Oral Presentation Asia-Pacific Vaccine and Immunotherapy Congress 2026

The pathogenesis and intestinal persistence of hypervirulent Klebsiella pneumoniae (#31)

Yunn-Hwen Gan 1
  1. Biochemistry/Infectious Diseases Translational Research Program, National University of Singapore, Singapore, SINGAPORE

Hypervirulent Klebsiella pneumoniae (hvKp), first described in the 1980s, is the leading cause of mono-microbial induced liver abscess in Asia and can cause tissue-invasive infections in otherwise healthy individuals. Majority of the liver abscess isolates belong to clonal group 23 (CG23) sublineage 1, which has rapidly disseminated across the world due to its acquisition of various chromosomal and plasmid virulence factors. Gut colonization by the pathobiont is recognized as the preceding event to bacteremic and metastatic infections when there are breaches to the intestinal barrier via different physiological triggers. We have dissected the contribution of these virulence factors to bacterial pathogenesis in the mammalian host and discovered how these factors are differentially important in contributing to the survival and fitness of the bacteria in different host niches. In recent years, the convergence of hypervirulence and multidrug resistance have been documented worldwide, leading to global concerns of the creation of “superbugs”. One important consideration is the intestines serving as a potential reservoir for developing of antibiotic resistance. We found that transient antibiotic exposure could trigger long term colonization of hvKp. Transient antibiotic exposure creates a permissive, low-diversity intestinal niche dominated by facultative anaerobes, which supports long-term, high-density hvKp colonization. The dysbiotic state creates an altered redox state and imposes a potent selective pressure favoring the rapid emergence of hypomucoid variants via phase-variable mutations in the rmpA regulator. This evolutionary trajectory reflects a virulence-colonization trade-off in high-nutrient, low-competition environments. Conversely, osmotic perturbation via laxatives elicits only a transient window of colonization-susceptibility that is rapidly closed by the recovery of a saccharolytic, Bacteroides-enriched community, which actively suppresses both pathogen colonization and adaptive evolution in the rmpA locus via the action of short chain fatty acids (SCFAs). These findings reveal insights on how transient antibiotic exposure could potentially drive long term intestinal colonization while diarrheal or other disturbances that do not rewire the energy and metabolic landscape of the gut microbiota despite change in species composition can be resilient to pathobiont colonization. These insights help tailor efforts to design mechanism-based microbiome interventions that could exert colonization resistance and decrease the spread of disease.