Carbapenem resistance and hypervirulence in Klebsiella pneumoniae are raising global public health concerns in the 21st century

Hypervirulence and antibiotic resistance in <i>Klebsiella pneumoniae</i> toward carbapenem antibiotics have raised global public health concerns, with increased incidence of community-acquired infections causing an unprecedented rise in mortality and morbidity in the 21^st century. Carbapenem-resistant <i>Klebsiella pneumoniae</i> (CRKp) and hypervirulent <i>Klebsiella pneumoniae</i> (hvKp), in general, harbor significant virulence factors such as siderophores, lipopolysaccharide (LPS), adhesive fimbriae, and capsules that contribute to its pathogenicity. The determinants of hvKp are usually found cardinal among larger virulence plasmids, which may also harbor carbapenem resistance genes, thereby making management of hypervirulent-carbapenem resistance strain nearly impossible. These virulence factors allow <i>K. pneumoniae</i> to escape phagocytosis; therefore, attempts to counter using immune cells such as neutrophils and macrophages fail. Further, immune-mediated attempts are frequently hampered by bacterial resistance to drugs, resulting in severe infections, particularly in immunocompromised patients. Although there are several management options for <i>K. pneumoniae</i> infections, there is still a need to find innovative approaches to control the illness in light of the increasing drug resistance pattern reported worldwide. As a result, the purpose of this review is to highlight the latest information regarding the resistance and virulence mechanisms that let bacteria evade human immune factors, as well as how to best manage them before the antibiotic regimen runs out.