Two case reports on the identification and management of hypervirulent Klebsiella pneumoniae isolated in Nebraska, USA

Background: (hvKp) is a globally emerging pathotype known for causing severe and disseminated infections across multiple organ systems. Diabetes is a risk factor for hvKp infection; however, otherwise healthy individuals from the community are also at risk. Case Summary: Two patients from Nebraska presented with complex abscesses of unknown origin. Both cases required interventional procedures and prolonged hospitalization. PCR-based testing, animal studies, and whole-genome sequencing analysis confirmed that hvKp was the offending pathotype. Conclusion: This report describes the first confirmed cases of hvKp infection in Nebraska, USA. These cases demonstrated the utility of using molecular methods to identify hvKp. The microbiology lab can be operationalized to provide valuable insights into the genetic makeup of pathogens, inform the institutional clinical decision-making processes, and epidemiological surveillance. This study highlights the collaborative relationships between the Infectious Diseases staff and the Clinical Microbiology Laboratory to work up complex cases.