Global trends of antimicrobial resistance and virulence of Klebsiella pneumoniae from different host sources.

Background: Klebsiella pneumoniae is ubiquitous in animals, humans, and the environment, facilitating the dissemination of antimicrobial resistance (AMR) and virulence traits. Most studies are primarily focused on human clinical isolates, leaving critical gaps in understanding non-human reservoirs and cross-species transmission risks.

Methods: We combined large-scale genomic analyses with in vitro and in vivo infection models to characterize the evolutionary dynamics of 2809 K. pneumoniae isolates sourced from 8 host species across 57 countries. We examined the potential for cross-host transmission of K. pneumoniae, explored its AMR and virulence characteristics across different hosts, and evaluated the temporal evolution of AMR and virulence.

Results: Here, we demonstrate that the rise in AMR strongly correlates with the global expansion of multidrug-resistant (MDR) sequence types, while the increase in virulence is partially driven by the acquisition of key virulence loci in certain MDR clones. Population structure analyses show no distinct genetic boundaries between human- and animal-derived strains, strengthening the evidence for cross-species transmission potential.

Conclusions: These findings underscore the urgent need for a One Health approach to address the dual threat of AMR and hypervirulence, providing critical insights to guide global surveillance and public health interventions.