants Council, University Grants Committee","doi-asserted-by":"publisher","award":["T11-104\/22-R"],"award-info":[{"award-number":["T11-104\/22-R"]}],"id":[{"id":"10.13039\/501100002920","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100002920","name":"Research Grants Council, University Grants Committee","doi-asserted-by":"publisher","award":["R1011-23"],"award-info":[{"award-number":["R1011-23"]}],"id":[{"id":"10.13039\/501100002920","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["journals.asm.org"],"crossmark-restriction":true},"short-container-title":["mSystems"],"published-print":{"date-parts":[[2025,4,22]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n          <jats:sec>\n            <jats:title\/>\n            <jats:p>\n              Carbapenem-resistant hypervirulent\n              <jats:italic>Klebsiella pneumoniae<\/jats:italic>\n              (CR-hv\n              <jats:italic>Kp<\/jats:italic>\n              ) has led to a high mortality rate in the clinical setting and garnered significant attention in the clinical and scientific communities. It is still not clear which major mechanisms mediate the rapid evolution of hv\n              <jats:italic>Kp<\/jats:italic>\n              in clinical settings since the plasmid-encoding hypervirulence phenotype is considered non-conjugative. In this study, we revealed a conjugative plasmid, p16HN200-Vir, encoding virulence-associated\n              <jats:italic>iuc<\/jats:italic>\n              operon (\n              <jats:italic>iucABCDiutA<\/jats:italic>\n              ) and resulting in a hypervirulent phenotype.\n              <jats:italic>In silico<\/jats:italic>\n              analysis of\n              <jats:italic>Kp<\/jats:italic>\n              strains from NCBI predicted a total of 94 p16HN200-Vir-like conjugative virulence plasmids. These sequences were identified in 19 sequence types (STs) of the host with significant geographical variations in distribution across countries and continents. Notably, ST11 was predominant in China, while ST147 and ST395 were prominent in the United Kingdom and Russia, respectively. These plasmids could be categorized into seven lineages, some of which formed distinct geographical clusters in China and the UK, while others exhibited a hybrid population. Importantly, most of the plasmids carried different carbapenemases, including\n              <jats:italic>bl<\/jats:italic>\n              a\n              <jats:sub>NDM-1\/5<\/jats:sub>\n              (lineage 6 and 7), and\n              <jats:italic>bla<\/jats:italic>\n              <jats:sub>OXA-48\/232<\/jats:sub>\n              (lineage 2 and 5). Specifically, plasmids recovered from the United Kingdom and Russia were lineage-specific, with\n              <jats:italic>bla<\/jats:italic>\n              <jats:sub>NDM-1<\/jats:sub>\n              present in lineage 6 and\n              <jats:italic>bla<\/jats:italic>\n              <jats:sub>NDM-5<\/jats:sub>\n              in lineage 7. Our data suggest that this type of conjugative plasmids has spread around the world and contributed significantly to the current rapid evolution of CR-hv\n              <jats:italic>Kp<\/jats:italic>\n              in clinical settings. Further surveillance of these types of conjugative plasmids in clinical\n              <jats:italic>Kp<\/jats:italic>\n              is warranted.\n            <\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>IMPORTANCE<\/jats:title>\n            <jats:p>\n              In this study, we found that the conjugative virulence plasmids containing carbapenem resistance genes could be conjugated to\n              <jats:italic>Klebsiella<\/jats:italic>\n              strains, enabling them to express antibiotic resistance and hypervirulence-associated phenotypes simultaneously. More importantly, we observed that the global dissemination of this type of multidrug resistance and hypervirulence conjugative plasmid is lineage specific. The UMAP projection revealed that the regional variations were correlated with ST types and serotypes, which poses a global threat of the CR-hv\n              <jats:italic>Kp<\/jats:italic>\n              infection worldwide.\n            <\/jats:p>\n          <\/jats:sec>","DOI":"10.1128\/msystems.01675-24","type":"journal-article","created":{"date-parts":[[2025,3,25]],"date-time":"2025-03-25T13:52:42Z","timestamp":1742910762000},"update-policy":"https:\/\/doi.org\/10.1128\/asmj-crossmark-policy-page","source":"Crossref","is-referenced-by-count":20,"title":["Global dissemination of conjugative virulence plasmids co-harboring hypervirulence and multidrug resistance genes in\n            <i>Klebsiella pneumoniae<\/i>"],"prefix":"10.1128","volume":"10","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-8716-3096","authenticated-orcid":false,"given":"Qi","family":"Xu","sequence":"first","affiliation":[{"name":"State Key Laboratory of Chemical Biology and Drug Discovery and the Department of Food Science and Nutrition, The Hong Kong Polytechnic University","place":["Kowloon, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ruanyang","family":"Sun","sequence":"additional","affiliation":[{"name":"State Key Laboratory of Chemical Biology and Drug Discovery and the Department of Food Science and Nutrition, The Hong Kong Polytechnic University","place":["Kowloon, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4546-4573","authenticated-orcid":true,"given":"Xiaoxuan","family":"Liu","sequence":"additional","affiliation":[{"name":"State Key Laboratory of Chemical Biology and Drug Discovery and the Department of Food Science and Nutrition, The Hong Kong Polytechnic University","place":["Kowloon, China"]},{"name":"Department of Infectious Diseases and Public Health, Jockey Club College of Veterinary Medicine and Life Sciences, City University of Hong Kong","place":["Kowloon, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Heng","family":"Heng","sequence":"additional","affiliation":[{"name":"State Key Laboratory of Chemical Biology and Drug Discovery and the Department of Food Science and Nutrition, The Hong Kong Polytechnic University","place":["Kowloon, China"]},{"name":"Department of Infectious Diseases and Public Health, Jockey Club College of Veterinary Medicine and Life Sciences, City University of Hong Kong","place":["Kowloon, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xuemei","family":"Yang","sequence":"additional","affiliation":[{"name":"State Key Laboratory of Chemical Biology and Drug Discovery and the Department of Food Science and Nutrition, The Hong Kong Polytechnic University","place":["Kowloon, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Miaomiao","family":"Xie","sequence":"additional","affiliation":[{"name":"State Key Laboratory of Chemical Biology and Drug Discovery and the Department of Food Science and Nutrition, The Hong Kong Polytechnic University","place":["Kowloon, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9876-724X","authenticated-orcid":true,"given":"Chen","family":"Yang","sequence":"additional","affiliation":[{"name":"State Key Laboratory of Chemical Biology and Drug Discovery and the Department of Food Science and Nutrition, The Hong Kong Polytechnic University","place":["Kowloon, China"]},{"name":"Department of Infectious Diseases and Public Health, Jockey Club College of Veterinary Medicine and Life Sciences, City University of Hong Kong","place":["Kowloon, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lianwei","family":"Ye","sequence":"additional","affiliation":[{"name":"State Key Laboratory of Chemical Biology and Drug Discovery and the Department of Food Science and Nutrition, The Hong Kong Polytechnic University","place":["Kowloon, China"]},{"name":"Department of Infectious Diseases and Public Health, Jockey Club College of Veterinary Medicine and Life Sciences, City University of Hong Kong","place":["Kowloon, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Edward Wai-Chi","family":"Chan","sequence":"additional","affiliation":[{"name":"State Key Laboratory of Chemical Biology and Drug Discovery and the Department of Food Science and Nutrition, The Hong Kong Polytechnic University","place":["Kowloon, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2174-7985","authenticated-orcid":true,"given":"Rong","family":"Zhang","sequence":"additional","affiliation":[{"name":"Department of Clinical Laboratory, School of Medicine, Second Affiliated Hospital of Zhejiang University","place":["Hangzhou, 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