Klebsiella pneumonia: Epidemiology, Causes, Effects, Pathogenicity and Its Secondary Metabolites

Manal Khaled Abood Al-Karwi (1) , Sarah Hussein Hamzah Emlk (2) , Hind Riyad Hussein AL-Alloush (3) , Hassan Nizar Jabbar Al-Shuwaili (4)
(1) University of Diyala, College of Science, Department of Biology, Iraq , Iran, Islamic Republic of
(2) University of Babylon, College of Science for Girls, Department of Biology, Iraq , Iran, Islamic Republic of
(3) University of Babylon, College of Science for Girls, Department of Biology, Iraq , Iran, Islamic Republic of
(4) Wasit University, College of Science, Department of Biology, Iraq , Iran, Islamic Republic of

Abstract

Klebsiella pneumoniae, an opportunistic pathogen, can infect humans by colonising mucosal surfaces and then spreading to other parts of the body. The germs Klebsiella are present in water, soil, and animals, and they can colonise healthcare facilities and medical equipment. This microbe is also responsible for a large number of community-acquired diseases around the world. These infections can spread to other parts of the body and cause a lot of problems, like death and illness. These infections may be associated with hypervirulent Klebsiella strains. The cell wall, lipopolysaccharide, fimbriae, and siderophores are the four main parts of this pathogenic bacterium. As a secondary metabolite, siderophores enable bacteria to take iron from their environment and transfer it to their internal compartment. Colonisation of a particular location by Klebsiella pneumoniae can occur for many different reasons. The local healthcare practices, antibiotic usage and misuse, infection control measures, nutrition, gender, age, and age all play a role in the risk of infection. Mechanisms of bacterial survival, development, and virulent infection are all part of the pathophysiology. Put another way, K. pneumoniae's pathophysiology is closely related to its CPS and LPS abilities to avoid the host's immune system, fimbriae's efficiency in attaching and colonising, and OMPs' ability to collect nutrients from its environment. But, iron-binding siderophores (described in detail below) play a significant role in the pathophysiology of Klebsiella pneumoniae by facilitating iron intake.

Full text article

Generated from XML file

References

Choby, J.E.; Howard-Anderson, J.; Weiss, D.S. Hypervirulent Klebsiella pneumoniae-clinical and molecular perspectives. J. Intern. Med. 2020, 287, 283–300.

WHO. Global Priority List of Antibiotic-Resistant Bacteria to Guide Research, Discovery, and Development of New Antibiotics; World Health Organization: Geneva, Switzerland, 2017.

Magill, S.S.; O’Leary, E.; Janelle, S.J.; Thompson, D.L.; Dumyati, G.; Nadle, J.; Wilson, L.E.; Kainer, M.A.; Lynfield, R.; Greissman, S.; et al. Changes in Prevalence of Health Care-Associated Infections in U.S. Hospitals. N. Engl. J. Med. 2018, 379, 1732–1744.

Pomakova, D.K.; Hsiao, C.-B.; Beanan, J.M.; Olson, R.; MacDonald, U.; Keynan, Y.; Russo, T.A. Clinical and phenotypic differences between classic and hypervirulent Klebsiella pneumonia: An emerging and under-recognized pathogenic variant. Eur. J. Clin. Microbiol. Infect. Dis. 2012, 31, 981–989.

Lan, P.; Shi, Q.; Zhang, P.; Chen, Y.; Yan, R.; Hua, X.; Jiang, Y.; Zhou, J.; Yu, Y. Core genome allelic profiles of clinical Klebsiella pneumoniae strains using a random forest algorithm based on multilocus sequence typing scheme for hypervirulence analysis. J. Infect. Dis. 2020, 221, 263–271.

Shon, A.S.; Bajwa, R.P.; Russo, T.A. Hypervirulent (hypermucoviscous) Klebsiella pneumoniae: A new and dangerous breed. Virulence 2013, 4, 107–118.

Lee, H.C.; Chuang, Y.C.; Yu, W.L.; Lee, N.Y.; Chang, C.M.; Ko, N.Y.; Wang, L.R.; Ko, W.C. Clinical implications of hypermucoviscosity phenotype in Klebsiella pneumoniae isolates: Association with invasive syndrome in patients with community-acquired bacteraemia. J. Intern. Med. 2006, 259, 606–614.

Li, W.; Sun, G.; Yu, Y.; Li, N.; Chen, M.; Jin, R.; Jiao, Y.; Wu, H. Increasing occurrence of antimicrobial-resistant hypervirulent (hypermucoviscous) Klebsiella pneumoniae isolates in China. Clin. Infect. Dis. 2014, 58, 225–232.

Liu, Y.; Li, X.Y.; Wan, L.G.; Jiang, W.Y.; Yang, J.H.; Li, F.Q. Virulence and transferability of resistance determinants in a novel Klebsiella pneumonia sequence type 1137 in China. Microb. Drug Resist. 2014, 20, 150–155.

Zhu, J.; Wang, T.; Chen, L.; Du, H. Virulence Factors in Hypervirulent Klebsiella pneumoniae. Front. Microbiol. 2021, 12, 642484. [CrossRef] 11. Ghssein, G.; Ezzeddine, Z. The Key Element Role of Metallophores in the Pathogenicity and Virulence of Staphylococcus aureus: A Review. Biology 2022, 11, 1525.

Lamb, A.L. Breaking a pathogen’s iron will: Inhibiting siderophore production as an antimicrobial strategy. Biochim. Biophys. Acta 2015, 1854, 1054–1070.

Wand, M.E.; Baker, K.S.; Benthall, G.; McGregor, H.; McCowen, J.W.I.; DeheerGraham, A.; Sutton, J.M. Characterization of Pre-Antibiotic Era Klebsiella pneumoniae Isolates with Respect to Antibiotic/Disinfectant Susceptibility and Virulence in Galleria mellonella. Antimicrob. Agents Chemother. 2015, 59, 3966–3972.

Russo, T.A.; Olson, R.; Macdonald, U.; Metzger, D.; Maltese, L.M.; Drake, E.J.; Gulick, A.M. Aerobactin mediates virulence and accounts for increased siderophore production under iron-limiting conditions by hypervirulent (hypermucoviscous) Klebsiella pneumoniae. Infect. Immun. 2014, 82, 2356–2367.

Khan, A.; Singh, P.; Srivastava, A. Synthesis, nature and utility of universal iron chelator-siderophore: A review. Microbiol. Res. 2018, 212–213, 103–111.

Goetz, D.H.; Holmes, M.A.; Borregaard, N.; Bluhm, M.E.; Raymond, K.N.; Strong, R.K. The neutrophil lipocalin NGAL is a bacteriostatic agent that interferes with siderophore-mediated iron acquisition. Mol. Cell. 2002, 10, 1033–1043.

Fischbach, M.A.; Lin, H.; Zhou, L.; Yu, Y.; Abergel, R.J.; Liu, D.R.; Raymond, K.N.; Wanner, B.L.; Strong, R.K.; Walsh, C.T.; et al. The pathogen-associated iroA gene cluster mediates bacterial evasion of lipocalin 2. Proc. Natl. Acad. Sci. USA 2006, 103, 16502–16507.

Russo, T.A.; Olson, R.; Macdonald, U.; Beanan, J.; Davidson, B.A. Aerobactin, but not yersiniabactin, salmochelin, or enterobactin, enables the growth/survival of hypervirulent (hypermucoviscous) Klebsiella pneumoniae ex vivo and in vivo. Infect. Immun. 2015, 83, 3325–3333.

Russo, T.A.; Olson, R.; Fang, C.T.; Stoesser, N.; Miller, M.; MacDonald, U.; Hutson, A.; Barker, J.H.; La Hoz, R.M.; Johnson, J.R. Identification of biomarkers for the differentiation of hypervirulent Klebsiella pneumonia from classical K. pneumoniae. J. Clin. Microbiol. 2018, 56, e00776-18.

Lam, M.M.C.; Wyres, K.L.; Judd, L.M.; Wick, R.R.; Jenney, A.; Brisse, S.; Holt, K.E. Tracking key virulence loci encoding aerobactin and salmochelin siderophore synthesis in Klebsiella pneumoniae. Genome Med. 2018, 10, 77.

Bergey, D.H.; David, R.; Boone, G.M.; Garrity, R.W.C.; Bergey, D.H. Bergey’s Manual of Systematic Bacteriology; Springer: New York, NY, USA; London, UK, 2001.

Wen, Z.; Zhang, J.-R. Chapter 3—Bacterial Capsules. In Molecular Medical Microbiology, 2nd ed.; Elsevier Ltd.: Amsterdam, The Netherlands, 2015.

Domenico, P.; Salo, R.J.; Cross, A.S.; Cunha, B.A. Polysaccharide capsule-mediated resistance to opsonophagocytosis in Klebsiella pneumonia. Infect. Immun. 1994, 62, 4495–4499.

Patridge, E.; Gareiss, P.; Kinch, M.S.; Hoyer, D. An analysis of FDA-approved drugs: Natural products and their derivatives. Drug Discov. Today 2016, 21, 204–207.

Jeong, Y.; Cho, S.-H.; Lee, H.; Choi, H.-K.; Kim, D.-M.; Lee, C.-G.; Cho, S.; Cho, B.-K. Current Status and Future Strategies to Increase Secondary Metabolite Production from Cyanobacteria. Microorganisms 2020, 8, 1849.

Said Hassane, C.; Fouillaud, M.; Le Goff, G.; Sklirou, A.D.; Boyer, J.B.; Trougakos, I.P.; Jerabek, M.; Bignon, J.; de Voogd, N.J.; Ouazzani, J.; et al. Microorganisms Associated with the Marine Sponge Scopalina hapalia: A Reservoir of Bioactive Molecules to Slow Down the Aging Process. Microorganisms 2020, 8, 1262.

Salikin, N.H.; Nappi, J.; Majzoub, M.E.; Egan, S. Combating Parasitic Nematode Infections, Newly Discovered Antinematode Compounds from Marine Epiphytic Bacteria. Microorganisms 2020, 8, 1963.

Nawaz, A.; Chaudhary, R.; Shah, Z.; Dufossé, L.; Fouillaud, M.; Mukhtar, H.; ul Haq, I. An Overview on Industrial and Medical Applications of Bio-Pigments Synthesized by Marine Bacteria. Microorganisms 2021, 9, 11.

Hwang, S.; Le, L.T.H.L.; Jo, S.-I.; Shin, J.; Lee, M.J.; Oh, D.-C. Pentaminomycins C–E: Cyclic Pentapeptides as Autophagy Inducers from a Mealworm Beetle Gut Bacterium. Microorganisms 2020, 8, 1390.

Shamikh, Y.I.; El Shamy, A.A.; Gaber, Y.; Abdelmohsen, U.R.; Madkour, H.A.; Horn, H.; Hassan, H.M.; Elmaidomy, A.H.; Alkhalifah, D.H.M.; Hozzein, W.N. Actinomycetes from the Red Sea Sponge Coscinoderma mathewsi: Isolation, Diversity, and Potential for Bioactive Compounds Discovery. Microorganisms 2020, 8, 783.

Authors

Manal Khaled Abood Al-Karwi
Sarah Hussein Hamzah Emlk
Hind Riyad Hussein AL-Alloush
Hassan Nizar Jabbar Al-Shuwaili
Al-Karwi, M. K. A., Hamzah Emlk, S. H., AL-Alloush, H. R. H., & Al-Shuwaili, H. N. J. (2024). Klebsiella pneumonia: Epidemiology, Causes, Effects, Pathogenicity and Its Secondary Metabolites. Journal of Current Medical Research and Opinion, 7(06), 2761–2771. https://doi.org/10.52845/CMRO/2024/7-6-14

Article Details