Table 1:

Features of classical versus hypervirulent Klebsiella pneumoniae infection 1,2,6–11

FeatureClassical Klebsiella pneumoniaeHypervirulent Klebsiella pneumonia
Predisposing factors

  • Older age

  • Immunocompromised

  • Diabetes

  • First reported in countries or individuals from Asian Pacific Rim, but now emerging globally

Distant spread (apart from hepatic abscess)NoneMultiple sites, including

  • Endophthalmitis

  • Meningitis

  • Pulmonary abscess

  • Splenic abscess

  • Pyelonephritis

  • Epididymitis

Hepatic abscess

  • Polymicrobial

  • Underlying biliary disease

  • Monomicrobial

  • No underlying biliary disease

  • Regional thrombophlebitis

    Radiographic characteristics — single, unilobar, solid, multilocular

Source of infectionNosocomialCommunity
Factors that increase virulenceNot applicableK1 and K2 capsular serotypes rmpA, rmp2, magA, aerobactin (iuc), salmochelin (iro)
TreatmentPathogen-directed antimicrobial therapy and abscess drainagePathogen-directed antimicrobial therapy and abscess drainage; surgical intervention should be considered if refractory
Antimicrobial resistanceCommonEmerging