Geographical distribution, disease association and diversity of Klebsiella pneumoniae K/L and O antigens in India: roadmap for vaccine development

• Published in: Microbial genomics 2024-07, Vol.10 (7)
• Main Authors: Shamanna, Varun, Srinivas, Srikanth, Couto, Natacha, Nagaraj, Geetha, Sajankila, Shyama Prasad, Krishnappa, Harshitha Gangaiah, Kumar, Kavitha Arakalgud, Aanensen, David M, Lingegowda, Ravikumar Kadahalli, Nihr Global Health Research Unit On Genomic Surveillance-India Consortium
• Format: Article
• Language: English
• Subjects: Antigens, Bacterial - genetics; Antigens, Surface; Bacterial Vaccines - immunology; Drug Resistance, Multiple, Bacterial - genetics; Genome, Bacterial; Humans; India - epidemiology; Klebsiella Infections - epidemiology; Klebsiella Infections - microbiology; Klebsiella Infections - prevention & control; Klebsiella pneumoniae - classification; Klebsiella pneumoniae - genetics; Klebsiella pneumoniae - isolation & purification; Klebsiella pneumoniae - pathogenicity; O Antigens - genetics; Pathogens and Epidemiology; Phylogeny; Serogroup; Vaccine Development; Virulence - genetics; Virulence Factors - genetics; Whole Genome Sequencing
• ISSN: 2057-5858; 2057-5858
• DOI: 10.1099/mgen.0.001271

poses a significant healthcare challenge due to its multidrug resistance and diverse serotype landscape. This study aimed to explore the serotype diversity of 1072 . and its association with geographical distribution, disease severity and antimicrobial/virulence patterns in India. Whole-genome sequencing was performed on the Illumina platform, and genomic analysis was carried out using the Kleborate tool. The analysis revealed a total of 78 different KL types, among which KL64 ( =274/1072, 26 %), KL51 ( =249/1072, 24 %), and KL2 ( =88/1072, 8 %) were the most prevalent. In contrast, only 13 distinct O types were identified, with O1/O2v1 ( =471/1072, 44 %), O1/O2v2 ( =353/1072, 33 %), and OL101 ( =66/1072, 6 %) being the predominant serotypes. The study identified 114 different sequence types (STs) with varying serotypes, with ST231 being the most predominant. O serotypes were strongly linked with STs, with O1/O2v1 predominantly associated with ST231. Simpson's diversity index and Fisher's exact test revealed higher serotype diversity in the north and east regions, along with intriguing associations between specific serotypes and resistance profiles. No significant association between KL or O types and disease severity was observed. Furthermore, we found the specific association of virulence factors yersiniabactin and aerobactin ( 0.05). Conventionally described hypervirulent clones (i.e. KL1 and KL2) in India lacked typical virulent markers (i.e. aerobactin), contrasting with other regional serotypes (KL51). The cumulative distribution of KL and O serotypes suggests that future vaccines may have to include either ~20 KL or four O types to cover >85 % of the carbapenemase-producing Indian population. The results highlight the necessity for comprehensive strategies to manage the diverse landscape of strains across different regions in India. Understanding regional serotype dynamics is pivotal for targeted surveillance, interventions, and tailored vaccine strategies to tackle the diverse landscape of infections across India. This article contains data hosted by Microreact.