{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,20]],"date-time":"2026-10-20T15:40:38Z","timestamp":1792510838087,"version":"4.5.0"},"reference-count":29,"publisher":"American Society for Microbiology","issue":"10","license":[{"start":{"date-parts":[[2026,10,6]],"date-time":"2026-10-06T00:00:00Z","timestamp":1791244800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,10,6]],"date-time":"2026-10-06T00:00:00Z","timestamp":1791244800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.asm.org\/non-commercial-tdm-license"}],"funder":[{"DOI":"10.13039\/100009619","name":"Japan Agency for Medical Research and Development","doi-asserted-by":"publisher","award":["25jm0210101h0004"],"award-info":[{"award-number":["25jm0210101h0004"]}],"id":[{"id":"10.13039\/100009619","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["journals.asm.org"],"crossmark-restriction":true},"short-container-title":["Microbiol Spectr"],"published-print":{"date-parts":[[2026,10,6]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title\/>\n                    <jats:p>\n                      Phenotypic identification of hypervirulent\n                      <jats:italic toggle=\"yes\">Klebsiella pneumoniae<\/jats:italic>\n                      in routine laboratories remains challenging. We evaluated tellurite resistance and selected carbohydrate fermentation tests as phenotypic tools for screening hypervirulent strains and improving lineage identification. A total of 193\n                      <jats:italic toggle=\"yes\">K. pneumoniae<\/jats:italic>\n                      species complex strains with available whole-genome sequencing data were analyzed, including\n                      <jats:italic toggle=\"yes\">K. pneumoniae<\/jats:italic>\n                      (\n                      <jats:italic toggle=\"yes\">n<\/jats:italic>\n                      = 152),\n                      <jats:italic toggle=\"yes\">K. variicola<\/jats:italic>\n                      (\n                      <jats:italic toggle=\"yes\">n<\/jats:italic>\n                      = 29), and\n                      <jats:italic toggle=\"yes\">K. quasipneumoniae<\/jats:italic>\n                      (\n                      <jats:italic toggle=\"yes\">n<\/jats:italic>\n                      = 12). Hypervirulent strains were defined as those carrying \u22654 of 5 virulence-associated genes (\n                      <jats:italic toggle=\"yes\">iucA<\/jats:italic>\n                      ,\n                      <jats:italic toggle=\"yes\">iroB<\/jats:italic>\n                      ,\n                      <jats:italic toggle=\"yes\">peg-344<\/jats:italic>\n                      ,\n                      <jats:italic toggle=\"yes\">rmpA<\/jats:italic>\n                      , and\n                      <jats:italic toggle=\"yes\">rmpA2<\/jats:italic>\n                      ). A total of 68 strains (35.2%) were classified as hypervirulent, and 74 (38.3%) carried\n                      <jats:italic toggle=\"yes\">ter<\/jats:italic>\n                      genes. Hypervirulent strains were strongly associated with\n                      <jats:italic toggle=\"yes\">ter<\/jats:italic>\n                      gene carriage, and the tellurite-resistant phenotype on MacConkey agar containing 4 \u03bcg\/mL potassium tellurite closely matched\n                      <jats:italic toggle=\"yes\">ter<\/jats:italic>\n                      gene carriage. Among tellurite-resistant strains, adonitol non-fermentation was useful for excluding non-hypervirulent\n                      <jats:italic toggle=\"yes\">K. variicola<\/jats:italic>\n                      . Using combined tellurite resistance and adonitol fermentation, the assay identified hypervirulent strains with a sensitivity of 86.8%, specificity of 89.6%, and accuracy of 88.6%, all higher than the string test. All 27 ST23 strains showed dulcitol fermentation and\n                      <jats:sc>l<\/jats:sc>\n                      -sorbose non-fermentation. Adonitol fermentation improved screening performance, whereas dulcitol and\n                      <jats:sc>l<\/jats:sc>\n                      -sorbose fermentation patterns supported presumptive identification of prototypical hypervirulent lineages. These findings support the potential utility of this culture-based approach for phenotypic screening of hypervirulent\n                      <jats:italic toggle=\"yes\">K. pneumoniae<\/jats:italic>\n                      in clinical microbiology laboratories.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>IMPORTANCE<\/jats:title>\n                    <jats:p>\n                      Hypervirulent\n                      <jats:italic toggle=\"yes\">Klebsiella pneumoniae<\/jats:italic>\n                      is associated with severe invasive infections, but practical methods for early recognition in routine clinical laboratories remain limited. Leveraging the strong association between hypervirulence genotype and\n                      <jats:italic toggle=\"yes\">ter<\/jats:italic>\n                      gene carriage, we developed a simple culture-based screening approach for the early presumptive identification of hypervirulent\n                      <jats:italic toggle=\"yes\">K. pneumoniae<\/jats:italic>\n                      . This approach, based on combined tellurite resistance and adonitol fermentation, shows higher sensitivity and specificity than the string test for identifying hypervirulent strains. Additionally, dulcitol and\n                      <jats:sc>l<\/jats:sc>\n                      -sorbose fermentation patterns support presumptive identification of prototypical hypervirulent lineages, including ST23. These phenotypic assays may expedite the identification of hypervirulent\n                      <jats:italic toggle=\"yes\">K. pneumoniae<\/jats:italic>\n                      and selected hypervirulent lineages in clinical microbiology laboratories.\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1128\/spectrum.01838-26","type":"journal-article","created":{"date-parts":[[2026,8,17]],"date-time":"2026-08-17T13:01:31Z","timestamp":1786971691000},"update-policy":"https:\/\/doi.org\/10.1128\/asmj-crossmark-policy-page","source":"Crossref","is-referenced-by-count":0,"title":["Phenotypic screening of hypervirulent\n                    <i>Klebsiella pneumoniae<\/i>\n                    using tellurite resistance and carbohydrate fermentation testing"],"prefix":"10.1128","volume":"14","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-8472-0413","authenticated-orcid":false,"given":"Koji","family":"Ohyama","sequence":"first","affiliation":[{"id":[{"id":"https:\/\/ror.org\/046f6cx68","id-type":"ROR","asserted-by":"publisher"}],"name":"Department of Microbiology, Fujita Health University School of Medicine","place":["Aichi, Japan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Akiko","family":"Sei","sequence":"additional","affiliation":[{"id":[{"id":"https:\/\/ror.org\/046f6cx68","id-type":"ROR","asserted-by":"publisher"}],"name":"Department of Microbiology, Fujita Health University School of Medicine","place":["Aichi, Japan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Takuya","family":"Hosoda","sequence":"additional","affiliation":[{"id":[{"id":"https:\/\/ror.org\/046f6cx68","id-type":"ROR","asserted-by":"publisher"}],"name":"Department of Microbiology, Fujita Health University School of Medicine","place":["Aichi, Japan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3073-6564","authenticated-orcid":true,"given":"Sohei","family":"Harada","sequence":"additional","affiliation":[{"id":[{"id":"https:\/\/ror.org\/02hcx7n63","id-type":"ROR","asserted-by":"publisher"}],"name":"Department of Microbiology and Infectious Diseases, Toho University School of Medicine","place":["Tokyo, Japan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christian","family":"Francisco","sequence":"additional","affiliation":[{"id":[{"id":"https:\/\/ror.org\/01rrczv41","id-type":"ROR","asserted-by":"publisher"}],"name":"Institute of Molecular Biology and Biotechnology, National Institutes of Health, University of the Philippines Manila","place":["Manila, Philippines"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Angelo","family":"dela Tonga","sequence":"additional","affiliation":[{"id":[{"id":"https:\/\/ror.org\/01rrczv41","id-type":"ROR","asserted-by":"publisher"}],"name":"Institute of Molecular Biology and Biotechnology, National Institutes of Health, University of the Philippines Manila","place":["Manila, Philippines"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6812-6043","authenticated-orcid":true,"given":"Janet S.","family":"Lee","sequence":"additional","affiliation":[{"id":[{"id":"https:\/\/ror.org\/01yc7t268","id-type":"ROR","asserted-by":"publisher"}],"name":"Division of Pulmonary and Critical Care Medicine, John T. Milliken Department of Medicine, Washington University in St. Louis School of Medicine","place":["St. Louis, USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9620-2525","authenticated-orcid":false,"given":"Yohei","family":"Doi","sequence":"additional","affiliation":[{"id":[{"id":"https:\/\/ror.org\/046f6cx68","id-type":"ROR","asserted-by":"publisher"}],"name":"Department of Microbiology, Fujita Health University School of Medicine","place":["Aichi, Japan"]},{"id":[{"id":"https:\/\/ror.org\/046f6cx68","id-type":"ROR","asserted-by":"publisher"}],"name":"Department of Infectious Diseases, Fujita Health University School of Medicine","place":["Aichi, Japan"]},{"id":[{"id":"https:\/\/ror.org\/01an3r305","id-type":"ROR","asserted-by":"publisher"}],"name":"Center for Innovative Antimicrobial Therapy, Division of Infectious Diseases, University of Pittsburgh School of Medicine","place":["Pittsburgh, USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4550-3499","authenticated-orcid":true,"given":"Masahiro","family":"Suzuki","sequence":"additional","affiliation":[{"id":[{"id":"https:\/\/ror.org\/046f6cx68","id-type":"ROR","asserted-by":"publisher"}],"name":"Department of Microbiology, Fujita Health University School of Medicine","place":["Aichi, Japan"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"235","reference":[{"key":"e_1_3_4_2_2","doi-asserted-by":"publisher","DOI":"10.1128\/CMR.00001-19"},{"key":"e_1_3_4_3_2","doi-asserted-by":"publisher","DOI":"10.4161\/viru.22718"},{"key":"e_1_3_4_4_2","doi-asserted-by":"publisher","DOI":"10.1016\/S1473-3099(17)30489-9"},{"key":"e_1_3_4_5_2","doi-asserted-by":"publisher","DOI":"10.1038\/s41579-019-0315-1"},{"key":"e_1_3_4_6_2","doi-asserted-by":"publisher","DOI":"10.1128\/JCM.01206-19"},{"key":"e_1_3_4_7_2","doi-asserted-by":"publisher","DOI":"10.1128\/JCM.00776-18"},{"key":"e_1_3_4_8_2","doi-asserted-by":"publisher","DOI":"10.1128\/mbio.02867-23"},{"key":"e_1_3_4_9_2","doi-asserted-by":"publisher","DOI":"10.1084\/jem.20030857"},{"key":"e_1_3_4_10_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2796.2006.01641.x"},{"key":"e_1_3_4_11_2","doi-asserted-by":"publisher","DOI":"10.1080\/21505594.2017.1317412"},{"key":"e_1_3_4_12_2","doi-asserted-by":"publisher","DOI":"10.1186\/s12941-022-00494-7"},{"key":"e_1_3_4_13_2","doi-asserted-by":"publisher","DOI":"10.1128\/JCM.03053-14"},{"key":"e_1_3_4_14_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.gene.2004.05.008"},{"key":"e_1_3_4_15_2","doi-asserted-by":"publisher","DOI":"10.1007\/s10096-010-0915-1"},{"key":"e_1_3_4_16_2","doi-asserted-by":"publisher","DOI":"10.3389\/fpubh.2022.946370"},{"key":"e_1_3_4_17_2","doi-asserted-by":"publisher","DOI":"10.1128\/jcm.23.5.869-872.1986"},{"key":"e_1_3_4_18_2","doi-asserted-by":"publisher","DOI":"10.1128\/JCM.42.8.3665-3669.2004"},{"key":"e_1_3_4_19_2","doi-asserted-by":"publisher","DOI":"10.1078\/0723-2020-00261"},{"key":"e_1_3_4_20_2","doi-asserted-by":"publisher","DOI":"10.1128\/JCM.00940-06"},{"key":"e_1_3_4_21_2","doi-asserted-by":"publisher","DOI":"10.1128\/aem.01687-25"},{"key":"e_1_3_4_22_2","doi-asserted-by":"publisher","DOI":"10.1038\/s41598-021-91456-0"},{"key":"e_1_3_4_23_2","doi-asserted-by":"publisher","DOI":"10.1038\/s41467-018-07641-9"},{"key":"e_1_3_4_24_2","doi-asserted-by":"publisher","DOI":"10.1038\/s41467-021-24448-3"},{"key":"e_1_3_4_25_2","doi-asserted-by":"publisher","DOI":"10.1093\/bioinformatics\/btz305"},{"key":"e_1_3_4_26_2","doi-asserted-by":"publisher","DOI":"10.1093\/nar\/gkae268"},{"key":"e_1_3_4_27_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijantimicag.2024.107275"},{"key":"e_1_3_4_28_2","doi-asserted-by":"publisher","DOI":"10.1128\/JCM.00826-18"},{"key":"e_1_3_4_29_2","doi-asserted-by":"publisher","DOI":"10.1128\/spectrum.02844-22"},{"key":"e_1_3_4_30_2","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0004982"}],"container-title":["Microbiology Spectrum"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.asm.org\/doi\/pdf\/10.1128\/spectrum.01838-26","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.asm.org\/doi\/pdf\/10.1128\/spectrum.01838-26","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,10,20]],"date-time":"2026-10-20T14:52:32Z","timestamp":1792507952000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.asm.org\/doi\/10.1128\/spectrum.01838-26"}},"subtitle":[],"editor":[{"given":"Paul M.","family":"Luethy","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"editor"}]}],"short-title":[],"issued":{"date-parts":[[2026,10,6]]},"references-count":29,"journal-issue":{"issue":"10","published-print":{"date-parts":[[2026,10,6]]}},"alternative-id":["10.1128\/spectrum.01838-26"],"URL":"https:\/\/doi.org\/10.1128\/spectrum.01838-26","relation":{},"ISSN":["2165-0497"],"issn-type":[{"value":"2165-0497","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,10,6]]},"assertion":[{"value":"2026-05-28","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-07-29","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-08-17","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e01838-26"}}