Current Management Strategies for Hypervirulent Klebsiella.

Hypervirulent Klebsiella pneumoniae (HvKp) is a highly invasive pathotype causing severe, community-acquired infections, unlike nosocomial classic K pneumoniae. First reported in 1986, HvKp is linked to liver abscess, bacteremia, and endophthalmitis, driven by K1/K2 polysaccharide capsule, hypermucoviscous capsule production and siderophores. It colonizes the gut, with high prevalence in the Asia-Pacific, but is emerging globally, including in Europe and the United States. The convergence of hypervirulence and multidrug resistance, notably carbapenem resistance, limits treatment options, prompting a World Health Organization alert in 2024. Management includes source control (percutaneous drainage) and antibiotics. Evidence-based treatment strategies are urgently needed.