{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,15]],"date-time":"2026-10-15T16:11:33Z","timestamp":1792080693059,"version":"4.4.0"},"reference-count":184,"publisher":"MDPI AG","issue":"5","license":[{"start":{"date-parts":[[2025,5,15]],"date-time":"2025-05-15T00:00:00Z","timestamp":1747267200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Pharmaceuticals"],"abstract":"<jats:p>Community-acquired infections caused by Klebsiella pneumoniae (K. pneumoniae) have become a significant global health concern, particularly with the emergence of hypervirulent strains (hvKP). These strains are associated with severe infections, such as pyogenic liver abscesses, even in otherwise healthy individuals. Initially reported in Taiwan in the 1980s, hvKP has now spread worldwide. The pathogenicity of hvKP is attributed to an array of virulence factors that enhance its ability to colonize and evade host immune defenses. Additionally, the convergence of hypervirulence with antibiotic resistance has further complicated treatment strategies. As a member of the ESKAPE group of pathogens, K. pneumoniae exhibits high resistance to multiple antibiotics, posing a challenge for healthcare settings. This review provides a comprehensive overview of hvKP, highlighting its structural and pathogenic differences from classical K. pneumoniae strains, key virulence factors, mechanisms of antibiotic resistance, and the increasing threat of multidrug-resistant hvKP. Lastly, we discuss current treatment guidelines and emerging therapeutic strategies to combat this formidable pathogen.<\/jats:p>","DOI":"10.3390\/ph18050724","type":"journal-article","created":{"date-parts":[[2025,5,15]],"date-time":"2025-05-15T04:39:16Z","timestamp":1747283956000},"page":"724","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":58,"title":["Hypervirulent Klebsiella pneumoniae: Insights into Virulence, Antibiotic Resistance, and Fight Strategies Against a Superbug"],"prefix":"10.3390","volume":"18","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-8541-7304","authenticated-orcid":false,"given":"Helal F.","family":"Hetta","sequence":"first","affiliation":[{"name":"Division of Microbiology, Immunology and Biotechnology, Department of Natural Products and Alternative Medicine, Faculty of Pharmacy, University of Tabuk, Tabuk 71491, Saudi Arabia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fawaz E.","family":"Alanazi","sequence":"additional","affiliation":[{"name":"Department of Pharmacology and Toxicology, Faculty of Pharmacy, University of Tabuk, Tabuk 71491, Saudi Arabia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5851-5088","authenticated-orcid":false,"given":"Mostafa A. Sayed","family":"Ali","sequence":"additional","affiliation":[{"name":"Department of Pharmacy Practice, Faculty of Pharmacy, University of Tabuk, Tabuk 71491, Saudi Arabia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6459-9700","authenticated-orcid":false,"given":"Ahmed D.","family":"Alatawi","sequence":"additional","affiliation":[{"name":"Department of Clinical Pharmacy, College of Pharmacy, Jouf University, Sakaka 72388, Saudi Arabia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5333-6956","authenticated-orcid":false,"given":"Hashim M.","family":"Aljohani","sequence":"additional","affiliation":[{"name":"Department of Clinical Laboratory Sciences, College of Applied Medical Sciences, Taibah University, Madina 41477, Saudi Arabia"},{"name":"Department of Pathology and Laboratory Medicine, College of Medicine, University of Cincinnati, Cincinnati, OH 45221, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2476-469X","authenticated-orcid":false,"given":"Rehab","family":"Ahmed","sequence":"additional","affiliation":[{"name":"Division of Microbiology, Immunology and Biotechnology, Department of Natural Products and Alternative Medicine, Faculty of Pharmacy, University of Tabuk, Tabuk 71491, Saudi Arabia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nuha A.","family":"Alansari","sequence":"additional","affiliation":[{"name":"Laboratory Medicine, College of Applied Medical Sciences, Umm Al-Qura University, Jeddah 22231, Saudi Arabia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fahad M.","family":"Alkhathami","sequence":"additional","affiliation":[{"name":"College of Applied Medical Sciences, University of Tabuk, Tabuk 47315, Saudi Arabia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alaa","family":"Albogmi","sequence":"additional","affiliation":[{"name":"Medical Laboratory Technology, King Abdulaziz University, Jeddah 80216, Saudi Arabia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bander M.","family":"Alharbi","sequence":"additional","affiliation":[{"name":"Medical Laboratory Technology, College of Applied Medical Sciences, University of Tabuk, Tabuk 47524, Saudi Arabia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hanadi S.","family":"Alanzi","sequence":"additional","affiliation":[{"name":"College of Applied Medical Sciences, University of Tabuk, Tabuk 47315, Saudi Arabia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Amirah B.","family":"Alaqyli","sequence":"additional","affiliation":[{"name":"College of Applied Medical Sciences, University of Tabuk, Tabuk 47315, Saudi Arabia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0008-7374-9334","authenticated-orcid":false,"given":"Yasmin N.","family":"Ramadan","sequence":"additional","affiliation":[{"name":"Department of Microbiology and Immunology, Faculty of Pharmacy, Assiut University, Assiut 71515, Egypt"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2025,5,15]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"1198","DOI":"10.1056\/NEJMoa1306801","article-title":"Multistate point-prevalence survey of health care\u2013associated infections","volume":"370","author":"Magill","year":"2014","journal-title":"N. 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