Klebsiella pneumoniae has an exceptional ability to acquire exogenous resistance-encoding and hypervirulence-encoding genetic elements. In this review we trace the key evolutionary routes of plasmids involved in the dissemination of such elements; we observed diverse, but convergent, evolutionary paths that eventually led to the emergence of conjugative plasmids which simultaneously encode carbapenem resistance and hypervirulence. One important evolutionary feature of these plasmids is that they contain a wide range of transposable elements that enable them to undergo frequent genetic transposition, resulting in plasmid fusion and presumably better adaptation of the plasmid to the bacterial host. Identifying the key molecular markers of resistance and virulence-bearing conjugative plasmids allows improved tracking and control of the life-threatening carbapenem-resistant and hypervirulent strains of K. pneumoniae.

肺炎克雷伯菌具有获得外源抗性编码和高毒力编码遗传元素的出色能力。在这篇综述中，我们追踪了参与此类元件传播的质粒的关键进化途径。我们观察到了多样化但趋同的进化途径，最终导致了同时编码碳青霉烯抗性和高毒力的结合质粒的出现。这些质粒的一个重要的进化特征是它们包含多种转座因子，使它们能够进行频繁的基因转座，从而导致质粒融合并可能使质粒更好地适应细菌宿主。肺炎克雷伯菌。