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<journal-id journal-id-type="publisher-id">Front. Microbiol.</journal-id>
<journal-title>Frontiers in Microbiology</journal-title>
<abbrev-journal-title abbrev-type="pubmed">Front. Microbiol.</abbrev-journal-title>
<issn pub-type="epub">1664-302X</issn>
<publisher>
<publisher-name>Frontiers Media S.A.</publisher-name>
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<article-meta>
<article-id pub-id-type="doi">10.3389/fmicb.2025.1657680</article-id>
<article-categories>
<subj-group subj-group-type="heading">
<subject>Microbiology</subject>
<subj-group>
<subject>Original Research</subject>
</subj-group>
</subj-group>
</article-categories>
<title-group>
<article-title>Multi-omics investigation reveals unique markers in <italic>Klebsiella pneumoniae</italic> compared to closely related species</article-title>
</title-group>
<contrib-group>
<contrib contrib-type="author">
<name>
<surname>Swiatek</surname>
<given-names>Lena-Sophie</given-names>
</name>
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<contrib contrib-type="author">
<name>
<surname>Surmann</surname>
<given-names>Kristin</given-names>
</name>
<xref ref-type="aff" rid="aff2"><sup>2</sup></xref>
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<name>
<surname>Eger</surname>
<given-names>Elias</given-names>
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<contrib contrib-type="author">
<name>
<surname>M&#x00FC;ller</surname>
<given-names>Justus U.</given-names>
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<xref ref-type="aff" rid="aff1"><sup>1</sup></xref>
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<contrib contrib-type="author">
<name>
<surname>Gesell Salazar</surname>
<given-names>Manuela</given-names>
</name>
<xref ref-type="aff" rid="aff2"><sup>2</sup></xref>
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<contrib contrib-type="author">
<name>
<surname>Heiden</surname>
<given-names>Stefan E.</given-names>
</name>
<xref ref-type="aff" rid="aff1"><sup>1</sup></xref>
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<contrib contrib-type="author">
<name>
<surname>Werner</surname>
<given-names>Guido</given-names>
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<xref ref-type="aff" rid="aff3"><sup>3</sup></xref>
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<name>
<surname>H&#x00FC;bner</surname>
<given-names>Nils-Olaf</given-names>
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<xref ref-type="aff" rid="aff4"><sup>4</sup></xref>
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<contrib contrib-type="author">
<name>
<surname>Bohnert</surname>
<given-names>J&#x00FC;rgen A.</given-names>
</name>
<xref ref-type="aff" rid="aff5"><sup>5</sup></xref>
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<contrib contrib-type="author">
<name>
<surname>Becker</surname>
<given-names>Karsten</given-names>
</name>
<xref ref-type="aff" rid="aff5"><sup>5</sup></xref>
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<contrib contrib-type="author">
<name>
<surname>V&#x00F6;lker</surname>
<given-names>Uwe</given-names>
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<xref ref-type="aff" rid="aff2"><sup>2</sup></xref>
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<name>
<surname>Schwabe</surname>
<given-names>Michael</given-names>
</name>
<xref ref-type="aff" rid="aff1"><sup>1</sup></xref>
<xref ref-type="author-notes" rid="fn0003"><sup>&#x2020;</sup></xref>
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<contrib contrib-type="author" corresp="yes" equal-contrib="yes">
<name>
<surname>Schaufler</surname>
<given-names>Katharina</given-names>
</name>
<xref ref-type="aff" rid="aff1"><sup>1</sup></xref>
<xref ref-type="aff" rid="aff6"><sup>6</sup></xref>
<xref ref-type="corresp" rid="c001"><sup>&#x002A;</sup></xref>
<xref ref-type="author-notes" rid="fn0003"><sup>&#x2020;</sup></xref>
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<aff id="aff1"><sup>1</sup><institution>Department of Epidemiology and Ecology of Antimicrobial Resistance, Helmholtz Institute for One Health, Helmholtz Centre for Infection Research HZI</institution>, <addr-line>Greifswald</addr-line>, <country>Germany</country></aff>
<aff id="aff2"><sup>2</sup><institution>Department of Functional Genomics, Interfaculty Institute for Genetics and Functional Genomics, University Medicine Greifswald</institution>, <addr-line>Greifswald</addr-line>, <country>Germany</country></aff>
<aff id="aff3"><sup>3</sup><institution>Division of Nosocomial Pathogens and Antibiotic Resistances, Department of Infectious Diseases, Robert Koch Institute</institution>, <addr-line>Wernigerode</addr-line>, <country>Germany</country></aff>
<aff id="aff4"><sup>4</sup><institution>Central Unit for Infection Prevention and Control, University Medicine Greifswald</institution>, <addr-line>Greifswald</addr-line>, <country>Germany</country></aff>
<aff id="aff5"><sup>5</sup><institution>Friedrich Loeffler-Institute of Medical Microbiology, University Medicine Greifswald</institution>, <addr-line>Greifswald</addr-line>, <country>Germany</country></aff>
<aff id="aff6"><sup>6</sup><institution>University Medicine Greifswald</institution>, <addr-line>Greifswald</addr-line>, <country>Germany</country></aff>
<author-notes>
<fn fn-type="edited-by" id="fn0004">
<p>Edited by: <ext-link ext-link-type="uri" xlink:href="https://loop.frontiersin.org/people/64579/overview">Vijay Pancholi</ext-link>, The Ohio State University, United States</p>
</fn>
<fn fn-type="edited-by" id="fn0005">
<p>Reviewed by: <ext-link ext-link-type="uri" xlink:href="https://loop.frontiersin.org/people/1282513/overview">Kwok Jian Goh</ext-link>, Monash University, Australia</p>
<p>Helena B. Cooper, Monash University, Australia</p>
</fn>
<corresp id="c001">&#x002A;Correspondence: Katharina Schaufler, <email>katharina.schaufler@helmholtz-hioh.de</email></corresp>
<fn fn-type="equal" id="fn0003"><p><sup>&#x2020;</sup>These authors have contributed equally to this work</p></fn>
</author-notes>
<pub-date pub-type="epub">
<day>20</day>
<month>08</month>
<year>2025</year>
</pub-date>
<pub-date pub-type="collection">
<year>2025</year>
</pub-date>
<volume>16</volume>
<elocation-id>1657680</elocation-id>
<history>
<date date-type="received">
<day>01</day>
<month>07</month>
<year>2025</year>
</date>
<date date-type="accepted">
<day>08</day>
<month>08</month>
<year>2025</year>
</date>
</history>
<permissions>
<copyright-statement>Copyright &#x00A9; 2025 Swiatek, Surmann, Eger, M&#x00FC;ller, Gesell Salazar, Heiden, Werner, H&#x00FC;bner, Bohnert, Becker, V&#x00F6;lker, Schwabe and Schaufler.</copyright-statement>
<copyright-year>2025</copyright-year>
<copyright-holder>Swiatek, Surmann, Eger, M&#x00FC;ller, Gesell Salazar, Heiden, Werner, H&#x00FC;bner, Bohnert, Becker, V&#x00F6;lker, Schwabe and Schaufler</copyright-holder>
<license xlink:href="http://creativecommons.org/licenses/by/4.0/">
<p>This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.</p>
</license>
</permissions>
<abstract>
<sec id="sec1">
<title>Introduction</title>
<p>The <italic>Klebsiella pneumoniae</italic> (KP) species complex (KpSC) comprises KP as the predominant species, and six other taxa including two subspecies each of <italic>Klebsiella</italic> var<italic>iicola</italic> (KV) and <italic>Klebsiella quasipneumoniae</italic> (KQ), all capable of causing clinical infections and often challenging to differentiate. Among these, KP is by far the most clinically significant, with the emergence of multidrug-resistant and hypervirulent strains leading to severe infections and limited treatment options, underscoring the need to understand the genomic features of KP.</p>
</sec>
<sec id="sec2">
<title>Methods</title>
<p>This study compared globally disseminated KP lineages with less abundant KV strains in synthetic human urine (SHU) across multiple omics levels to identify characteristics differentiating these closely related species. Moreover, a large genomic dataset of over 6,000 publicly available genomes of KP, KV, and KQ was constructed for comparisons to other members of the KpSC.</p>
</sec>
<sec id="sec3">
<title>Results</title>
<p>Among eight clinical KP strains representing four different sequence types (STs), we identified 107 genes comprising the KP-specific core genome, while these genes were absent from two selected KV genomes. Transcriptome and proteome analyses in SHU revealed different regulatory patterns between KP and KV strains, with metabolic responses playing a pivotal role. A total of 193 genes specific to the investigated KP STs were identified, exhibiting differential expression at the transcriptomic and/or proteomic levels. Comparison to the genomic dataset highlighted genes adaptively regulated or uniquely present in KP genomes. For example, certain genes for citrate metabolism are uniquely upregulated in KP and a gene cluster for the cellobiose phosphotransferase system, previously linked to bacterial virulence and biofilm formation, was found exclusively in KP.</p>
</sec>
<sec id="sec4">
<title>Discussion</title>
<p>Our study underscores the metabolic flexibility of KP strains in response to specific environmental conditions, potentially contributing to opportunistic pathogenicity. We identified markers enriched in KP STs, providing a foundation for future investigations including their relevance for diagnostics.</p>
</sec>
</abstract>
<kwd-group>
<kwd>multi-omics</kwd>
<kwd><italic>Klebsiella pneumoniae</italic> species complex and its differences</kwd>
<kwd>multidrug resistance</kwd>
<kwd>markers</kwd>
<kwd>synthetic human urine</kwd>
</kwd-group>
<counts>
<fig-count count="5"/>
<table-count count="2"/>
<equation-count count="0"/>
<ref-count count="110"/>
<page-count count="19"/>
<word-count count="16276"/>
</counts>
<custom-meta-wrap>
<custom-meta>
<meta-name>section-at-acceptance</meta-name>
<meta-value>Microbial Physiology and Metabolism</meta-value>
</custom-meta>
</custom-meta-wrap>
</article-meta>
</front>
<body>
<sec sec-type="intro" id="sec5">
<label>1</label>
<title>Introduction</title>
<p>The genus <italic>Klebsiella</italic> encompasses diverse opportunistic pathogens, which are either part of the <italic>Klebsiella pneumoniae</italic> species complex (KpSC), sharing &#x003E;95.0% average nucleotide identity, or belonging to other <italic>Klebsiella</italic> species (e.g., <italic>K. oxytoca, K. michiganensis</italic> or <italic>K. pasteurii</italic>) (<xref ref-type="bibr" rid="ref108">Wyres et al., 2020a</xref>). The KpSC consists of seven taxa, including <italic>K. pneumoniae</italic> (KP), and the subspecies of <italic>K. quasipneumoniae</italic>, namely <italic>K. quasipneumoniae</italic> subsp. <italic>quasipneumoniae</italic> and <italic>K. quasipneumoniae</italic> subsp. <italic>similipneumoniae</italic> (summarized as KQ), and <italic>K.</italic> var<italic>iicola</italic>, namely <italic>Klebsiella variicola</italic> subsp. <italic>variicola</italic> and <italic>Klebsiella variicola</italic> subsp. <italic>tropica</italic> (summarized as KV), which are closely related (<xref ref-type="bibr" rid="ref81">Rosenblueth et al., 2004</xref>; <xref ref-type="bibr" rid="ref9">Brisse et al., 2014</xref>; <xref ref-type="bibr" rid="ref33">Holt et al., 2015</xref>). Although KQ and KV have the potential to cause clinical outbreaks, they are generally less prevalent in clinical settings compared to KP (<xref ref-type="bibr" rid="ref10">Brisse and Verhoef, 2001</xref>; <xref ref-type="bibr" rid="ref33">Holt et al., 2015</xref>; <xref ref-type="bibr" rid="ref110">Wyres et al., 2019</xref>, <xref ref-type="bibr" rid="ref109">2020b</xref>; <xref ref-type="bibr" rid="ref49">Lam et al., 2021</xref>; <xref ref-type="bibr" rid="ref30">Gorrie et al., 2022</xref>; <xref ref-type="bibr" rid="ref45">Kochan et al., 2022</xref>; <xref ref-type="bibr" rid="ref98">Thorpe et al., 2022</xref>; <xref ref-type="bibr" rid="ref11">Calland et al., 2023</xref>). Due to their similarity, differentiation using microbiological methods or MALDI-TOF is often inaccurate (<xref ref-type="bibr" rid="ref109">Wyres et al., 2020b</xref>; <xref ref-type="bibr" rid="ref30">Gorrie et al., 2022</xref>). However, local whole-genome sequencing (WGS) investigations of clinical isolates in regions such as Australia, South and Southeast Asia, and Italy have shown that 82.0&#x2013;91.0% of isolates previously identified as KpSC are actually KP, 2.5&#x2013;14.0% are KV, and 4.0&#x2013;6.9% are KQ, with other <italic>Klebsiella</italic> species occurring even less frequently (<xref ref-type="bibr" rid="ref109">Wyres et al., 2020b</xref>; <xref ref-type="bibr" rid="ref30">Gorrie et al., 2022</xref>; <xref ref-type="bibr" rid="ref11">Calland et al., 2023</xref>). The dominant prevalence of KP within the KpSC is evident not only in clinical samples but also across various environmental niches including farm animal, community members, hospital patients, water and other environmental sources (65.0% KP, 24.0% KQ, 6.0% KV, and 4.0% <italic>K. aerogenes</italic> (<xref ref-type="bibr" rid="ref11">Calland et al., 2023</xref>)). Another study in Italy demonstrated that KP from clinical, community, animal and environmental niches accounts for 49.0%, followed by <italic>K. michiganensis</italic> (9.0%), KV (8.5%), and KQ (1.0%) of all investigated isolates (<xref ref-type="bibr" rid="ref98">Thorpe et al., 2022</xref>). In 2021, Lam et al. reported that genomic data for <italic>Klebsiella</italic> spp. (<italic>n</italic>&#x202F;=&#x202F;13,156) is mostly available for KP (86.0% of genomes), followed by other members of the KpSC (9.4%) (<xref ref-type="bibr" rid="ref49">Lam et al., 2021</xref>). Moreover, this large-scale genomic analysis showed that the frequencies of harboring crucial virulence factors is notably lower in KQ (0.8&#x2013;2.0%) and KV (0.4&#x2013;3.0%) compared to KP (7.0&#x2013;44.0%) (<xref ref-type="bibr" rid="ref49">Lam et al., 2021</xref>). In line with this, other studies have consistently shown that yersiniabactin siderophores and the virulence-associated regulator of the mucoid phenotype <italic>rmpA</italic>, were detected in every third KP isolate in Australia (<xref ref-type="bibr" rid="ref30">Gorrie et al., 2022</xref>) and Japan (<xref ref-type="bibr" rid="ref36">Imai et al., 2019</xref>; <xref ref-type="bibr" rid="ref60">Matsuda et al., 2023</xref>), but were rarely found in KV and KQ (<xref ref-type="bibr" rid="ref56">Lu et al., 2018</xref>). Similarly, the highest carriage of antibiotic resistance genes occurred among clinical KP isolates from Australia and Italy (21.0%) (<xref ref-type="bibr" rid="ref30">Gorrie et al., 2022</xref>) compared to 7.0&#x2013;8.0% (<xref ref-type="bibr" rid="ref30">Gorrie et al., 2022</xref>) in isolates identified as KV and KQ (<xref ref-type="bibr" rid="ref30">Gorrie et al., 2022</xref>; <xref ref-type="bibr" rid="ref98">Thorpe et al., 2022</xref>). Additionally, the predominant occurrence of these genes in KP was confirmed in a non-redundant <italic>Klebsiella</italic> dataset of 9,705 genomes (<xref ref-type="bibr" rid="ref49">Lam et al., 2021</xref>).</p>
<p>A recent systematic analysis of the global burden of bacterial antimicrobial resistance (AMR) estimated the significant public health impact of multidrug-resistant (MDR) KP infections, which were associated with over 600,000 deaths worldwide in 2019 (<xref ref-type="bibr" rid="ref66">Murray et al., 2022</xref>). This is further emphasized by the World Health Organization&#x2019;s Bacterial Priority Pathogens List in 2024, which ranks carbapenem- and third-generation cephalosporin-resistant KP among the top ten critical pathogens (<xref ref-type="bibr" rid="ref96">Tacconelli et al., 2018</xref>; <xref ref-type="bibr" rid="ref105">World Health Organization, 2024</xref>). KP colonizes human mucosal surfaces, serving as important reservoirs for subsequent infection (<xref ref-type="bibr" rid="ref19">Davis and Matsen, 1974</xref>; <xref ref-type="bibr" rid="ref29">Gorrie et al., 2017</xref>, <xref ref-type="bibr" rid="ref30">2022</xref>; <xref ref-type="bibr" rid="ref58">Martin and Bachman, 2018</xref>; <xref ref-type="bibr" rid="ref15">Chang et al., 2021</xref>). As an opportunistic pathogen, KP is associated with a wide range of diseases, including pneumonia, urinary tract infection (UTI), pyogenic liver abscess, meningitis, and bloodstream infections (<xref ref-type="bibr" rid="ref26">Friedl&#x00E4;nder, 1882</xref>; <xref ref-type="bibr" rid="ref74">Podschun and Ullmann, 1998</xref>; <xref ref-type="bibr" rid="ref14">Chang et al., 2000</xref>; <xref ref-type="bibr" rid="ref44">Ko et al., 2002</xref>; <xref ref-type="bibr" rid="ref57">Magill et al., 2014</xref>). Multiple studies have identified the urinary tract as the most frequent isolation source of KP, with prevalence ranging from 39.0&#x2013;66.0% (<xref ref-type="bibr" rid="ref30">Gorrie et al., 2022</xref>; <xref ref-type="bibr" rid="ref60">Matsuda et al., 2023</xref>; <xref ref-type="bibr" rid="ref80">Rodr&#x00ED;guez-Medina et al., 2024</xref>), and have recognized KP as the second most common cause of UTI after <italic>Escherichia coli</italic> (<xref ref-type="bibr" rid="ref25">Flores-Mireles et al., 2015</xref>).</p>
<p>Multi-locus sequence typing (MLST), applicable across the entirety of KpSC (<xref ref-type="bibr" rid="ref6">Bialek-Davenet et al., 2014</xref>), facilitates the differentiation of KP into various sequence types (STs), each distinguished by unique global dissemination and distribution patterns (<xref ref-type="bibr" rid="ref22">Diancourt et al., 2005</xref>; <xref ref-type="bibr" rid="ref108">Wyres et al., 2020a</xref>). The aforementioned study by Lam et al. revealed considerable phylogenetic diversity, encompassing isolates belonging to at least 1,452 distinct STs (<xref ref-type="bibr" rid="ref49">Lam et al., 2021</xref>). Among a selected non-redundant KP-dataset, MDR and hypervirulent clinical isolates comprised 63.4% and were distributed among 30 different STs (<xref ref-type="bibr" rid="ref49">Lam et al., 2021</xref>).</p>
<p>The most successful STs, also termed international high-risk clonal lineages, exhibit widespread dissemination globally and are primarily associated with KP. They contribute significantly to the propagation of AMR genes, often harboring them on extra-chromosomal elements. These lineages possess notable colonization and persistence capabilities within hosts, coupled with heightened virulence and pathogenicity, resulting in recurrent infections (<xref ref-type="bibr" rid="ref59">Mathers et al., 2015</xref>). However, the mechanisms underlying their global dissemination potential remain inadequately explored (<xref ref-type="bibr" rid="ref20">de Lagarde et al., 2021</xref>). Noteworthy among the high-risk clonal lineages are ST15, ST147, and ST258, primarily associated with MDR, including the expression of extended-spectrum <italic>&#x03B2;</italic>-lactamases (ESBL) and carbapenemases (<xref ref-type="bibr" rid="ref43">Knothe et al., 1983</xref>; <xref ref-type="bibr" rid="ref68">Nordmann et al., 2009</xref>; <xref ref-type="bibr" rid="ref107">Wyres and Holt, 2018</xref>). Additionally, certain STs, such as ST23, are characterized mostly as hypervirulent <italic>K. pneumoniae</italic> (hvKp), marked by the presence of multiple virulence factors and a common lack of MDR. These strains are often associated with severe infections in healthy community members (<xref ref-type="bibr" rid="ref92">Shon et al., 2013</xref>; <xref ref-type="bibr" rid="ref6">Bialek-Davenet et al., 2014</xref>; <xref ref-type="bibr" rid="ref85">Russo et al., 2018</xref>). Of particular concern is the emergence of convergent KP strains, combining traits of hvKp and MDR strains, exemplified by ST307 (<xref ref-type="bibr" rid="ref6">Bialek-Davenet et al., 2014</xref>; <xref ref-type="bibr" rid="ref53">Li et al., 2014</xref>; <xref ref-type="bibr" rid="ref31">Gu et al., 2018</xref>; <xref ref-type="bibr" rid="ref32">Heiden et al., 2020</xref>; <xref ref-type="bibr" rid="ref49">Lam et al., 2021</xref>; <xref ref-type="bibr" rid="ref61">Mendes et al., 2022</xref>; <xref ref-type="bibr" rid="ref24">ECDC, 2024</xref>), which may even demonstrate resistance to recently approved antibiotics like cefiderocol (<xref ref-type="bibr" rid="ref89">Schaufler et al., 2023</xref>). Local outbreaks featuring sporadic KP STs underscore the opportunistic nature and complexity of the KP species (<xref ref-type="bibr" rid="ref108">Wyres et al., 2020a</xref>).</p>
<p>The &#x201C;success&#x201D; and prevalence of KP, particularly in clinical environments, is influenced by a multifaceted interplay of factors, including the accumulation of resistance and/or virulence genes, as well as colonization abilities, which are often prerequisites for subsequent infections (<xref ref-type="bibr" rid="ref30">Gorrie et al., 2022</xref>). Despite KP&#x2019;s prominent presence in clinical settings, investigating mechanisms beyond conventional virulence and resistance attributes is crutial (<xref ref-type="bibr" rid="ref63">Moraes et al., 2024</xref>; <xref ref-type="bibr" rid="ref69">O&#x2019;Brien et al., 2025</xref>). Leveraging the available genomic data could facilitate more in-depth investigations into the distinctions between KP and other closely related species, particularly within the KpSC. The multifaceted diversity within the KpSC is evident in its complex accessory genome, which harbors a multitude of fitness and virulence factors associated with capsule and lipopolysaccharide production, iron acquisition, and various other functions (<xref ref-type="bibr" rid="ref33">Holt et al., 2015</xref>). While gene content remains relatively conserved within lineages among different clinical isolates, significant diversity exists among different lineages, even within the same species (<xref ref-type="bibr" rid="ref30">Gorrie et al., 2022</xref>).</p>
<p>Our hypothesis posits that KP displays unique characteristics distinct from closely related species such as KQ and KV. To explore this hypothesis, our study utilized genomics, transcriptomics, and proteomics analyses under conditions mimicking the urinary tract environment. We aimed to identify specific molecular markers that could elucidate differences within the complex that might also contribute to improved future diagnostics.</p>
</sec>
<sec sec-type="materials|methods" id="sec6">
<label>2</label>
<title>Materials and methods</title>
<sec id="sec7">
<label>2.1</label>
<title>Bacterial strains</title>
<p>We included four of the most prevalent KP sequence types (ST15, ST147, ST258, and ST307). Strains belonging to these KP STs are recognized for their MDR and/or virulence profiles (<xref ref-type="supplementary-material" rid="SM1">Supplementary Figure 1</xref>) (<xref ref-type="bibr" rid="ref108">Wyres et al., 2020a</xref>; <xref ref-type="bibr" rid="ref49">Lam et al., 2021</xref>). We specifically selected two clinical isolates for each of these STs, along with two strains of KV, for comprehensive transcriptomic, proteomic, and phenotypic analysis (<xref ref-type="table" rid="tab1">Table 1</xref>). The decision to include KV for comparison was based on several factors: (i) epidemiological evidence suggests that KV infections are notably less frequent in clinical settings compared to KP (<xref ref-type="bibr" rid="ref9">Brisse et al., 2014</xref>; <xref ref-type="bibr" rid="ref57">Magill et al., 2014</xref>; <xref ref-type="bibr" rid="ref33">Holt et al., 2015</xref>; <xref ref-type="bibr" rid="ref110">Wyres et al., 2019</xref>; <xref ref-type="bibr" rid="ref30">Gorrie et al., 2022</xref>; <xref ref-type="bibr" rid="ref98">Thorpe et al., 2022</xref>; <xref ref-type="bibr" rid="ref60">Matsuda et al., 2023</xref>), (ii) the close relationship within the KpSC allowed for a more comprehensive understanding of the differentiating factors (<xref ref-type="bibr" rid="ref33">Holt et al., 2015</xref>; <xref ref-type="bibr" rid="ref110">Wyres et al., 2019</xref>), and (iii) the availability of a sufficient number of KV genomes in public databases facilitated comparative genomic analyses to explore distinctions between KV and KP (<xref ref-type="bibr" rid="ref49">Lam et al., 2021</xref>). Moreover, we selected KV instead of other KP STs because various KP STs often emerge as local problem clones within specific regions or healthcare settings (<xref ref-type="bibr" rid="ref108">Wyres et al., 2020a</xref>). The KV isolates of the ST347 and ST906 were provided from a sampling set of clinical <italic>Klebsiella</italic> spp. isolates (<xref ref-type="bibr" rid="ref5">Becker et al., 2018</xref>). The definition of different pathotypes of the isolates was done by using Kleborate to calculate the resistance score (0&#x202F;=&#x202F;no ESBL, no carbapenemases (CARB) (regardless of colistin resistance); 1&#x202F;=&#x202F;ESBL, no CARB (regardless of colistin resistance); 2&#x202F;=&#x202F;CARB without colistin resistance (regardless of ESBL genes or OmpK mutations); 3&#x202F;=&#x202F;CARB with colistin resistance (regardless of ESBL genes or OmpK mutations)) and the virulence score (0&#x202F;=&#x202F;negative for all of yersiniabactin (<italic>ybt</italic>), colibactin (<italic>clb</italic>), aerobactin (<italic>iuc</italic>), 1&#x202F;=&#x202F;<italic>ybt</italic> only, 2&#x202F;=&#x202F;<italic>ybt</italic> and <italic>clb</italic> (or <italic>clb</italic> only), 3&#x202F;=&#x202F;aerobactin (without <italic>ybt</italic> or <italic>clb</italic>), 4&#x202F;=&#x202F;aerobactin with <italic>ybt</italic> (without <italic>clb</italic>), 5&#x202F;=&#x202F;<italic>ybt</italic>, <italic>clb</italic> and <italic>iuc</italic>). Based on that we defined resistant cKp with a resistance score &#x2265;1 and a virulence score &#x003C;3 and convergent KP refers to isolates with at least one acquired ESBL gene and a virulence score &#x2265;3 (<xref ref-type="bibr" rid="ref49">Lam et al., 2021</xref>). Kleborate was primarily developed to screen the genome assemblies of species within the KpSC, including <italic>K. pneumoniae</italic>, <italic>K. quasipneumoniae</italic> and <italic>K.</italic> var<italic>iicola</italic>. The same thresholds are used to assign virulence and resistance scores, regardless of KpSC species. Therefore, we decided to apply the same criteria for classifying strains as &#x201C;classical&#x201D; (cKv), &#x201C;hypervirulent&#x201D; (hvKv) or &#x201C;convergent&#x201D; (conKv). Note that while convergent and hypervirulent KV isolates have been described, none have been used in this study (<xref ref-type="bibr" rid="ref56">Lu et al., 2018</xref>).</p>
<table-wrap position="float" id="tab1">
<label>Table 1</label>
<caption>
<p>Overview of clinical <italic>Klebsiella</italic> spp. strains used in this study.</p>
</caption>
<table frame="hsides" rules="groups">
<thead>
<tr>
<th align="left" valign="top">Species/ST</th>
<th align="center" valign="top">Strains included in omics</th>
<th align="center" valign="top">Original strain name</th>
<th align="center" valign="top">Source</th>
<th align="center" valign="top">Year of isolation</th>
<th align="center" valign="top">Pathotype</th>
<th align="center" valign="top">Reference</th>
</tr>
</thead>
<tbody>
<tr>
<td align="left" valign="middle" rowspan="2">KV/NA</td>
<td align="center" valign="middle">PBIO3543 (ST347)</td>
<td align="center" valign="middle">275/15</td>
<td align="center" valign="middle">Body fluid</td>
<td align="center" valign="middle">2011</td>
<td align="center" valign="middle">cKv</td>
<td align="center" valign="middle">
<xref ref-type="bibr" rid="ref5">Becker et al. (2018)</xref>
</td>
</tr>
<tr>
<td align="center" valign="middle">PBIO3544 (ST906)</td>
<td align="center" valign="middle">328/15</td>
<td align="center" valign="middle">Anal swab</td>
<td align="center" valign="middle">2014</td>
<td align="center" valign="middle">cKv</td>
<td align="center" valign="middle">
<xref ref-type="bibr" rid="ref5">Becker et al. (2018)</xref>
</td>
</tr>
<tr>
<td align="left" valign="middle" rowspan="2">KP/ST15</td>
<td align="center" valign="middle">PBIO3546</td>
<td align="center" valign="middle">331/15</td>
<td align="center" valign="middle">Pleural fluid</td>
<td align="center" valign="middle">2014</td>
<td align="center" valign="middle">cKp</td>
<td align="center" valign="middle">
<xref ref-type="bibr" rid="ref5">Becker et al. (2018)</xref>
</td>
</tr>
<tr>
<td align="center" valign="middle">PBIO3547</td>
<td align="center" valign="middle">334/15</td>
<td align="center" valign="middle">Urine</td>
<td align="center" valign="middle">2012</td>
<td align="center" valign="middle">cKp</td>
<td align="center" valign="middle">
<xref ref-type="bibr" rid="ref5">Becker et al. (2018)</xref>
</td>
</tr>
<tr>
<td align="left" valign="middle" rowspan="2">KP/ST147</td>
<td align="center" valign="middle">PBIO3553</td>
<td align="center" valign="middle">313/15</td>
<td align="center" valign="middle">Urine</td>
<td align="center" valign="middle">2011</td>
<td align="center" valign="middle">cKp</td>
<td align="center" valign="middle">
<xref ref-type="bibr" rid="ref5">Becker et al. (2018)</xref>
</td>
</tr>
<tr>
<td align="center" valign="middle">PBIO3554</td>
<td align="center" valign="middle">315/15</td>
<td align="center" valign="middle">Tracheal secretion</td>
<td align="center" valign="middle">2012</td>
<td align="center" valign="middle">cKp</td>
<td align="center" valign="middle">
<xref ref-type="bibr" rid="ref5">Becker et al. (2018)</xref>
</td>
</tr>
<tr>
<td align="left" valign="middle" rowspan="2">KP/ST258</td>
<td align="center" valign="middle">PBIO3556</td>
<td align="center" valign="middle">278/15</td>
<td align="center" valign="middle">Urine</td>
<td align="center" valign="middle">2012</td>
<td align="center" valign="middle">cKp</td>
<td align="center" valign="middle">
<xref ref-type="bibr" rid="ref5">Becker et al. (2018)</xref>
</td>
</tr>
<tr>
<td align="center" valign="middle">PBIO3557</td>
<td align="center" valign="middle">287/15</td>
<td align="center" valign="middle">Urine</td>
<td align="center" valign="middle">2014</td>
<td align="center" valign="middle">cKp</td>
<td align="center" valign="middle">
<xref ref-type="bibr" rid="ref5">Becker et al. (2018)</xref>
</td>
</tr>
<tr>
<td align="left" valign="middle" rowspan="2">KP/ST307</td>
<td align="center" valign="middle">PBIO3559</td>
<td align="center" valign="middle">333/15</td>
<td align="center" valign="middle">Central venous catheter</td>
<td align="center" valign="middle">2014</td>
<td align="center" valign="middle">cKp</td>
<td align="center" valign="middle">
<xref ref-type="bibr" rid="ref5">Becker et al. (2018)</xref>
</td>
</tr>
<tr>
<td align="center" valign="middle">PBIO1953</td>
<td align="center" valign="middle">va20750</td>
<td align="center" valign="middle">Tracheal secretion</td>
<td align="center" valign="middle">2019</td>
<td align="center" valign="middle">conKp</td>
<td align="center" valign="middle">
<xref ref-type="bibr" rid="ref32">Heiden et al. (2020)</xref>
</td>
</tr>
</tbody>
</table>
<table-wrap-foot>
<p>The sequence type (ST) of <italic>K. pneumoniae</italic> (KP) and <italic>K. variicola</italic> (KV) included in all phenotypic analyses are summarized. Information on the isolates including their source, year of isolation and original description is provided. The pathotype for KP isolates was manually assigned based on Kleborate resistance and virulence scores. cKp, classical KP; cKv, classical KV; conKp, convergent KP.</p>
</table-wrap-foot>
</table-wrap>
</sec>
<sec id="sec8">
<label>2.2</label>
<title>Cultivation and harvest of bacterial strains</title>
<p>KP together with <italic>E. coli</italic> are the most common bacteria in UTI which is a risk factor for development of severe infectious disease (<xref ref-type="bibr" rid="ref25">Flores-Mireles et al., 2015</xref>; <xref ref-type="bibr" rid="ref72">Paczosa and Mecsas, 2016</xref>; <xref ref-type="bibr" rid="ref71">Oliveira et al., 2022</xref>). Therefore, all cultivations of bacterial strains were performed in synthetic human urine (SHU), composited according to <xref ref-type="bibr" rid="ref1">Abbott et al. (2020)</xref> with shaking (150&#x2013;220&#x202F;rpm) at 37&#x00B0;C. For growth kinetics 5.0&#x202F;mL of SHU were inoculated with a single colony of the respective strain (<xref ref-type="table" rid="tab1">Table 1</xref>) and incubated overnight. Then, 10.0&#x202F;mL of SHU were inoculated at an optical density of 0.05 at <italic>&#x03BB;</italic>&#x202F;=&#x202F;600&#x202F;nm (OD<sub>600</sub>) and growth was monitored by measurements every 30&#x202F;min for 8&#x202F;h. In its original recipe SHU contains 6.8&#x202F;mM citrate (<xref ref-type="bibr" rid="ref1">Abbott et al., 2020</xref>), this was not added to the citrate depleted SHU to check for citrate-dependent growth phenotypes. Strains were grown overnight in either normal SHU or citrate depleted and from that cultures in a 24-well suspension plate (Sarstedt, N&#x00FC;mbrecht, Germany) were inoculated at OD<sub>600 nm</sub> of 0.05 and incubated at 37&#x00B0;C with double orbital shaking (180&#x202F;rpm) before each measurement every 30&#x202F;min using a Spark&#x00AE; Multimode Microplate Reader (TECAN, Switzerland). To mitigate the variability in biological replicates, total protein and RNA were extracted from cultures that were initiated through a systematic serial dilution of 5.0&#x202F;mL overnight cultures, originating from a glycerol stock. Subsequently, pre-cultures (20.0&#x202F;mL of SHU) were inoculated at an OD<sub>600</sub> of 0.05, starting from mid-exponential phase overnight cultures. Once the pre-cultures reached the mid-exponential phase again, the main cultures (100.0&#x202F;mL of SHU) were inoculated in a similar manner. Cell harvest during the mid-exponential phase involved cooling in liquid nitrogen and centrifugation (3&#x202F;min; 4&#x00B0;C; 8,000 x <italic>g</italic>). Cell pellets were stored at &#x2212;80&#x00B0;C until RNA and protein preparation.</p>
</sec>
<sec id="sec9">
<label>2.3</label>
<title>Isolation of chromosomal DNA and whole genome sequencing</title>
<p>Extraction of total DNA for all strains except PBIO1953 (which was previously sequenced; ERR4422314 (<xref ref-type="bibr" rid="ref32">Heiden et al., 2020</xref>)) was performed using the MasterPure DNA Purification Kit for Blood, Version 2 (Lucigen, Middelton, WI, USA), according to the manufacturer&#x2019;s instructions. Afterwards, DNA was quantified with dsDNA HS Assay Kit using Qubit 4 fluorometer (Thermo Fisher Scientific, Waltham, MA, USA) and then shipped to SeqCenter (Pittsburgh, PA, USA). Library preparation was performed using the Illumina DNA Prep Kit and IDT 10&#x202F;bp UDI indices (Illumina, San Diego, CA, USA), hybrid whole genome sequencing was carried out on an Illumina NovaSeq X Plus (2&#x202F;&#x00D7;&#x202F;151&#x202F;bp reads) and Oxford Nanopore R10.4.1 flowcells run on a MinION platform. Demultiplexing, quality control, and adapter trimming were performed using bcl-convert (v. 4.1.5) (<xref ref-type="bibr" rid="ref76">Prjibelski et al., 2020</xref>).</p>
</sec>
<sec id="sec10">
<label>2.4</label>
<title>Assembly and annotation</title>
<p>Raw sequencing Illumina reads were adapter- and quality-trimmed using Trim galore.<xref ref-type="fn" rid="fn0001"><sup>1</sup></xref> The Trycycler pipeline (v. 0.5.3) (<xref ref-type="bibr" rid="ref103">Wick et al., 2021</xref>) was used to generate most accurate hybrid assemblies by combining assemblies from flye (v. 2.9.2) (<xref ref-type="bibr" rid="ref46">Kolmogorov et al., 2019</xref>), miniasm and minipolish (v. 0.1.3) (<xref ref-type="bibr" rid="ref102">Wick and Holt, 2023</xref>) and raven (v. 1.8.1) (<xref ref-type="bibr" rid="ref99">Vaser and &#x0160;iki&#x0107;, 2021</xref>). The combined assemblies were polished according to the pipeline instructions using Polypolish (v. 0.5.0) (<xref ref-type="bibr" rid="ref101">Wick and Holt, 2022</xref>) and POLCA (from MaSuRCA v. 4.1.0) with the Illumina short-reads. Since Trycycler sometimes misses small plasmids, short-reads and long-reads were additionally assembled with Unicycler (v. 0.5.0) (<xref ref-type="bibr" rid="ref104">Wick et al., 2017</xref>). Both assemblies were compared and missing plasmid contigs from Unicycler were added to the Trycycler output, thus we obtained a closed reference with all plasmids for each of the strains. For PBIO1953 the previously assembled closed genome (ERR4422314) was used (<xref ref-type="bibr" rid="ref32">Heiden et al., 2020</xref>). All genomes were annotated with Bakta (v. 1.7.0, database version 5). All genomes were further analyzed with Kleborate (v. 2.3.2) (<xref ref-type="bibr" rid="ref49">Lam et al., 2021</xref>) to verify the ST and determine resistance and virulence features.</p>
</sec>
<sec id="sec11">
<label>2.5</label>
<title>Pangenome analysis</title>
<p>To establish the foundation for subsequent analyses, we curated a dataset that included the genomes of two different KV strains (PBIO3543 and PBIO3544) along with eight KP strains (PBIO3546, PBIO3547, PBIO3553, PBIO3554, PBIO3556, PBIO3557, PBIO3559, and PBIO1953) (<xref ref-type="table" rid="tab1">Table 1</xref>). Utilizing the obtained closed genomes of these strains, we constructed a pangenome. Using the pangenome analysis pipeline Proteinortho (v. 6.2.3) (<xref ref-type="bibr" rid="ref52">Lechner et al., 2011</xref>), we performed orthologous protein sequence clustering with coverage of &#x2265;50.0% and e-value 1e-5 (other settings: default). The resulting pangenome was further subdivided into a core genome, containing genes shared by all strains included in the study, and an accessory genome, consisting of genes unique to specific subsets of strains included in the study (<xref ref-type="bibr" rid="ref97">Tettelin et al., 2008</xref>; <xref ref-type="bibr" rid="ref82">Rouli et al., 2015</xref>). The accessory genome was subdivided into the shell genome (genes present in a minimum of two and a maximum of nine strains), the cloud genome (genes unique to a single genome within the dataset), and to a group comprising genes shared by all KP strains but absent in KV strains, further referred to as markers. The visualization of the distribution of genes within the pangenome was performed using the ggplot2 package and RStudio (v. 4.3.1). A reference-independent, alignment-free method based on whole genome data was selected to compare the isolates of the two different species KP and KV using mashtree (v.1.2.0). To visualize the relationship of the used strains, we determined the genetic distance with mashtree (v.1.2.0), and plotted the resulting tree with iTOL (v.6.8.1) (<xref ref-type="bibr" rid="ref21">Den Bakker et al., 2022</xref>) including metadata like ST, resistance score based on Kleborate (<xref ref-type="bibr" rid="ref49">Lam et al., 2021</xref>), source of isolation, carriage of ESBL and carbapenemase genes, and selected marker genes. Notably, this pangenome dataset served as the database for subsequent transcriptomic and proteomic analyses.</p>
</sec>
<sec id="sec12">
<label>2.6</label>
<title>Isolation of total RNA and sequencing</title>
<p>Total bacterial RNA was isolated by mechanical disruption and acid phenol-chloroform extraction as previously described with minor modifications (<xref ref-type="bibr" rid="ref67">Nicolas et al., 2012</xref>) from mid-exponential growth phase. The bacterial pellet (equivalent to 8 OD units) was resuspended in 200&#x202F;&#x03BC;L of ice-cold killing buffer (composition, 20.0&#x202F;mM Tris&#x2013;HCl, pH 7.5; 5.0&#x202F;mM MgCl<sub>2</sub>; 20.0&#x202F;mM NaN<sub>3</sub>). Subsequently, mechanical disruption was carried out using a Mikro-Dismembrator S (Sartorius, Goettingen, Germany) for 2&#x202F;min at 2600&#x202F;rpm. The resulting cell powder was resuspended in 2.0&#x202F;mL of lysis buffer (composition, 4 M guanidine-thiocyanate; 25.0&#x202F;mM sodium acetate, pH 5.2; 0.5% (wt/vol) sodium <italic>N</italic>-lauroylsarcosine) prewarmed at 50&#x00B0;C and then stored at &#x2212;80&#x00B0;C until RNA preparation. The RNA extraction consisted of two washes with 1 volume of acid phenol solution (ROTI&#x00AE;Aqua-P/C/I, Carl Roth, Karlsruhe, Germany) and one round with 1 volume 24:1 chloroform-isoamyl alcohol (chloroform ROTIPURAN&#x00AE;&#x202F;&#x2265;&#x202F;99%/IAA pH 8.0, Carl Roth). The upper phase was transferred into a fresh tube to avoid carry-over of DNA-containing interphase. Following the addition of 1/10 volume of 3.0&#x202F;M sodium acetate, RNA was precipitated with 1.0&#x202F;mL of isopropanol overnight at &#x2212;20&#x00B0;C. Upon centrifugation (15&#x202F;min, 15,000 rpm, 4&#x00B0;C) the resulting RNA pellet was washed twice with 70.0% (vol/vol) ethanol before the dried pellet was solubilized in 100&#x202F;&#x03BC;L of RNase-free water. Samples were treated with rDNase (Macherey-Nagel, D&#x00FC;ren, Germany) according to the manufacturer&#x2019;s protocol to minimize DNA contamination. Purification was carried out using the RNA Clean-Up Kit (Macherey-Nagel). Finally, the RNA concentration was determined using a NanoDrop spectrometer (NanoDrop 8000, PeqLab, Erlangen, Germany).</p>
<p>RNA samples were shipped frozen to Novogene (Cambridge, United Kingdom) and, following rRNA depletion and mRNA library preparation, sequenced using 2&#x202F;&#x00D7;&#x202F;151&#x202F;bp reads (Illumina NovaSeq 6000, stranded).</p>
</sec>
<sec id="sec13">
<label>2.7</label>
<title>Differential gene expression</title>
<p>Trim Galore (v. 0.6.8)<xref ref-type="fn" rid="fn0002"><sup>2</sup></xref> was used for the adapter and quality trimming of the raw sequencing reads. The trimmed reads were then mapped with Bowtie 2 (v. 2.5.1/mode: &#x2013;very-sensitive-local) (<xref ref-type="bibr" rid="ref50">Langmead and Salzberg, 2012</xref>), using the assemblies of the previously generated genomes as references for the individual strains (<xref ref-type="table" rid="tab1">Table 1</xref>). The gene counts were calculated using featureCounts (v. 2.0.1/stranded-mode) (<xref ref-type="bibr" rid="ref54">Liao et al., 2014</xref>) based on the annotation for the respective strain. Next, the gene names in the count tables were replaced with the cluster IDs of the pangenome and the different count tables were merged together. The modified count table was imported into RStudio (v. 4.3.1), and genes differentially expressed in comparisons between each KV strain and each KP strain, as well as among the KV strains themselves, were identified with DESeq2 (v. 1.40.0) in default mode. The obtained data were submitted to further analysis for identification of unique KP characteristics across omics levels (refer 2.12).</p>
</sec>
<sec id="sec14">
<label>2.8</label>
<title>Isolation of intracellular proteins</title>
<p>Prior to isolation of intracellular proteins, samples from mid-exponential growth phase were washed twice with ice-cold phosphate-buffered saline (PBS; Thermo Fisher Scientific), and the pellet was suspended in 100&#x202F;&#x03BC;L of a solution comprising of 20.0&#x202F;mM HEPES (pH 8.0) and 2.0% (wt/vol) sodium dodecyl sulfate (SDS), followed by denaturation at 95&#x00B0;C for 1&#x202F;min with vigorous shaking. Subsequently, the cells were disrupted using a Mikro-Dismembrator S (Sartorius, G&#x00F6;ttingen, Germany) for 3&#x202F;min at 2600&#x202F;rpm. The obtained cell powder was then resuspended in 150&#x202F;&#x03BC;L of preheated (95&#x00B0;C) 20.0&#x202F;mM HEPES (pH 8.0) and transferred into a 1.5&#x202F;mL low binding pre-lubricated tube (Sorenson&#x2122; BioScience Inc., Salt Lake City, UT). After cooling to room temperature (RT), 4.0&#x202F;mM MgCl<sub>2</sub> and 0.005&#x202F;U/&#x03BC;L benzonase (Pierce Universal Nuclease, Thermo Fisher Scientific) were added to the lysates. Ultrasonication was performed for 5&#x202F;min and the resulting cell debris was pelleted by centrifugation (30&#x202F;min; RT; 17,000 x <italic>g</italic>). The resulting supernatants containing soluble protein lysates were transferred into a fresh 1.5&#x202F;mL low binding pre-lubricated tube (Sorenson&#x2122; BioScience Inc.) to ensure optimal conditions for further downstream analysis.</p>
</sec>
<sec id="sec15">
<label>2.9</label>
<title>Bicinchoninic acid assay</title>
<p>In order to standardize protein amount for subsequent mass spectrometric analysis, protein concentration was quantified as previously described (<xref ref-type="bibr" rid="ref7">Blankenburg et al., 2019</xref>; <xref ref-type="bibr" rid="ref78">Reder et al., 2023</xref>) using the MicroBCA&#x2122;Protein Assay Kit (Thermo Fisher Scientific) according to the manufacturer&#x2019;s instructions. Briefly, samples were diluted at a 1:50 ratio. Concurrently, standards containing a known concentration of bovine serum albumin were prepared to match the concentrations of SDS and HEPES in both the samples and standards. All samples and standards were each mixed with equal volumes of the working reaction in duplicates and incubated at 68&#x00B0;C for 1&#x202F;h. The standards were measured first, followed by sample measurements, all performed in duplicates using the OT-2 robot (Opentrons, Long Island City, NY) and BioTek Synergy (Agilent Technologies, Waldbronn, Germany). The acquired data were evaluated using the MassSpecPreppy Shiny application (v. 1.1.1) based on the determined standard curves for accurate quantification (<xref ref-type="bibr" rid="ref78">Reder et al., 2023</xref>).</p>
</sec>
<sec id="sec16">
<label>2.10</label>
<title>Single pot solid-phase enhanced sample preparation (SP3)</title>
<p>Prior mass spectrometric analysis the samples were prepared using the Single pot solid-phase enhanced sample preparation (SP3) protocol as described by Blankenburg et al. with slight modifications (<xref ref-type="bibr" rid="ref7">Blankenburg et al., 2019</xref>). For the trypsin digestion, 5&#x202F;&#x03BC;g of total protein in 10&#x202F;&#x03BC;L of 20.0&#x202F;mM HEPES (pH 8.0) were incubated (18&#x202F;min shaking at 1400&#x202F;rpm) with 10&#x202F;&#x03BC;L of equal volumes of hydrophilic (Speedbead magnetic carboxylated modified particles, GE Healthcare, United Kingdom) and hydrophobic (Sera-Mag Speedbead carboxylated-modified particles, Thermo Fisher Scientific) magnetic beads. The supernatant was discarded by sedimentation of beads on a magnetic rack, followed by two washing steps with 70.0% (vol/vol) ethanol and one washing step with 100% (vol/vol) acetonitrile (ACN) before air-drying. Trypsin digestion was performed in freshly prepared 20.0&#x202F;mM ammonium bicarbonate buffer at trypsin to protein ratio of 1:25 for 18&#x202F;h at 37&#x00B0;C. The digestion process was stopped by the addition of ACN to a final concentration of 95.0% (vol/vol) (18&#x202F;min shaking at 1400&#x202F;rpm). The beads were further washed and desalted with 100% (vol/vol) ACN and air-dried before elution in 10&#x202F;&#x03BC;L of 2.0% (vol/vol) DMSO by sonication for 5&#x202F;min. The beads were then pelleted by pulse centrifugation, and the resulting supernatant was transferred to a fresh microcentrifuge tube. The eluate was subsequently diluted with an equal volume of buffer A containing 2.0% (vol/vol) ACN and 0.2% (vol/vol) acetic acid and stored at &#x2212;20&#x00B0;C until mass spectrometry.</p>
</sec>
<sec id="sec17">
<label>2.11</label>
<title>Acquisition and analysis of mass spectrometry data</title>
<p>Peptides were separated using an UltiMate 3,000 nanoLC device (Thermo Fisher Scientific) with a pre-column (Acclaim PepMap; Thermo Fisher Scientific) and an analytical column (Accucore; Thermo Fisher Scientific) by applying a binary gradient with buffer A [0.1% (vol/vol) acetic acid in HPLC-grade water] and buffer B (0.1% (vol/vol) acetic acid in ACN) at a flow rate of 300&#x202F;nL/min. After ionization, peptides were analyzed with a Q ExactiveTMHF mass spectrometer (Thermo Fisher Scientific) in data independent acquisition (DIA) mode. Specification of the used gradient and detailed settings on nanoLC-MS/MS data acquisition are provided (<xref ref-type="supplementary-material" rid="SM1">Supplementary Table 1</xref>). Raw data were mapped against in-house established pangenome database including whole genome sequences of all analyzed strains using Spectronaut (v. 18.1) (Biognosys, Schlieren, Switzerland). All search parameters are provided (<xref ref-type="supplementary-material" rid="SM1">Supplementary Table 2</xref>). In brief, trypsin/P was set as the digesting enzyme with 0 missed cleavage allowed. Oxidation at methionine was set as variable modification. Peptides with min. Seven amino acids displaying a <italic>q</italic>-value cut-off for detection of &#x003C;0.001 were selected for further analyses. Only proteins detected with at least two peptides were considered for statistical analysis, which was performed using RStudio (v. 4.1.3 (2022-03-10)) with the tidyverse package (v. 1.3.2). Normalization factors were obtained from Spectronaut analysis. Missing values (intensity&#x202F;=&#x202F;0) were replaced with the half-minimal intensity value from the whole dataset. Detected methionine oxidized peptides were excluded from further quantitative analysis. Ion intensities per sample and peptide were summed to calculate peptide intensities. Protein intensities were calculated in the Spectronaut software as intensity-based absolute quantification (iBAQ) values. With the iBAQ algorithm, the summed intensities of the peptides of one protein are divided by the number of theoretically observable peptides (summarized in (<xref ref-type="bibr" rid="ref84">Rozanova et al., 2021</xref>)). iBAQ intensities were separated into quantiles by regarding intensities in the lower two quantiles as close to detection limit. Statistical comparison was accomplished on peptide level with the PECA package (v. 1.30.0) by applying a ROTS test (ROPECA approach - reproducibility-optimized peptide change averaging) (<xref ref-type="bibr" rid="ref94">Suomi and Elo, 2017</xref>). Proteome data have been stored at the ProteomeXchange Consortium via the PRIDE partner repository (<xref ref-type="bibr" rid="ref73">Perez-Riverol et al., 2019</xref>) with the dataset identifier PXD047744.</p>
</sec>
<sec id="sec18">
<label>2.12</label>
<title>Identification of unique KP characteristics across omics levels</title>
<p>The investigation of KP&#x2019;s unique features was conducted at genomic, transcriptomic, and proteomic levels, and aimed to identify genes that are uniquely present or induced in SHU in all scrutinized KP strains compared to their KV counterparts, and to KQ on genomic level (<xref ref-type="table" rid="tab1">Table 1</xref>; <xref ref-type="supplementary-material" rid="SM1">Supplementary Tables 3, 4</xref>). At the genomic level, we selected for genes by filtering for presence in all KP genome and absent in the KV genomes (<xref ref-type="supplementary-material" rid="SM1">Supplementary Table 3</xref>). The evaluation of transcriptomic and proteomic data based on the pangenome followed a systematic approach. Transcriptomic and proteomic profiles of each KP strain were compared individually with each KV strain. In addition, comparisons were made among the KV strains themselves. A gene was considered differentially expressed and a protein as differentially abundant if the absolute value of the log2 fold change (L2FC) was equal to or greater than 1.5, and the adjusted <italic>p</italic>-value was less than or equal to 0.05 (|L2FC|&#x202F;&#x2265;&#x202F;1.5; p-value adjusted&#x2264;0.05). Subsequently, genes were filtered to include only those differentially expressed in all eight KP strains when compared to both KV strains, excluding those differentially expressed among the KV strains. The cumulative set of genes meeting these criteria was denoted as genomic, transcriptomic or proteomic markers (<xref ref-type="supplementary-material" rid="SM1">Supplementary Tables 3, 4</xref>), meaning characteristics, that are unique among the KP strains. The transcriptomic and proteomic markers encompass genes that may also be present in the genome of KV but are not expressed in SHU, as well as genes absent in KV genomes (differentially encoded), yet appearing differentially expressed in KP. Still these genes have been included since this approach aimed to understand the complex interplay of genomic differences and expression patterns on transcriptomic and proteomic levels. The different transcriptomic and proteomic profiles were visualized using the pheatmap package in RStudio (v. 4.3.1).</p>
</sec>
<sec id="sec19">
<label>2.13</label>
<title>Homologous clustering-approach</title>
<p>To contextualize the identified genes in a broader genetic background, we downloaded all publicly available KP, KV, and KQ genomes from the National Center for Biotechnology Information (NCBI) database (<xref ref-type="bibr" rid="ref87">Sayers et al., 2022</xref>) (25 Aug 2022). Kleborate was used to assign species, ST and resistance and virulence score to every genome. We filtered the genomes for eight globally recognized KP STs: ST11, ST15, ST23, ST101, ST147, ST258, ST307 and ST512, in total 5,758 KP genomes along with 982 genomes of KV and KQ (<xref ref-type="supplementary-material" rid="SM1">Supplementary Table 5</xref>; <xref ref-type="supplementary-material" rid="SM1">Supplementary Figure 1</xref>) (<xref ref-type="bibr" rid="ref108">Wyres et al., 2020a</xref>). Prediction of protein coding genes of downloaded assemblies was performed using Prokka (v. 1.14.6) (<xref ref-type="bibr" rid="ref91">Seemann, 2014</xref>). A time- and resource-saving approach was chosen to cluster all protein sequences from the KP, KV and KQ genomes using cd-hit (v. 4.8.1) (<xref ref-type="bibr" rid="ref27">Fu et al., 2012</xref>). This dataset will be further referred to as homologous clustering. Very strict thresholds of 95.0% sequence identity and sequence coverage were applied to ensure that only very similar sequences were included within a cluster. For further classification, we borrowed the terminology for pangenome analyses, and classified the clusters analogous to the previous generated pangenome into a core (present in &#x2265;95.0% of the genomes), a shell (present in &#x2265;15.0, &#x003C;95.0% of the genomes), a cloud (present in &#x003C;15.0% of the genomes) and the group with the markers (present in &#x2265;95.0% of the KP, &#x003C;10% of the KV and KQ genomes). Note that distinct clustering cut-offs were chosen for the two approaches (pangenome and homologous clustering). This decision was guided by varying sample sizes, the consideration of syntenies during the construction of the pangenome (most assemblies of the clustering-approach were not closed), and the aim to detect variations in the sequences within the extensive homologous clustering. We then identified which gene from the pangenome analysis belonged to the respective clusters in the homologous clustering by using BLASTP (BALST+ v.2.13.0, &#x2212;task blastp) and manual curation (80% identity and 80% sequence coverage).</p>
</sec>
<sec id="sec20">
<label>2.14</label>
<title>Functional categorization</title>
<p>For in-depth analysis, genes matching the previously described criteria for the so-called markers underwent examination regarding their physiological functions concerning bacterial fitness and virulence. This assessment incorporated Bakta and eggNOG online (v. 2.1.9) annotations (<xref ref-type="bibr" rid="ref35">Huerta-Cepas et al., 2019</xref>; <xref ref-type="bibr" rid="ref13">Cantalapiedra et al., 2021</xref>). The Kyoto Encyclopedia of Genes and Genomes (KEGG) (<xref ref-type="bibr" rid="ref41">Kanehisa et al., 2023</xref>) from eggNOG annotation was used for dissecting the involvement of specific genes within their respective functional pathways. Information about the cluster of orthologous groups (COG) was plotted for genes up- or down-regulated on transcriptomic or proteomic levels. However, COG annotation could not be determined for all genes (<xref ref-type="supplementary-material" rid="SM1">Supplementary Figure 2</xref>). To compensate for this limitation, our functional analysis was expanded through the creation of specialized functional categories (<xref ref-type="supplementary-material" rid="SM1">Supplementary Tables 6, 7</xref>). These categories were crafted to include the distinctive characteristics of all markers and summarize them following a similar structure of the COG database. The determination of these characteristics drew from information sourced from the KEGG and associated databases (including UniProt and STRING), ensuring that each gene was systematically classified into only one of the categories (<xref ref-type="bibr" rid="ref93">Snel et al., 2000</xref>; <xref ref-type="bibr" rid="ref95">Szklarczyk et al., 2021</xref>; <xref ref-type="bibr" rid="ref18">Consortium T.U, 2023</xref>; <xref ref-type="bibr" rid="ref41">Kanehisa et al., 2023</xref>). This approach not only provided a holistic understanding of the functional landscape but also facilitated the identification of unique features among KP. Upon categorization, we went beyond to closely study how selected markers reveal a potential association with to bacterial virulence and fitness by incorporating previously published literature.</p>
</sec>
<sec id="sec21">
<label>2.15</label>
<title>Software and statistical analysis</title>
<p>All phenotypic experiments were performed with three or more independent biological replicates and respective statistical analyses were performed using GraphPad Prism (v. 9.3.0) for Windows (GraphPad Software, San Diego, CA, USA). Data were expressed as mean and standard deviation. Assessment of statistical significance was performed via one-way analysis of variation (ANOVA) with uncorrected Fisher&#x2019;s Least Significant Difference or unpaired parametric t-test using Bonferroni-Dunn correction for multiple comparisons. Values lower than 0.05 were used to show significance (&#x002A;<italic>p</italic>&#x202F;&#x003C;&#x202F;0.050; &#x002A;&#x002A;<italic>p</italic>&#x202F;&#x003C;&#x202F;0.010; &#x002A;&#x002A;&#x002A;<italic>p</italic>&#x202F;&#x003C;&#x202F;0.001). For transcriptomic and proteomic analyses, a |L2FC|&#x202F;&#x003E;&#x202F;1.5 with an adjusted <italic>p</italic>-value equal or smaller than 0.050 was considered as significant. We used large language models, such as ChatGPT (GPT-4), to assist in revising portions of the manuscript. All AI-generated content was thoroughly reviewed, edited, and approved by the authors to ensure its accuracy and integrity.</p>
</sec>
</sec>
<sec sec-type="results" id="sec22">
<label>3</label>
<title>Results</title>
<sec id="sec23">
<label>3.1</label>
<title>Pangenome analysis revealed differences among KP and KV strains, but also similarities</title>
<p>To uncover distinctive traits of KP compared to other species within the KpSC, we curated a set of ten KP and KV strains from our collection for multi-omics analysis. This set comprised two strains each of four highly successful, international high-risk KP STs recognized for their MDR and/or virulence profiles according to Kleborate (<xref ref-type="bibr" rid="ref49">Lam et al., 2021</xref>), alongside two distinct STs of KV, all of them carbapenemases- and or ESBL-producers (<xref ref-type="bibr" rid="ref5">Becker et al., 2018</xref>; <xref ref-type="bibr" rid="ref32">Heiden et al., 2020</xref>).</p>
<p>Our aim was to examine a comprehensive range of genetic, transcriptomic, and proteomic factors. First, we investigated the distribution of genes among all ten genomes by performing a pangenome analysis using Proteinortho (<xref ref-type="fig" rid="fig1">Figure 1A</xref>). This revealed a total number of 8,519 genes within the pangenome, from which 48% were shared by all strains (core genome). The shell genome consists of genes shared by at least two and a maximum of nine strains and accounts for 30% of the gene content. Notably, around 10% of the shell genome (<italic>n</italic>&#x202F;=&#x202F;256 genes) comprises genes unique to KV (<xref ref-type="supplementary-material" rid="SM1">Supplementary Table 3</xref>). However, further analysis of these unique genes was not conducted, as it was beyond the scope of this study. The cloud genome included 1,784 genes, which were uniquely present in only one strain (approximately 21.0%). Finally, the most interesting result was a group we refer to as &#x201C;genomic markers from the pangenome&#x201D; (GM) including 107 genes (1.3%) present in all KP but absent in the KV strains (<xref ref-type="supplementary-material" rid="SM1">Supplementary Table 3</xref>). According to the KEGG database, the GM were associated with diverse functions in metabolic pathways, encompassing carbohydrates, lipids, nucleotides, amino acids, and other secondary metabolites. We found an enrichment of gene functions related to membrane transport mechanisms, such as ABC transporters, the phosphotransferase system (PTS), and two-component systems. Among others, respective genes encoded proteins of the cellobiose PTS (<italic>cel</italic> cluster), ensuring uptake and utilization of this carbohydrate. Another example was <italic>fabG</italic>, which is involved in fatty acid metabolism. As stated above, genes with functions in amino acid, but also nucleotide metabolism, were quite prominent among the GM including the <italic>phn</italic> gene cluster encoding ABC transporter components enabling the sensing and utilization of phosphonates. In contrast to the KV strains, KP also encoded a <italic>pgt</italic> gene cluster of the two-component system responsible for phosphoglycerate transport. In addition to these metabolism-related genes, we found <italic>ompC</italic> encoding an outer membrane porin and <italic>kacAT</italic> encoding a type II toxin-antitoxin as unique genes of the KP strains among the GM (<xref ref-type="fig" rid="fig1">Figure 1B</xref>).</p>
<fig position="float" id="fig1">
<label>Figure 1</label>
<caption>
<p>Pangenome analysis and genetic distance-based tree (mashtree) of the selected strains. <bold>(A)</bold> Pangenome analysis grouped genes regarding their occurrence in all strains (core), in minimum two and maximum nine strains (shell), in only one strain (cloud) or in all eight <italic>K. pneumoniae</italic> (KP) but not the <italic>K. variicola</italic> (KV) strains (markers). Numbers in square brackets indicate the number of genes within the respective category. <bold>(B)</bold> Based on the whole genomic data, the analyzed dataset including eight different KP and two KV strains was analyzed regarding its phylogenetic relationships considering relevant metadata like the sequence type (ST), resistance score (RES), acquired resistances (extended-spectrum <italic>&#x03B2;</italic>-lactamase [ESBL], carbapenemases [CARB]) and the source of isolation (SOI). The resistance score was determined based on Kleborate (0&#x202F;=&#x202F;no ESBL, no CARB (regardless of colistin resistance); 1&#x202F;=&#x202F;ESBL, no CARB (regardless of colistin resistance); 2&#x202F;=&#x202F;CARB without colistin resistance (regardless of ESBL genes or OmpK mutations); 3&#x202F;=&#x202F;CARB with colistin resistance (regardless of ESBL genes or OmpK mutations)). Additionally, the presence or absence of selected groups of marker genes based on KEGG analysis is shown. The phylogenetic tree was constructed using iTOL (v. 6.8.1) and edited with Inkscape.</p>
</caption>
<graphic xlink:href="fmicb-16-1657680-g001.tif" mimetype="image" mime-subtype="tiff">
<alt-text content-type="machine-generated">A donut chart labeled &#x201C;A&#x201D; shows gene categories: core (4090), shell (2538), cloud (1784), and markers (107). A phylogenetic tree labeled &#x201C;B&#x201D; compares sequences of analyzed strains with color-coded sequence types, resistance scores, isolation sources, and presence of ESBL, carbapenemase, and encoded genes. A key explains colors and symbols used.</alt-text>
</graphic>
</fig>
<p>Mashtree in combination with Kleborate analysis was performed to understand the dataset in more detail. As expected, the mashtree analysis showed a clear separation of the KV from the KP genomes, with the latter closely clustering together, including the respective STs. More importantly, Kleborate revealed a resistance score of &#x003E;2 for all except one strain (PBIO3547). In addition to <italic>ampC,</italic> each strain carried a minimum of one additional <italic>&#x03B2;</italic>-lactamase gene. In five of eight KP strains, genes encoding for both ESBL and carbapenemases were detected. Note that all strains originate from human sources with KV strains obtained from body fluid and an anal swab (PBIO3543 and PBIO3544, respectively) (<xref ref-type="bibr" rid="ref5">Becker et al., 2018</xref>). Four KP strains were isolated from urine (PBIO3547, PBIO3553, PBIO3556, and PBIO3557), two from tracheal secretion (PBIO3554, and PBIO1953), and one from pleural fluid (PBIO3559) (<xref ref-type="bibr" rid="ref5">Becker et al., 2018</xref>; <xref ref-type="bibr" rid="ref32">Heiden et al., 2020</xref>).</p>
<p>In summary, pangenome analysis of the dataset demonstrated differences between the two species, impacted by the presence of KP-specific genes associated with metabolic features.</p>
</sec>
<sec id="sec24">
<label>3.2</label>
<title>Transcriptome and proteome analysis in urine-like conditions demonstrated similar regulatory patterns among KP in contrast to KV strains</title>
<p>Following the genomic analysis, which revealed 107 GM in KP, we next screened for differentially expressed genes and differentially abundant proteins to (i) explore whether the GM would translate to the transcriptome and/or proteome, and (ii) to identify different core markers and regulatory patterns on transcriptomic and/or proteomic levels. Given that KP is a leading cause of UTI, we sampled in SHU, which likely reflects relevant nutritional conditions of urine (<xref ref-type="bibr" rid="ref25">Flores-Mireles et al., 2015</xref>; <xref ref-type="bibr" rid="ref72">Paczosa and Mecsas, 2016</xref>; <xref ref-type="bibr" rid="ref71">Oliveira et al., 2022</xref>). Interestingly, KP grew significantly better in SHU than the KV strains (<italic>p</italic>&#x202F;&#x003C;&#x202F;0.001) (<xref ref-type="fig" rid="fig2">Figures 2A</xref>,<xref ref-type="fig" rid="fig2">B</xref>). However, this distinct difference between KV and KP strains was not observed when grown in LB medium and only one of the KV strains showed slightly diminished growth (<xref ref-type="supplementary-material" rid="SM1">Supplementary Figures 3, 4</xref>). Combined with the genomic data presented, that revealed KP-specific genes for phosphonate (<italic>phn</italic>) phosphoglycerate (<italic>pgt</italic>) and cellobiose (<italic>cel</italic>) transport (<xref ref-type="fig" rid="fig1">Figure 1B</xref>), this indicates a superior capacity for nutrient utilization by the KP compared to KV strains. Such enhanced nutrient utilization is particularly crucial in environments with limited nutrient availability, such as the urinary tract (<xref ref-type="bibr" rid="ref37">Ipe and Ulett, 2016</xref>; <xref ref-type="bibr" rid="ref1">Abbott et al., 2020</xref>). Note that this not only applied to the strains obtained from UTI but all KP isolates that were used in this analysis and isolated from different sources. Transcriptomic and proteomic analyses for all eight KP and two KV strains were performed to explore the underlying processes potentially supporting enhanced growth of KP and revealed major differences between KP and KV at both levels within the principal component analysis. In addition, differences among the KP were smaller and strains of the same ST clustered closely together (<xref ref-type="supplementary-material" rid="SM1">Supplementary Figure 5</xref>). Next, we compared the data of each KP with each KV strain and the two KV strains with each other. Genes that appeared significantly expressed (|L2FC|&#x202F;&#x2265;&#x202F;1.5; <italic>p</italic>-value adjusted&#x2264;0.05) in all comparisons of KP vs. KV strains, but not between the two KV strains, were referred to as transcriptomic markers (TM) and proteomic markers (PM), respectively. By plotting the decimal logarithm (log<sub>10</sub>) of the normalized read counts (NRC) and the log<sub>10</sub> of iBAQ values of all genes fitting the previously mentioned criteria, we obtained the regulatory patterns of all TM and PM. Comparison of these markers revealed that the overall patterns were seemingly different on transcriptomic versus proteomic levels (<xref ref-type="fig" rid="fig2">Figures 2C</xref>,<xref ref-type="fig" rid="fig2">D</xref>). However, they clearly show that all KP strains, independent of their ST, shared a similar expression profile, which was different from the two KV strains.</p>
<fig position="float" id="fig2">
<label>Figure 2</label>
<caption>
<p>Growth kinetics and expression profiles of <italic>K. pneumoniae</italic> (KP) and <italic>K. variicola</italic> (KV) strains in SHU. Strains were cultivated in SHU in biological triplicates. <bold>(A)</bold> Growth kinetics are displayed using GraphPad Prism and Gompertz-Growth fitting. <bold>(B)</bold> The area under the curve was calculated from three individual cultivations (<italic>n</italic>&#x202F;=&#x202F;3). The significance of differences was calculated using one-way ANOVA (&#x002A;<italic>p</italic>&#x202F;&#x003C;&#x202F;0.050; &#x002A;&#x002A;<italic>p</italic>&#x202F;&#x003C;&#x202F;0.010; &#x002A;&#x002A;&#x002A;<italic>p</italic>&#x202F;&#x003C;&#x202F;0.001). <bold>(C&#x202F;+&#x202F;D)</bold> The normalized read counts (NRC) obtained from transcriptomic analysis <bold>(C)</bold> and the intensity-based absolute quantification (iBAQ) obtained from proteomic analysis <bold>(D)</bold> are plotted for each strain. The regulatory profiles of transcriptomic markers (TM) and proteomic markers (PM) are shown as separate heatmaps. The decimal logarithm (log<sub>10</sub>) was applied to all values for better visualization of differences.</p>
</caption>
<graphic xlink:href="fmicb-16-1657680-g002.tif" mimetype="image" mime-subtype="tiff">
<alt-text content-type="machine-generated">Panel A shows a line graph with optical density over time for different samples. Panel B presents a bar graph with area under the curve for each sample, adding highlighting significant difference between KV and KP. Panel C is a heat map of differentially expressed genes, while Panel D depicts a heat map of proteins with differential abundance levels. Samples are labeled with their strain ID, divided into KV and KP.</alt-text>
</graphic>
</fig>
<p>In general, the number of genes detected in the TM (<italic>n</italic>&#x202F;=&#x202F;155) group was higher than in the PM (<italic>n</italic>&#x202F;=&#x202F;48) group (<xref ref-type="supplementary-material" rid="SM1">Supplementary Figure 6</xref>). Moreover, a higher number of genes was upregulated in all individual comparisons of KP vs. KV on transcriptomic levels. Upregulated genes within the TM included 143, while only a total number of 12 genes were downregulated. Detected up- and down-regulations on proteomic levels were rather equal for the individual comparisons, with a slightly higher number of downregulations (<italic>n</italic>&#x202F;=&#x202F;28) than upregulations (<italic>n</italic>&#x202F;=&#x202F;20) among the PM. The total number of regulated genes suggests that the strains responded highly individually to the specific growth conditions in SHU. Nevertheless, a substantial overlap in markers across the different KP strains within each omics layer (155 TM, 48&#x202F;PM) indicates common response mechanisms in KP that were absent in KV. Please note, that TMs and PMs must be classified into (i) genes that occur exclusively in KP (GM) or KV and are therefore considered as differentially expressed, and (ii) genes that occur in both KV and KP (core genome). Among the 155 TM genes, 103 were also detected as GM, while 52 were found in the core genome of the selected dataset. Of the 49 genes belonging to the PM, six were discovered as GM, 24 were assigned to the core, and 19 to the shell genome of the selected dataset. A total of 11 genes were classified as both TM and PM, 5 of which are also encoded in KV genomes (core genome) and 6 of which are only found in KP genomes (GM). This multi-omics analysis highlights that more than 96.0% of GM exhibited transcriptional activity, with detectable RNA levels under conditions mimicking urine. However, it also suggests that only a minority undergoes sufficient translation to be detected by proteomics under these experimental conditions. In addition, we identified genes from the core genome present in all strains of the dataset that exhibited unique expression patterns in KP strains, thereby being integral components of the groups of TM and/or PM. This suggests that the growth advantages observed in KP strains within SHU may not solely stem from their specific genetic makeup. Instead, they may be bolstered by shared regulatory and response mechanisms, which collectively enhance their overall fitness in nutrient-limited environments like the urinary tract.</p>
</sec>
<sec id="sec25">
<label>3.3</label>
<title>In-depth characterization revealed common functional pathways on transcriptomic and proteomic levels in KP</title>
<p>The observed regulatory profiles on transcriptomic and proteomics levels for KP were further investigated regarding their physiological functions. Since categorization based on the COG database was insufficient (<xref ref-type="supplementary-material" rid="SM1">Supplementary Figure 2</xref>), specialized categories were manually assigned using information from eggNOG (e.g., COG, KEGG), BLASTP and literature research (<xref ref-type="supplementary-material" rid="SM1">Supplementary Table 6</xref>). Genes were first differentiated based on their up- or downregulation and abundance of proteins. Then, they were clustered into four different groups, namely porin/transporter, metabolism, regulation/stress response, and others (<xref ref-type="fig" rid="fig3">Figure 3</xref>). To facilitate a detailed characterization, more specific categories were assigned to all regulated genes (<xref ref-type="supplementary-material" rid="SM1">Supplementary Table 7</xref>). Indeed, transcriptomic and proteomic profiles not only varied in their number of up- or down-regulated genes and abundance of proteins but also in their putative functions. Nevertheless, some similarities were found. For instance, regulation of metabolic pathways was seemingly a key mechanism when growing KP in SHU. On transcriptomic levels, 49.0% of the up- and 25.0% of the down-regulated genes were assigned to this group, while on proteomic levels, 65.0% of proteins with higher abundance in KP compared to KV and 41.0% of proteins with lower abundance in KP compared to KV were involved. Moreover, most of the more specific categories were shared on both transcriptomic and proteomic levels, namely sulfur, nitrogen/ammonia, phosphate, biotin/fatty acid, carbohydrate, amino acid, ribosomes/tRNA, peptide, and citrate metabolism. Downregulations or lower abundance also affected transporters, with 25.0% on transcriptomic and 21.0% on proteomic levels. Genes with regulatory functions and involved in stress response had a greater impact on the proteomic (10.0% up- and 17.0% downregulated, respectively) than on the transcriptomic level (12.5% up- and 8.0% downregulated, respectively). Downregulation of genes and lower abundance of proteins involved in resistance, e.g., penicillin or chromate resistance, was observed, while genes for DNA replication and repair were upregulated and showed a higher abundance of corresponding proteins. Regulations and protein abundances also varied concerning toxin-antitoxin systems and chaperones. Overall, the in-depth characterization revealed that the regulatory patterns on a functional level are rather similar on transcriptomic and proteomic levels and that they mainly concern metabolic pathways.</p>
<fig position="float" id="fig3">
<label>Figure 3</label>
<caption>
<p>Functional analysis of transcriptomic markers (TM) and proteomic markers (PM). Functional evaluation of all TM <bold>(A)</bold> and PM <bold>(B)</bold> was performed by creating categories on three different levels of specificity based on all regulations. First, we only considered log2 fold changes (L2FC)&#x202F;&#x003E;&#x202F;1.5 (up-regulated [UP]) or &#x003C; &#x2212;1.5 (down-regulated [DOWN]). Second, four different groups were assigned for broad categorization: porins/transporter, metabolism, regulation/stress response, and others, as indicated in the legend. Third, more specific categories within the previously differentiated groups were chosen and each of the TM and PM was assigned to these categories. Visualization was done using GraphPad Prism and Inkscape.</p>
</caption>
<graphic xlink:href="fmicb-16-1657680-g003.tif" mimetype="image" mime-subtype="tiff">
<alt-text content-type="machine-generated">Krona plots labeled A and B, depicting categorized gene expression data. Each circle is divided into colored segments representing different gene categories, with inner circles labeled UP and DOWN. A color key indicates categories: porins/transporter (green), metabolism (blue), regulation/stress response (red), and others (orange).</alt-text>
</graphic>
</fig>
</sec>
<sec id="sec26">
<label>3.4</label>
<title>Comparing regulated genes to a large set of KpSC genomes revealed unique markers and regulatory mechanisms in KP</title>
<p>The 193 differentially expressed genes on transcriptomic and/or proteomic levels between KP and KV in SHU were then further investigated to explore whether they would play a role as markers of the investigated KP STs in a broader context. We therefore leveraged 6,740 publicly available genome assemblies comprising KV and KQ as less prevalent representatives and eight different, international high-risk KP STs (i.e., ST11, ST15, ST23, ST101, ST147, ST258, ST307, and ST512) (<xref ref-type="supplementary-material" rid="SM1">Supplementary Figure 7</xref>) for this clustering-approach (<xref ref-type="supplementary-material" rid="SM1">Supplementary Table 5</xref>). All proteins were clustered based on a sequence identity and coverage greater than and equal to 95.0%, to also decipher species-conserved variations within the protein sequence. This resulted in 192,172 clusters within the cloud genome, 2,785 within the shell genome, and 3,083 clusters within the core genome. Additionally, we conducted an investigation to identify clusters primarily associated with KP genes (maximum of 10.0% of each of the KV and KQ genomes and a minimum of 95.0% of each KP ST represented within the cluster) and identified 273 genomic markers from homologous clustering (GM-L). By comparing the TMs and PMs with the clustering approach, we identified genes that were (i) included in the GM-L and differentially expressed in the transcriptome and/or proteome (<italic>n</italic>&#x202F;=&#x202F;31), or (ii) differentially expressed (either on transcriptomic and/or proteomic levels) but which did not match the criteria for being included in the GM-L (<italic>n</italic>&#x202F;=&#x202F;162) (<xref ref-type="supplementary-material" rid="SM1">Supplementary Figure 8</xref>). This demonstrates that genes, which were present in all genomes of the dataset, showed unique induction in KP in urine-like conditions. As mentioned above, most of the regulations addressed metabolic mechanisms (<xref ref-type="fig" rid="fig3">Figure 3</xref>). An in-depth literature and database (including KEGG, UniProt and STRING) review allowed us to filter for relevant regulations within the different categories of markers. To address the knowledge gap of explaining KP&#x2019;s clinical significance, this analysis focused on those potentially exhibiting meaningful infection-biological relevance (<xref ref-type="table" rid="tab2">Table 2</xref>) (<xref ref-type="bibr" rid="ref93">Snel et al., 2000</xref>; <xref ref-type="bibr" rid="ref95">Szklarczyk et al., 2021</xref>; <xref ref-type="bibr" rid="ref18">Consortium T.U, 2023</xref>; <xref ref-type="bibr" rid="ref41">Kanehisa et al., 2023</xref>). Form this filtering, the most interesting example for the first category (i), includes genes for a cellobiose PTS (<italic>celABF</italic>) that were upregulated on transcriptomic and/or proteomic levels in urine-like conditions in KP and absent in KV/KQ while present in the majority (&#x2265;95.0%) of all KP genomes (<xref ref-type="fig" rid="fig4">Figure 4</xref>). It is well-known that bacteria encode several variants of cellobiose-specific uptake systems (<xref ref-type="bibr" rid="ref88">Schaefler and Malamy, 1969</xref>). Hence, we investigated the presence of gene variants of <italic>celB</italic> in a representative strain (PBIO1953, ST307). This showed that further genes with similarity to <italic>celB</italic> occurred to a maximum of 30.0% sequence identity in the ST307 isolate PBIO1953. Another interesting candidate of this category was <italic>fabG</italic>, which has a central function in fatty acid biosynthesis. A group of genes found in the second category (ii) which was present in &#x003E;99.8% of the investigated genomes, encodes for a cytochrome ubiquinol oxidase (<italic>cydAB</italic>), coupling the reduction of molecular oxygen to the generation of a proton motive force and thus energy production. In addition, on transcriptomic levels, we found two gene clusters upregulated in KP strains, which are responsible for the acquisition of different phosphorus sources. The first cluster included seven genes of a phosphonate ABC-transporter (<italic>phnRXVTWSU</italic>). While these genes were absent in the majority of KV genomes, they were present in most KQ and KP genomes. A similar pattern was observed for the second gene cluster encoding genes for a two-component system involved in phosphoglycerate transport (<italic>pgtABCP</italic>). This gene cluster did not occur in KV but in 10.0&#x2013;50.0% of the KQ genomes and in more than 92.0% of the KP genomes. In addition, genes involved in citrate uptake were identified in the second category (ii). While they occurred equally in all genomes of the large clustering approach, they were only induced in KP suggesting unique regulatory mechanisms (<xref ref-type="fig" rid="fig4">Figure 4</xref>).</p>
<table-wrap position="float" id="tab2">
<label>Table 2</label>
<caption>
<p>Selected differentially expressed genes with particular biological relevance.</p>
</caption>
<table frame="hsides" rules="groups">
<thead>
<tr>
<th align="left" valign="top">Gene names</th>
<th align="center" valign="top">Description</th>
<th align="center" valign="top">Occurrence (category)</th>
<th align="left" valign="top">Previous observations</th>
<th align="center" valign="top">Source</th>
</tr>
</thead>
<tbody>
<tr>
<td align="left" valign="middle"><italic>citWXY</italic></td>
<td align="center" valign="middle">Citrate uptake</td>
<td align="center" valign="middle">(ii)</td>
<td align="left" valign="middle">Non-essential, but facilitates citrate utilization, two-component system requires careful regulation</td>
<td align="center" valign="middle"><xref ref-type="bibr" rid="ref79">Reinelt et al. (2003)</xref> and <xref ref-type="bibr" rid="ref16">Chen et al. (2009)</xref></td>
</tr>
<tr>
<td align="left" valign="middle"><italic>cydAB</italic></td>
<td align="center" valign="middle">Cytochrome ubiquinol oxidase</td>
<td align="center" valign="middle">(ii)</td>
<td align="left" valign="middle">Generates a proton motive force through reduction of molecular oxygen promotes bacterial virulence, resistance and evasion of the host immune system</td>
<td align="center" valign="middle">
<xref ref-type="bibr" rid="ref28">Giuffr&#x00E8; et al. (2014)</xref>
</td>
</tr>
<tr>
<td align="left" valign="middle"><italic>phnRXVTWSU</italic></td>
<td align="center" valign="middle">Phosphonate ABC-transporter</td>
<td align="center" valign="middle">(ii)</td>
<td align="left" valign="middle">Provides ability to utilize alternative phosphorus sources</td>
<td align="center" valign="middle"><xref ref-type="bibr" rid="ref38">Ivan et al. (2014)</xref> and <xref ref-type="bibr" rid="ref75">Poehlein et al. (2017)</xref></td>
</tr>
<tr>
<td align="left" valign="middle"><italic>pgtABCP</italic></td>
<td align="center" valign="middle">Phosphoglycerate transport</td>
<td align="center" valign="middle">(ii)</td>
<td align="left" valign="middle">Two component system and transport detected as virulence factor in ExPEC strains</td>
<td align="center" valign="middle">
<xref ref-type="bibr" rid="ref47">Kong et al. (2017)</xref>
</td>
</tr>
<tr>
<td align="left" valign="middle"><italic>celABF</italic></td>
<td align="center" valign="middle">Cellobiose PTS</td>
<td align="center" valign="middle">(i)</td>
<td align="left" valign="middle">Enables cellobiose uptake, which is not digested by humans <italic>celB</italic> mutants show reduced virulence and biofilm formation</td>
<td align="center" valign="middle">
<xref ref-type="bibr" rid="ref106">Wu et al. (2012)</xref>
</td>
</tr>
<tr>
<td align="left" valign="middle"><italic>fabG</italic></td>
<td align="center" valign="middle">3-Oxoacyl-ACP reductase</td>
<td align="center" valign="middle">(i)</td>
<td align="left" valign="middle">Enables lipid supply for production and maintenance of the cell envelope</td>
<td align="center" valign="middle">
<xref ref-type="bibr" rid="ref77">Ramos et al. (2018)</xref>
</td>
</tr>
</tbody>
</table>
<table-wrap-foot>
<p>The gene names, a description, as well as summary of previous observations and the respective sources are shown for selected groups of genes which resulted from the in-depth multi-omics analysis. The groups are (i) included in the genomic markers from homologous clustering (GM-L) and differentially expressed in the transcriptome and/or proteome, and (ii) differentially expressed (either on transcriptomic and/or proteomic levels) but did not match the criteria for being included in the GM-L.</p>
</table-wrap-foot>
</table-wrap>
<fig position="float" id="fig4">
<label>Figure 4</label>
<caption>
<p>Detection of corresponding gene expression on multi-omics levels. Genes identified as differentially expressed on transcriptomic and/or proteomic levels were selected regarding their biological relevance based on literature research, as described. Heatmaps for all profiles, either expression on transcriptomic or proteomic level or occurrence on genomic level are shown and respective genes, strain or sequence type (ST) are indicated. ND means the protein was not detectable. <bold>(A)</bold> Transcriptomic profile of selected genes was generated by mapping the decimal logarithm (log<sub>10</sub>) of the normalized read counts (NRC) for each analyzed strain. <bold>(B)</bold> Profile of the expression detected on proteomic level of selected genes was generated by mapping the log<sub>10</sub> of the intensity-based absolute quantification (iBAQ) values for each analyzed strain. <bold>(C)</bold> Selected genes were mapped against the homologs clustering (BLASTP).</p>
</caption>
<graphic xlink:href="fmicb-16-1657680-g004.tif" mimetype="image" mime-subtype="tiff">
<alt-text content-type="machine-generated">Three heatmaps labeled A, B, and C show gene and protein abundances data. Panel A displays data in shades from light to dark red, indicating log-transformed gene expression values across different samples. Panel B adds grey for &#x201C;not detected&#x201D; (ND) values. Panel C depicts occurrence percentages ranging from 0 to 100%, with darker shades representing higher occurrence. Genes are listed on the y-axis, and sample IDs along the x-axis. Color intensities vary across each heatmap, reflecting differences in data values for gene expression and occurrence.</alt-text>
</graphic>
</fig>
<p>Integrating the smaller, deeply characterized dataset with the extensive genomic dataset enhanced resolution and robustness of the analysis. By including a higher diversity of genomes and incorporating genomes of another species (KQ) into the clustering approach, this strategy improved the categorization of marker. Moreover, it enabled a more nuanced interpretation of their distribution across a broader range of KP genomes and sequence types.</p>
</sec>
<sec id="sec27">
<label>3.5</label>
<title>Genetic and regulatory diversity in citrate pathways influences adaptation to urine-like conditions</title>
<p>Citrate is not only a major component of the synthetic human urine but also abundant in urine, and strains encoding specific citrate uptake genes can utilize it as a sole carbon source under anaerobic conditions (<xref ref-type="bibr" rid="ref16">Chen et al., 2009</xref>). To assess the impact of induced citrate metabolism, we modified SHU by depleting citrate and monitored the growth of both KP and KV strains. While this alteration had no noticeable effect on KV growth, it significantly reduced the growth of KP, bringing it down to KV levels (<xref ref-type="fig" rid="fig5">Figure 5B</xref>; <xref ref-type="supplementary-material" rid="SM1">Supplementary Figure 9</xref>). This finding underscores the functional importance of citrate utilization in KP and highlights its role as a specific fitness advantage under urine-like conditions. It has been shown that two genomic regions encoding genes for anaerobic citrate metabolism are encoded in <italic>K. pneumoniae</italic> genomes with remarkable genomic differences (<xref ref-type="bibr" rid="ref16">Chen et al., 2009</xref>). Notably, we only detected KP-specific induction of one of the two regions (<xref ref-type="fig" rid="fig5">Figure 5A</xref>). Investigations of the present dataset revealed that the patterns of induced citrate metabolism and enhanced growth in presence of citrate did not correlate with either the presence of the one or two genomic regions, or with DGE of known regulators, e.g., CitB (response regulator), CitA (sensor kinase), or catabolite repressor protein (CRP). Expression of citrate genes is induced by CitB, which in turn stimulates CRP binding, consequently reduced CRP levels result in decreased gene expression (<xref ref-type="bibr" rid="ref62">Meyer et al., 2001</xref>). Based on comparison with previously published CitB and CRP binding sites, we performed an multiple sequence alignment of KV and KP genomes (<xref ref-type="bibr" rid="ref62">Meyer et al., 2001</xref>). We were able to detect pronounced sequence variation within potential CRP binding sites in the intergenic region of <italic>citW</italic> and <italic>citY</italic>, potentially explaining the different phenotypes (<xref ref-type="fig" rid="fig5">Figure 5C</xref>). Note that sequence variation within another part of the intergenic region was also detected for the KP ST147 isolates (PBIO3553 and PBIO3554). However, this did not affect the citrate-dependent phenotype.</p>
<fig position="float" id="fig5">
<label>Figure 5</label>
<caption>
<p>Genomic organization, growth impact, and sequence variation of citrate metabolism in <italic>K. pneumoniae</italic> (KP) and <italic>K. variicola</italic> (KV) strains. <bold>(A)</bold> Schematic representation of the two genomic regions encoding citrate metabolism genes in <italic>K. pneumoniae</italic>, visualized using Proksee. Genes involved in anaerobic citrate utilization are highlighted. <bold>(B)</bold> Strains were cultivated in synthetic human urine (SHU) with or without citrate supplementation in biological triplicates. The area under the curve (AUC) of growth kinetics for KP and KV strains cultivated in SHU with or without citrate supplementation was calculated from three independent cultures (<italic>n</italic>&#x202F;=&#x202F;3). Significance of difference for each strain was assessed by unpaired parametric t-test using Bonferroni-Dunn correction for multiple comparisons (&#x002A;<italic>p</italic>&#x202F;&#x003C;&#x202F;0.050; &#x002A;&#x002A;<italic>p</italic>&#x202F;&#x003C;&#x202F;0.010). <bold>(C)</bold> Multiple sequence alignment of the <italic>citWXYZ</italic> genomic region, performed with Clustalw and visualized in SnapGene. The intergenic region (324&#x202F;bp) of <italic>citW</italic> and <italic>citY</italic> is highlighted in boxes.</p>
</caption>
<graphic xlink:href="fmicb-16-1657680-g005.tif" mimetype="image" mime-subtype="tiff">
<alt-text content-type="machine-generated">Diagram labeled A-C depicting citrate utilization genes and the impact on growth. Panel A shows gene arrangement over athe two genomic region. Panel B shows a bar graph comparing the area under the curve with and without citrate, with significant differences using asterisks. Panel C presents a DNA alignment, comparing citrate gene sequence in various samples. This highlights the cit genes and intergenic regions with shading.</alt-text>
</graphic>
</fig>
<p>The example of altered regulation of citrate genes demonstrates how a multi-omics approach is able to elucidate the impact of small genetic changes on transcriptomic and proteomic levels with significant relevance for the phenotypic appearance.</p>
</sec>
</sec>
<sec sec-type="discussion" id="sec28">
<label>4</label>
<title>Discussion</title>
<p>Overall, multi-level omics studies have the potential to unveil adaptive and regulatory mechanisms of certain pathogens across various ecological niches, distinguishing them from more other, sometimes closely-related bacteria (<xref ref-type="bibr" rid="ref70">O&#x2019;Donnell et al., 2020</xref>; <xref ref-type="bibr" rid="ref64">Mu et al., 2023</xref>). Despite the close relationship among members of the KpSC, KP stands out as the most prevalent and apparently successful member within the KpSC and the broader <italic>Klebsiella</italic> genus. It frequently serves as the causative agent of different infections, including UTIs (<xref ref-type="bibr" rid="ref108">Wyres et al., 2020a</xref>; <xref ref-type="bibr" rid="ref80">Rodr&#x00ED;guez-Medina et al., 2024</xref>).</p>
<p>Here, we employed different levels of a multi-omics approach to understand the differences of <italic>K. pneumoniae</italic> when compared to <italic>K. quasipneumoniae</italic> and <italic>K. variicola</italic> (<xref ref-type="bibr" rid="ref108">Wyres et al., 2020a</xref>; <xref ref-type="bibr" rid="ref49">Lam et al., 2021</xref>; <xref ref-type="bibr" rid="ref30">Gorrie et al., 2022</xref>; <xref ref-type="bibr" rid="ref66">Murray et al., 2022</xref>). To the best of our knowledge, this study represents the first attempt to explore species-specific distinctions and pinpoint potentially novel markers specific to KP by leveraging genomic, transcriptomic, and proteomic data from a selection of clinical KpSC isolates, along with an extensive dataset comprising 6,740 publicly available whole genomes. We made a deliberate choice not to compare to rarer KP STs, as these are frequently linked to localized outbreaks despite their lower prevalence (<xref ref-type="bibr" rid="ref108">Wyres et al., 2020a</xref>). In contrast, KV and KQ are rarely linked to outbreaks but still possess the capability to cause infections. Moreover, they are closely related to KP. Additionally, there was a correspondingly substantial number of genomes available for these species (<xref ref-type="bibr" rid="ref108">Wyres et al., 2020a</xref>; <xref ref-type="bibr" rid="ref49">Lam et al., 2021</xref>).</p>
<p>Our hypothesis posited that KP harbors distinct markers that are either absent or not induced in KV and KQ. These KP-specific markers may arise due to adaptive evolutionary processes undergone by successful KP lineages, resulting in core genes or gene functions that differ from those found in other bacteria (<xref ref-type="bibr" rid="ref33">Holt et al., 2015</xref>; <xref ref-type="bibr" rid="ref108">Wyres et al., 2020a</xref>). For the multi-omics analysis, KP isolates representing four distinct STs, which are members of the four most frequently detected KP clonal groups, were utilized (<xref ref-type="bibr" rid="ref108">Wyres et al., 2020a</xref>). Indeed, our findings, combining growth kinetics in urine-like conditions with omics investigations, suggest that KP likely efficiently exploits available nutrients to subsequently induce additional metabolic pathways, resulting in enhanced growth and overall adaptation to this specific environment compared to KV. This conclusion is supported by the unique presence of various gene clusters categorized as GMs (e.g., <italic>phn, pgt,</italic> and <italic>cel</italic>) that are often associated with diverse metabolic pathways but also by the induction of the GMs and additional genes in urine-like conditions in KP but not KV (e.g., <italic>cit</italic>, and <italic>cyd</italic>). It is widely recognized that an adequate response and adaptation to specialized host environments, such as the urinary tract, are prerequisites for establishing subsequent infection (<xref ref-type="bibr" rid="ref3">Alteri and Mobley, 2012</xref>; <xref ref-type="bibr" rid="ref58">Martin and Bachman, 2018</xref>). Subsequent proteome and transcriptome analyses corroborated our initial observations. Not only did we identify similar regulatory patterns across all KP compared to KV strains, but our results also reinforce the notion that induced metabolic features enhance the ability to respond to specialized environments, such as the SHU tested in this study. These differentially expressed metabolic pathways included citrate acquisition, cytochrome ubiquinol oxidase, phosphorus source utilization, cellobiose utilization, and fatty acid biosynthesis, which appear to be crucial for general survival and growth (<xref ref-type="bibr" rid="ref106">Wu et al., 2012</xref>; <xref ref-type="bibr" rid="ref28">Giuffr&#x00E8; et al., 2014</xref>; <xref ref-type="bibr" rid="ref8">Blin et al., 2017</xref>; <xref ref-type="bibr" rid="ref100">Vornhagen et al., 2019</xref>).</p>
<p>A broad metabolic flexibility, as observed in KP, is essential for its capability to cause infections at multiple sites within hosts (<xref ref-type="bibr" rid="ref58">Martin and Bachman, 2018</xref>). Such metabolic adaptation has been documented in extraintestinal <italic>E. coli</italic>, where they alter their metabolism from a commensal lifestyle in the intestine to a pathogenic one in the urinary tract (<xref ref-type="bibr" rid="ref3">Alteri and Mobley, 2012</xref>). In addition to host colonization and adaptation, bacteria engage in competition with other microorganisms for nutrients, leading to varying preferences in the utilization of alternative nutrients (<xref ref-type="bibr" rid="ref2">Alteri et al., 2015</xref>). Intriguingly, previous research has demonstrated that metabolic adaptation, facilitated by mechanisms like two-component systems, can trigger the expression of virulence-associated genes (<xref ref-type="bibr" rid="ref3">Alteri and Mobley, 2012</xref>). For instance, we identified genes encoding for the cellobiose PTS across all omics levels, including the homologous clustering approach. This included the induction of the cellobiose PTS, including <italic>celB</italic>, which is known to play a role in bacterial biofilm formation and <italic>in vivo</italic> virulence in a mouse model of intragastric infection (<xref ref-type="bibr" rid="ref106">Wu et al., 2012</xref>). The association between PTS and virulence has been previously demonstrated, such as the connection between the fructose PTS and fimbriae expression in <italic>E. coli</italic> (<xref ref-type="bibr" rid="ref83">Rouquet et al., 2009</xref>). Also, the induction of the bacterial <sc>l</sc>-fucose metabolism seemingly promotes gastrointestinal colonization by KP, which increases the risk for a subsequent infection (<xref ref-type="bibr" rid="ref12">Cano et al., 2022</xref>; <xref ref-type="bibr" rid="ref34">Hudson et al., 2022</xref>).</p>
<p>We also identified markers that were present in KQ and KP genomes but absent in KV including genes for phosphorus metabolism (<italic>phn and pgt</italic>) that enable utilization of alternative phosphor sources, e.g., phosphonate (<xref ref-type="bibr" rid="ref47">Kong et al., 2017</xref>; <xref ref-type="bibr" rid="ref75">Poehlein et al., 2017</xref>). The broad occurrence of <italic>phn</italic> genes in clinical KP isolates, important for 2-aminoethylphosphonate transport and degradation, has already been reported (<xref ref-type="bibr" rid="ref38">Ivan et al., 2014</xref>; <xref ref-type="bibr" rid="ref75">Poehlein et al., 2017</xref>). Another example of the association between metabolism and virulence in KP under urine-like conditions is the <italic>pgt-</italic>operon, which is not only responsible for phosphoglycerate uptake via a two-component system but encoded on a pathogenicity island in uropathogenic <italic>E. coli</italic> together with the virulence-associated capsule (<italic>kps</italic>) locus (K15) (<xref ref-type="bibr" rid="ref74">Podschun and Ullmann, 1998</xref>; <xref ref-type="bibr" rid="ref90">Schneider et al., 2004</xref>). Further experiments are planned to investigate <italic>phn</italic> and <italic>pgt</italic> expression, among others, in KQ vs. KP in SHU.</p>
<p>In addition, we observed a KP-specific induction of the <italic>cydAB</italic> genes in SHU, despite their presence in all ten phenotypically characterized strains and in over 99.8% of the 6,740 KpSC. genomes. Apart from their role in generating proton motive forces, these genes have been associated with various other functions. This includes involvement in stress response, virulence, and evasion of the host immune system, as well as resistance to several classes of antimicrobials (<xref ref-type="bibr" rid="ref28">Giuffr&#x00E8; et al., 2014</xref>).</p>
<p>Most interestingly, a gene cluster contributing to citrate utilization was found to be equally distributed among KV, KQ, and KP genomes, but only induced in KP in SHU. Note that citrate is abundant in urine, making this inducible response particularly relevant in UTIs (<xref ref-type="bibr" rid="ref86">Sarigul et al., 2019</xref>). We provided phenotypic evidence supporting the physiological relevance of citrate utilization in KP. When citrate was depleted from the SHU, the growth advantage previously observed for KP over KV was markedly reduced, indicating that the induction of citrate-associated pathways contributes to the enhanced fitness of KP under these conditions. These examples illustrate that KpSC core genes undergo differential regulation when exposed to the same conditions. This regulation may be influenced by differences in regulatory transcripts and proteins or by genomic alterations in regulatory regions. We found evidence suggesting that sequence variation in KV compared to KP likely reduces the binding of regulatory proteins such as CRP. This reduction in binding appears to affect the activity of regulators, such as CitB, which in turn influences the expression of citrate-related genes (<xref ref-type="bibr" rid="ref62">Meyer et al., 2001</xref>).</p>
<p>Moreover, prior studies have demonstrated that genes essential for citrate uptake not only confer the ability for citrate utilization but also serve in environmental sensing. The tight regulation of this process is facilitated by the two-component system CitAB (<xref ref-type="bibr" rid="ref79">Reinelt et al., 2003</xref>). Bacterial cells adjust gene expression in response to environmental changes, especially concerning nutrient depletion and availability (<xref ref-type="bibr" rid="ref42">Kinsella et al., 2011</xref>). Therefore, under <italic>in vitro</italic> conditions using a nutrient-defined synthetic urine medium, we expect bacteria to regulate genes involved in specialized metabolic pathways to optimize the use of available nutrients. However, it has also been commonly observed in <italic>in vivo</italic> settings that metabolic pathways significantly contribute to KP virulence and infection (<xref ref-type="bibr" rid="ref4">Bachman et al., 2015</xref>; <xref ref-type="bibr" rid="ref77">Ramos et al., 2018</xref>). For example, by using a transposon library, Bachman and colleagues elucidated key processes crucial for KP fitness in a lung infection model, pinpointing genes linked to bacterial metabolism, such as branched-chain amino acid metabolism (<xref ref-type="bibr" rid="ref4">Bachman et al., 2015</xref>). The importance of metabolic flexibility, defined by the ability to acquire and utilize different metabolites, has also been demonstrated for mucosal surface colonization even prior to the establishment and manifestation of infection (<xref ref-type="bibr" rid="ref42">Kinsella et al., 2011</xref>; <xref ref-type="bibr" rid="ref3">Alteri and Mobley, 2012</xref>; <xref ref-type="bibr" rid="ref100">Vornhagen et al., 2019</xref>). Vornhagen et al. showed that the citrate synthase GltA is essential for bacterial replication in the lung and intestine and mutation results in reduced metabolic flexibility including severe limitation of glycolic substrate utilization (<xref ref-type="bibr" rid="ref100">Vornhagen et al., 2019</xref>). Our results suggest increased metabolic adaptation of KP vs. KV in urine-like conditions is not only limited to induction of citrate metabolism but a variety of metabolic pathways, which possibly contribute to the success of KP as an opportunistic pathogen. The flexible utilization of available nutrients can bolster the establishment of robust colonization, along with fimbrial attachment and capsule expression (<xref ref-type="bibr" rid="ref40">Joseph et al., 2021</xref>). This, in turn, enhances the likelihood of subsequent infection (<xref ref-type="bibr" rid="ref30">Gorrie et al., 2022</xref>).</p>
<p>It is evident that MDR and/or hypervirulent KP strains pose a significant threat to public health, necessitating urgent exploration of alternative treatment strategies (Geneva: <xref ref-type="bibr" rid="ref105">World Health Organization, 2024</xref>). Our results offer valuable insights that could be integrated into further research in this area including differentiation of KP from KV and KQ in diagnostics approaches. Additionally, we have identified genes that may contribute to KP&#x2019;s virulence potential in global dissemination. Alternative interventions, such as anti-virulence strategies targeting dysregulated metabolic pathways, hold promise (<xref ref-type="bibr" rid="ref65">Murima et al., 2014</xref>). These approaches offer several advantages over conventional antibiotic therapy, including the availability of numerous (new) targets, reduced evolutionary pressure, minimal impact on the host commensal flora, and protection of immunocompromised individuals (<xref ref-type="bibr" rid="ref17">Clatworthy et al., 2007</xref>; <xref ref-type="bibr" rid="ref23">Dickey et al., 2017</xref>; <xref ref-type="bibr" rid="ref51">Lau et al., 2023</xref>). Successful examples of alternative treatment strategies already exist, such as the inhibition of bacterial adhesion and colonization with mannosides in UTIs (<xref ref-type="bibr" rid="ref39">Jarvisa et al., 2016</xref>) or the neutralization of toxins produced by <italic>Clostridioides difficile</italic> with antibodies (<xref ref-type="bibr" rid="ref55">Lowy et al., 2010</xref>). Another example is targeting metabolic pathways, as demonstrated by trimethoprim&#x2019;s inhibition of folate metabolism, resulting in bacterial stress due to the lack of essential metabolites required for DNA, RNA, and protein synthesis (<xref ref-type="bibr" rid="ref48">Kwon et al., 2010</xref>). In our study, we uncovered the unique induction of the two-component system CitYZ homologous to CitAB in KP compared to KV. Disrupting the tight regulation, which senses and regulates citrate utilization, could potentially decrease KP fitness and prevent infection manifestation (<xref ref-type="bibr" rid="ref79">Reinelt et al., 2003</xref>; <xref ref-type="bibr" rid="ref9">Brisse et al., 2014</xref>). Another promising target for anti-virulence approaches is FabG, considering the potential of other proteins in the same pathway (e.g., FabI, FabB, FabH) as drug targets against KP (<xref ref-type="bibr" rid="ref77">Ramos et al., 2018</xref>). These findings underscore the potential of the genes identified in our study, which warrant further investigation in subsequent studies.</p>
<p>In conclusion, our study offers significant insights into the genomics and adaptive responses of KP under urine-like conditions compared to KV, a closely related species within the KpSC. By investigating the expression of key genes and pathways unique to KP compared to other members of the KpSC, we contribute to the understanding of the complexity behind KP&#x2019;s global prevalence and success. Our findings indicate that KP, in contrast to other KpSC species, possesses distinct genetic characteristics, and its regulation at the transcriptomic and proteomic levels is primarily focused on metabolic pathways. Ongoing prospective studies aim to explore whether the markers identified in this study can be utilized as novel druggable targets.</p>
<sec id="sec29">
<label>4.1</label>
<title>Limitations</title>
<p>There are some limitations to note. First, although our selection of KpSC species isolates provides a robust dataset, encompassing international high-risk clonal lineages of KP along with less prevalent KV and KQ, this selection was influenced by the availability of public genomic data. Transcriptomic and proteomic analyses in this study were limited to KP and KV, excluding KQ. To mitigate this limitation, homologous clustering including KQ was incorporated into the analysis to provide broader comparative context and minimize potential bias in the identification of KP-specific markers. Second, while KP is a major contributor to UTIs, its role extends to various other infectious contexts, and pathogenic strains may not necessarily enter through the urinary tract and the urinary tract may not always be the primary infection site. Despite this, the use of synthetic human urine remains a relevant model for simulating conditions found in critical KpSC infection sites. Third, functional validation of markers, such as through knock-out experiments, remains challenging, particularly with MDR isolates. Additionally, the sample size for transcriptomic and proteomic analyses is limited. Finally, while both KV and KQ show differences in the <italic>citW&#x2013;citY</italic> intergenic region compared to KP, phenotypic validation and an increased sample size are required to make definitive conclusions about how these variations influence citrate utilization and contribute to KP&#x2019;s apparent superiority.</p>
</sec>
</sec>
</body>
<back>
<sec sec-type="data-availability" id="sec30">
<title>Data availability statement</title>
<p>The original contributions presented in the study are publicly available. This data can be found here: <ext-link xlink:href="https://www.ebi.ac.uk/ena" ext-link-type="uri">https://www.ebi.ac.uk/ena</ext-link>, PRJEB71341; <ext-link xlink:href="http://www.proteomexchange.org/" ext-link-type="uri">http://www.proteomexchange.org/</ext-link>, PXD047744.</p>
</sec>
<sec sec-type="author-contributions" id="sec31">
<title>Author contributions</title>
<p>L-SS: Writing &#x2013; original draft, Writing &#x2013; review &#x0026; editing, Software, Investigation, Data curation, Methodology, Formal analysis, Validation, Visualization. KrS: Writing &#x2013; review &#x0026; editing, Methodology, Formal analysis, Investigation, Data curation, Software. EE: Writing &#x2013; review &#x0026; editing. JM: Writing &#x2013; review &#x0026; editing, Formal analysis. MG: Writing &#x2013; review &#x0026; editing, Investigation. SH: Data curation, Software, Writing &#x2013; review &#x0026; editing. GW: Resources, Writing &#x2013; review &#x0026; editing. N-OH: Writing &#x2013; review &#x0026; editing, Resources. JB: Writing &#x2013; review &#x0026; editing, Resources. KB: Resources, Writing &#x2013; review &#x0026; editing. UV: Resources, Writing &#x2013; review &#x0026; editing. MS: Methodology, Data curation, Writing &#x2013; review &#x0026; editing, Visualization, Investigation, Formal analysis, Software. KaS: Project administration, Funding acquisition, Conceptualization, Resources, Supervision, Writing &#x2013; review &#x0026; editing.</p>
</sec>
<sec sec-type="funding-information" id="sec32">
<title>Funding</title>
<p>The author(s) declare that financial support was received for the research and/or publication of this article. This work was supported by the German Federal Ministry of Research, Technology and Space (BMFTR) within the &#x201C;DISPATch_MRGN-Disarming pathogens as a different strategy to fight antimicrobial-resistant Gram-negatives&#x201D; project (grant no. 01KI2410).</p>
</sec>
<ack>
<p>We thank Stephan Michalik for creating the R scripts for statistical analysis of proteome data and Sara-Lucia Wawrzyniak for her excellent technical support.</p>
</ack>
<sec sec-type="COI-statement" id="sec33">
<title>Conflict of interest</title>
<p>The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.</p>
<p>The author(s) declared that they were an editorial board member of Frontiers, at the time of submission. This had no impact on the peer review process and the final decision.</p>
</sec>
<sec sec-type="ai-statement" id="sec34">
<title>Generative AI statement</title>
<p>The authors declare that Gen AI was used in the creation of this manuscript. We used large language models, such as ChatGPT (GPT-4), to assist in revising portions of the manuscript. All AI-generated content was thoroughly reviewed, edited, and approved by the authors to ensure its accuracy and integrity.</p>
<p>Any alternative text (alt text) provided alongside figures in this article has been generated by Frontiers with the support of artificial intelligence and reasonable efforts have been made to ensure accuracy, including review by the authors wherever possible. If you identify any issues, please contact us.</p>
</sec>
<sec sec-type="disclaimer" id="sec35">
<title>Publisher&#x2019;s note</title>
<p>All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article, or claim that may be made by its manufacturer, is not guaranteed or endorsed by the publisher.</p>
</sec>
<sec sec-type="supplementary-material" id="sec36">
<title>Supplementary material</title>
<p>The Supplementary material for this article can be found online at: <ext-link xlink:href="https://www.frontiersin.org/articles/10.3389/fmicb.2025.1657680/full#supplementary-material" ext-link-type="uri">https://www.frontiersin.org/articles/10.3389/fmicb.2025.1657680/full#supplementary-material</ext-link></p>
<supplementary-material xlink:href="Supplementary_file_1.pdf" id="SM1" mimetype="application/pdf" xmlns:xlink="http://www.w3.org/1999/xlink"/>
<supplementary-material xlink:href="Supplementary_file_2.xlsx" id="SM2" mimetype="application/vnd.openxmlformats-officedocument.spreadsheetml.sheet" xmlns:xlink="http://www.w3.org/1999/xlink"/>
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<fn-group>
<fn id="fn0001"><p><sup>1</sup><ext-link xlink:href="https://github.com/FelixKrueger/TrimGalore" ext-link-type="uri">https://github.com/FelixKrueger/TrimGalore</ext-link></p></fn>
<fn id="fn0002"><p><sup>2</sup><ext-link xlink:href="https://github.com/FelixKrueger/TrimGalore" ext-link-type="uri">https://github.com/FelixKrueger/TrimGalore</ext-link></p></fn>
</fn-group>
<ref-list>
<title>References</title>
<ref id="ref1"><citation citation-type="journal"><person-group person-group-type="author"><name><surname>Abbott</surname><given-names>I. J.</given-names></name> <name><surname>van Gorp</surname><given-names>E.</given-names></name> <name><surname>Wijma</surname><given-names>R. A.</given-names></name> <name><surname>Meletiadis</surname><given-names>J.</given-names></name> <name><surname>Mouton</surname><given-names>J. W.</given-names></name> <name><surname>Peleg</surname><given-names>A. Y.</given-names></name></person-group> (<year>2020</year>). <article-title>Evaluation of pooled human urine and synthetic alternatives in a dynamic bladder infection in vitro model simulating oral fosfomycin therapy</article-title>. <source>J. Microbiol. Methods</source> <volume>171</volume>:<fpage>105861</fpage>. doi: <pub-id pub-id-type="doi">10.1016/j.mimet.2020.105861</pub-id>, PMID: <pub-id pub-id-type="pmid">32035114</pub-id></citation></ref>
<ref id="ref2"><citation citation-type="journal"><person-group person-group-type="author"><name><surname>Alteri</surname><given-names>C. J.</given-names></name> <name><surname>Himpsl</surname><given-names>S. D.</given-names></name> <name><surname>Mobley</surname><given-names>H. L. T.</given-names></name></person-group> (<year>2015</year>). <article-title>Preferential use of central metabolism in vivo reveals a nutritional basis for Polymicrobial infection</article-title>. <source>PLoS Pathog.</source> <volume>11</volume>, <fpage>e1004601</fpage>&#x2013;<lpage>e1004613</lpage>. doi: <pub-id pub-id-type="doi">10.1371/journal.ppat.1004601</pub-id>, PMID: <pub-id pub-id-type="pmid">25568946</pub-id></citation></ref>
<ref id="ref3"><citation citation-type="journal"><person-group person-group-type="author"><name><surname>Alteri</surname><given-names>C. J.</given-names></name> <name><surname>Mobley</surname><given-names>H. L. T.</given-names></name></person-group> (<year>2012</year>). <article-title><italic>Escherichia coli</italic> physiology and metabolism dictates adaptation to diverse host microenvironments</article-title>. <source>Curr. Opin. Microbiol.</source> <volume>15</volume>, <fpage>3</fpage>&#x2013;<lpage>9</lpage>. doi: <pub-id pub-id-type="doi">10.1016/j.mib.2011.12.004</pub-id>, PMID: <pub-id pub-id-type="pmid">22204808</pub-id></citation></ref>
<ref id="ref4"><citation citation-type="journal"><person-group person-group-type="author"><name><surname>Bachman</surname><given-names>M. A.</given-names></name> <name><surname>Breen</surname><given-names>P.</given-names></name> <name><surname>Deornellas</surname><given-names>V.</given-names></name> <name><surname>Mu</surname><given-names>Q.</given-names></name> <name><surname>Zhao</surname><given-names>L.</given-names></name> <name><surname>Wu</surname><given-names>W.</given-names></name> <etal/></person-group>. (<year>2015</year>). <article-title>Genome-wide identification of <italic>Klebsiella pneumoniae</italic> fitness genes during lung infection</article-title>. <source>MBio</source> <volume>6</volume>:<fpage>e00775</fpage>. doi: <pub-id pub-id-type="doi">10.1128/mBio.00775-15</pub-id>, PMID: <pub-id pub-id-type="pmid">26060277</pub-id></citation></ref>
<ref id="ref5"><citation citation-type="journal"><person-group person-group-type="author"><name><surname>Becker</surname><given-names>L.</given-names></name> <name><surname>Kaase</surname><given-names>M.</given-names></name> <name><surname>Pfeifer</surname><given-names>Y.</given-names></name> <name><surname>Fuchs</surname><given-names>S.</given-names></name> <name><surname>Reuss</surname><given-names>A.</given-names></name> <name><surname>Von Laer</surname><given-names>A.</given-names></name> <etal/></person-group>. (<year>2018</year>). <article-title>Genome-based analysis of Carbapenemase-producing <italic>Klebsiella pneumoniae</italic> isolates from German hospital patients, 2008-2014</article-title>. <source>Antimicrob Resist Infect Control</source> <volume>7</volume>, <fpage>1</fpage>&#x2013;<lpage>12</lpage>. doi: <pub-id pub-id-type="doi">10.1186/s13756-018-0352-y</pub-id></citation></ref>
<ref id="ref6"><citation citation-type="journal"><person-group person-group-type="author"><name><surname>Bialek-Davenet</surname><given-names>S.</given-names></name> <name><surname>Criscuolo</surname><given-names>A.</given-names></name> <name><surname>Ailloud</surname><given-names>F.</given-names></name> <name><surname>Passet</surname><given-names>V.</given-names></name> <name><surname>Jones</surname><given-names>L.</given-names></name> <name><surname>Garin</surname><given-names>B.</given-names></name> <etal/></person-group>. (<year>2014</year>). <article-title>Genomic definition of hypervirulent and multidrug-resistant <italic>Klebsiella pneumoniae</italic> clonal groups</article-title>. <source>Emerg. Infect. Dis.</source> <volume>20</volume>, <fpage>1812</fpage>&#x2013;<lpage>1820</lpage>. doi: <pub-id pub-id-type="doi">10.3201/eid2011.140206</pub-id>, PMID: <pub-id pub-id-type="pmid">25341126</pub-id></citation></ref>
<ref id="ref7"><citation citation-type="journal"><person-group person-group-type="author"><name><surname>Blankenburg</surname><given-names>S.</given-names></name> <name><surname>Hentschker</surname><given-names>C.</given-names></name> <name><surname>Nagel</surname><given-names>A.</given-names></name> <name><surname>Hildebrandt</surname><given-names>P.</given-names></name> <name><surname>Michalik</surname><given-names>S.</given-names></name> <name><surname>Dittmar</surname><given-names>D.</given-names></name> <etal/></person-group>. (<year>2019</year>). <article-title>Improving proteome coverage for small sample amounts: an advanced method for proteomics approaches with low bacterial cell numbers</article-title>. <source>Proteomics</source> <volume>19</volume>:<fpage>e1900192</fpage>. doi: <pub-id pub-id-type="doi">10.1002/pmic.201900192</pub-id></citation></ref>
<ref id="ref8"><citation citation-type="journal"><person-group person-group-type="author"><name><surname>Blin</surname><given-names>C.</given-names></name> <name><surname>Passet</surname><given-names>V.</given-names></name> <name><surname>Touchon</surname><given-names>M.</given-names></name> <name><surname>Rocha</surname><given-names>E. P. C.</given-names></name> <name><surname>Brisse</surname><given-names>S.</given-names></name></person-group> (<year>2017</year>). <article-title>Metabolic diversity of the emerging pathogenic lineages of <italic>Klebsiella pneumoniae</italic></article-title>. <source>Environ. Microbiol.</source> <volume>19</volume>, <fpage>1881</fpage>&#x2013;<lpage>1898</lpage>. doi: <pub-id pub-id-type="doi">10.1111/1462-2920.13689</pub-id>, PMID: <pub-id pub-id-type="pmid">28181409</pub-id></citation></ref>
<ref id="ref9"><citation citation-type="journal"><person-group person-group-type="author"><name><surname>Brisse</surname><given-names>S.</given-names></name> <name><surname>Passet</surname><given-names>V.</given-names></name> <name><surname>Grimont</surname><given-names>P. A. D.</given-names></name></person-group> (<year>2014</year>). <article-title>Description of <italic>Klebsiella quasipneumoniae</italic> sp. nov., isolated from human infections, with two subspecies, <italic>Klebsiella quasipneumoniae</italic> subsp. <italic>quasipneumoniae</italic> subsp. nov. and <italic>Klebsiella quasipneumoniae</italic> subsp. <italic>similipneumoniae</italic> subsp. nov., and demonstration that <italic>Klebsiella singaporensis</italic> is a junior heterotypic synonym of <italic>Klebsiella variicola</italic></article-title>. <source>Int. J. Syst. Evol. Microbiol.</source> <volume>64</volume>, <fpage>3146</fpage>&#x2013;<lpage>3152</lpage>. doi: <pub-id pub-id-type="doi">10.1099/ijs.0.062737-0</pub-id></citation></ref>
<ref id="ref10"><citation citation-type="journal"><person-group person-group-type="author"><name><surname>Brisse</surname><given-names>S.</given-names></name> <name><surname>Verhoef</surname><given-names>J.</given-names></name></person-group> (<year>2001</year>). <article-title>Phylogenetic diversity of Klebsiella pneumoniae and <italic>Klebsiella oxytoca</italic> clinical isolates revealed by randomly amplified polymorphic DNA, gyrA and parC genes sequencing and automated ribotyping</article-title>. <source>Int. J. Syst. Evol. Microbiol.</source> <volume>51</volume>, <fpage>915</fpage>&#x2013;<lpage>924</lpage>. doi: <pub-id pub-id-type="doi">10.1099/00207713-51-3-915</pub-id>, PMID: <pub-id pub-id-type="pmid">11411715</pub-id></citation></ref>
<ref id="ref11"><citation citation-type="journal"><person-group person-group-type="author"><name><surname>Calland</surname><given-names>J. K.</given-names></name> <name><surname>Haukka</surname><given-names>K.</given-names></name> <name><surname>Kpordze</surname><given-names>S. W.</given-names></name> <name><surname>Brusah</surname><given-names>A.</given-names></name> <name><surname>Corbella</surname><given-names>M.</given-names></name> <name><surname>Merla</surname><given-names>C.</given-names></name> <etal/></person-group>. (<year>2023</year>). <article-title>Population structure and antimicrobial resistance among Klebsiella isolates sampled from human, animal, and environmental sources in Ghana: a cross-sectional genomic one health study</article-title>. <source>The Lancet Microbe</source> <volume>4</volume>, <fpage>e943</fpage>&#x2013;<lpage>e952</lpage>. doi: <pub-id pub-id-type="doi">10.1016/S2666-5247(23)00208-2</pub-id>, PMID: <pub-id pub-id-type="pmid">37858320</pub-id></citation></ref>
<ref id="ref12"><citation citation-type="journal"><person-group person-group-type="author"><name><surname>Cano</surname><given-names>&#x00C1;.</given-names></name> <name><surname>Guti&#x00E9;rrez-Guti&#x00E9;rrez</surname><given-names>B.</given-names></name> <name><surname>Machuca</surname><given-names>I.</given-names></name> <name><surname>Torre-Gim&#x00E9;nez</surname><given-names>J.</given-names></name> <name><surname>Gracia-Ahufinger</surname><given-names>I.</given-names></name> <name><surname>Natera</surname><given-names>A. M.</given-names></name> <etal/></person-group>. (<year>2022</year>). <article-title>Association between timing of colonization and risk of developing <italic>Klebsiella pneumoniae</italic> Carbapenemase-Producing <italic>K. pneumoniae</italic> infection in hospitalized patients</article-title>. <source>Microbiol. Spectr.</source> <volume>10</volume>, <fpage>e0197021</fpage>&#x2013;<lpage>e0197011</lpage>. doi: <pub-id pub-id-type="doi">10.1128/spectrum.01970-21</pub-id>, PMID: <pub-id pub-id-type="pmid">35323035</pub-id></citation></ref>
<ref id="ref13"><citation citation-type="journal"><person-group person-group-type="author"><name><surname>Cantalapiedra</surname><given-names>C. P.</given-names></name> <name><surname>Hern&#x0317;andez-Plaza</surname><given-names>A.</given-names></name> <name><surname>Letunic</surname><given-names>I.</given-names></name> <name><surname>Bork</surname><given-names>P.</given-names></name> <name><surname>Huerta-Cepas</surname><given-names>J.</given-names></name></person-group> (<year>2021</year>). <article-title>EggNOG-mapper v2: functional annotation, orthology assignments, and domain prediction at the metagenomic scale</article-title>. <source>Mol. Biol. Evol.</source> <volume>38</volume>, <fpage>5825</fpage>&#x2013;<lpage>5829</lpage>. doi: <pub-id pub-id-type="doi">10.1093/molbev/msab293</pub-id></citation></ref>
<ref id="ref14"><citation citation-type="journal"><person-group person-group-type="author"><name><surname>Chang</surname><given-names>S. C.</given-names></name> <name><surname>Fang</surname><given-names>C. T.</given-names></name> <name><surname>Hsueh</surname><given-names>P. R.</given-names></name> <name><surname>Chen</surname><given-names>Y. C.</given-names></name> <name><surname>Luh</surname><given-names>K. T.</given-names></name></person-group> (<year>2000</year>). <article-title><italic>Klebsiella pneumoniae</italic> isolates causing liver abscess in Taiwan</article-title>. <source>Diagn. Microbiol. Infect. Dis.</source> <volume>37</volume>, <fpage>279</fpage>&#x2013;<lpage>284</lpage>. doi: <pub-id pub-id-type="doi">10.1016/S0732-8893(00)00157-7</pub-id>, PMID: <pub-id pub-id-type="pmid">10974581</pub-id></citation></ref>
<ref id="ref15"><citation citation-type="journal"><person-group person-group-type="author"><name><surname>Chang</surname><given-names>D.</given-names></name> <name><surname>Sharma</surname><given-names>L.</given-names></name> <name><surname>Dela Cruz</surname><given-names>C. S.</given-names></name> <name><surname>Zhang</surname><given-names>D.</given-names></name></person-group> (<year>2021</year>). <article-title>Clinical epidemiology, risk factors, and control strategies of <italic>Klebsiella pneumoniae</italic> infection</article-title>. <source>Front. Microbiol.</source> <volume>12</volume>, <fpage>1</fpage>&#x2013;<lpage>9</lpage>. doi: <pub-id pub-id-type="doi">10.3389/fmicb.2021.750662</pub-id></citation></ref>
<ref id="ref16"><citation citation-type="journal"><person-group person-group-type="author"><name><surname>Chen</surname><given-names>Y. T.</given-names></name> <name><surname>Liao</surname><given-names>T. L.</given-names></name> <name><surname>Wu</surname><given-names>K. M.</given-names></name> <name><surname>Lauderdale</surname><given-names>T. L.</given-names></name> <name><surname>Yan</surname><given-names>J. J.</given-names></name> <name><surname>Huang</surname><given-names>I. W.</given-names></name> <etal/></person-group>. (<year>2009</year>). <article-title>Genomic diversity of citrate fermentation in <italic>Klebsiella pneumoniae</italic></article-title>. <source>BMC Microbiol.</source> <volume>9</volume>, <fpage>1</fpage>&#x2013;<lpage>9</lpage>. doi: <pub-id pub-id-type="doi">10.1186/1471-2180-9-168</pub-id>, PMID: <pub-id pub-id-type="pmid">19682387</pub-id></citation></ref>
<ref id="ref17"><citation citation-type="journal"><person-group person-group-type="author"><name><surname>Clatworthy</surname><given-names>A. E.</given-names></name> <name><surname>Pierson</surname><given-names>E.</given-names></name> <name><surname>Hung</surname><given-names>D. T.</given-names></name></person-group> (<year>2007</year>). <article-title>Targeting virulence: a new paradigm for antimicrobial therapy</article-title>. <source>Nat. Chem. Biol.</source> <volume>3</volume>, <fpage>541</fpage>&#x2013;<lpage>548</lpage>. doi: <pub-id pub-id-type="doi">10.1038/nchembio.2007.24</pub-id>, PMID: <pub-id pub-id-type="pmid">17710100</pub-id></citation></ref>
<ref id="ref18"><citation citation-type="journal"><person-group person-group-type="author"><collab id="coll1">Consortium T.U</collab></person-group> (<year>2023</year>). <article-title>UniProt: the universal protein knowledgebase in 2023</article-title>. <source>Nucleic Acids Res</source> <volume>51</volume>, <fpage>D523</fpage>&#x2013;<lpage>D531</lpage>. doi: <pub-id pub-id-type="doi">10.1093/nar/gkac1052</pub-id>, PMID: <pub-id pub-id-type="pmid">36408920</pub-id></citation></ref>
<ref id="ref19"><citation citation-type="journal"><person-group person-group-type="author"><name><surname>Davis</surname><given-names>T. J.</given-names></name> <name><surname>Matsen</surname><given-names>J. M.</given-names></name></person-group> (<year>1974</year>). <article-title>Prevalence and characteristics of Klebsiella species: relation to association with a hospital environment</article-title>. <source>J. Infect. Dis.</source> <volume>130</volume>, <fpage>402</fpage>&#x2013;<lpage>405</lpage>. doi: <pub-id pub-id-type="doi">10.1093/infdis/130.4.402</pub-id>, PMID: <pub-id pub-id-type="pmid">4613760</pub-id></citation></ref>
<ref id="ref20"><citation citation-type="journal"><person-group person-group-type="author"><name><surname>de Lagarde</surname><given-names>M.</given-names></name> <name><surname>Vanier</surname><given-names>G.</given-names></name> <name><surname>Arsenault</surname><given-names>J.</given-names></name> <name><surname>Fairbrother</surname><given-names>J. M.</given-names></name></person-group> (<year>2021</year>). <article-title>High risk clone: a proposal of criteria adapted to the one health context with application to enterotoxigenic <italic>Escherichia coli</italic> in the pig population</article-title>. <source>Antibiotics</source> <volume>10</volume>, <fpage>1</fpage>&#x2013;<lpage>19</lpage>. doi: <pub-id pub-id-type="doi">10.3390/antibiotics10030244</pub-id>, PMID: <pub-id pub-id-type="pmid">33671102</pub-id></citation></ref>
<ref id="ref21"><citation citation-type="journal"><person-group person-group-type="author"><name><surname>Den Bakker</surname><given-names>H. C.</given-names></name> <name><surname>Deng</surname><given-names>X.</given-names></name> <name><surname>Carleton</surname><given-names>H. A.</given-names></name></person-group> (<year>2022</year>). <article-title>Mashtree: a rapid comparison of whole genome sequence files</article-title>. <source>J. Open Source Soft.</source> <volume>4</volume>:<fpage>1762</fpage>. doi: <pub-id pub-id-type="doi">10.21105/joss.01762</pub-id></citation></ref>
<ref id="ref22"><citation citation-type="journal"><person-group person-group-type="author"><name><surname>Diancourt</surname><given-names>L.</given-names></name> <name><surname>Passet</surname><given-names>V.</given-names></name> <name><surname>Verhoef</surname><given-names>J.</given-names></name> <name><surname>Grimont</surname><given-names>P. A. D.</given-names></name> <name><surname>Brisse</surname><given-names>S.</given-names></name></person-group> (<year>2005</year>). <article-title>Multilocus sequence typing of <italic>Klebsiella pneumoniae</italic> nosocomial isolates</article-title>. <source>J. Clin. Microbiol.</source> <volume>43</volume>, <fpage>4178</fpage>&#x2013;<lpage>4182</lpage>. doi: <pub-id pub-id-type="doi">10.1128/JCM.43.8.4178&#x2013;4182.2005</pub-id></citation></ref>
<ref id="ref23"><citation citation-type="journal"><person-group person-group-type="author"><name><surname>Dickey</surname><given-names>S. W.</given-names></name> <name><surname>Cheung</surname><given-names>G. Y. C.</given-names></name> <name><surname>Otto</surname><given-names>M.</given-names></name></person-group> (<year>2017</year>). <article-title>Different drugs for bad bugs: Antivirulence strategies in the age of antibiotic resistance</article-title>. <source>Nat. Rev. Drug Discov.</source> <volume>16</volume>, <fpage>457</fpage>&#x2013;<lpage>471</lpage>. doi: <pub-id pub-id-type="doi">10.1038/nrd.2017.23</pub-id>, PMID: <pub-id pub-id-type="pmid">28337021</pub-id></citation></ref>
<ref id="ref24"><citation citation-type="journal"><person-group person-group-type="author"><collab id="coll2">ECDC</collab></person-group> (<year>2024</year>). <article-title>Emergence of hypervirulent K lebsiella pneum oniae ST23 carrying carbapenemase genes in EU / EEA countries event background urgent inquiry and data request to EURGen-net</article-title>. <source>Eur. Cent. Dis. Prev. Control</source> <volume>14</volume>:<fpage>3023</fpage>. doi: <pub-id pub-id-type="doi">10.2900/993023</pub-id></citation></ref>
<ref id="ref25"><citation citation-type="journal"><person-group person-group-type="author"><name><surname>Flores-Mireles</surname><given-names>A. L.</given-names></name> <name><surname>Walker</surname><given-names>J. N.</given-names></name> <name><surname>Caparon</surname><given-names>M.</given-names></name> <name><surname>Hultgren</surname><given-names>S. J.</given-names></name></person-group> (<year>2015</year>). <article-title>Urinary tract infections: epidemiology, mechanisms of infection and treatment options</article-title>. <source>Nat. Rev. Microbiol.</source> <volume>13</volume>, <fpage>269</fpage>&#x2013;<lpage>284</lpage>. doi: <pub-id pub-id-type="doi">10.1038/nrmicro3432</pub-id>, PMID: <pub-id pub-id-type="pmid">25853778</pub-id></citation></ref>
<ref id="ref26"><citation citation-type="journal"><person-group person-group-type="author"><name><surname>Friedl&#x00E4;nder</surname><given-names>C.</given-names></name></person-group> (<year>1882</year>). <article-title>Ueber die Schizomyceten bei der acuten fibr sen</article-title>. <source>Arch. Pathol. Anat. und Physiol. und Klin. Med.</source> <volume>87</volume>, <fpage>319</fpage>&#x2013;<lpage>324</lpage>. doi: <pub-id pub-id-type="doi">10.1007/BF01880516</pub-id></citation></ref>
<ref id="ref27"><citation citation-type="journal"><person-group person-group-type="author"><name><surname>Fu</surname><given-names>L.</given-names></name> <name><surname>Niu</surname><given-names>B.</given-names></name> <name><surname>Zhu</surname><given-names>Z.</given-names></name> <name><surname>Wu</surname><given-names>S.</given-names></name> <name><surname>Li</surname><given-names>W.</given-names></name></person-group> (<year>2012</year>). <article-title>Bioinformatics applications note sequence analysis CD-HIT: accelerated for clustering the next-generation sequencing data</article-title>. <source>Bioinforma. Apllications Note</source> <volume>28</volume>, <fpage>3150</fpage>&#x2013;<lpage>3152</lpage>. doi: <pub-id pub-id-type="doi">10.1093/bioinformatics/bts565</pub-id></citation></ref>
<ref id="ref28"><citation citation-type="journal"><person-group person-group-type="author"><name><surname>Giuffr&#x00E8;</surname><given-names>A.</given-names></name> <name><surname>Borisov</surname><given-names>V. B.</given-names></name> <name><surname>Arese</surname><given-names>M.</given-names></name> <name><surname>Sarti</surname><given-names>P.</given-names></name> <name><surname>Forte</surname><given-names>E.</given-names></name></person-group> (<year>2014</year>). <article-title>Cytochrome bd oxidase and bacterial tolerance to oxidative and nitrosative stress</article-title>. <source>Biochim. Biophys. Acta Bioenerg.</source> <volume>1837</volume>, <fpage>1178</fpage>&#x2013;<lpage>1187</lpage>. doi: <pub-id pub-id-type="doi">10.1016/j.bbabio.2014.01.016</pub-id>, PMID: <pub-id pub-id-type="pmid">24486503</pub-id></citation></ref>
<ref id="ref29"><citation citation-type="journal"><person-group person-group-type="author"><name><surname>Gorrie</surname><given-names>C. L.</given-names></name> <name><surname>Mirc Eta</surname><given-names>M.</given-names></name> <name><surname>Wick</surname><given-names>R. R.</given-names></name> <name><surname>Edwards</surname><given-names>D. J.</given-names></name> <name><surname>Thomson</surname><given-names>N. R.</given-names></name> <name><surname>Strugnell</surname><given-names>R. A.</given-names></name> <etal/></person-group>. (<year>2017</year>). <article-title>Gastrointestinal carriage is a major reservoir of <italic>Klebsiella pneumoniae</italic> infection in intensive care patients</article-title>. <source>Clin. Infect. Dis.</source> <volume>65</volume>, <fpage>208</fpage>&#x2013;<lpage>215</lpage>. doi: <pub-id pub-id-type="doi">10.1093/cid/cix270</pub-id>, PMID: <pub-id pub-id-type="pmid">28369261</pub-id></citation></ref>
<ref id="ref30"><citation citation-type="journal"><person-group person-group-type="author"><name><surname>Gorrie</surname><given-names>C. L.</given-names></name> <name><surname>Mir&#x010D;eta</surname><given-names>M.</given-names></name> <name><surname>Wick</surname><given-names>R. R.</given-names></name> <name><surname>Judd</surname><given-names>L. M.</given-names></name> <name><surname>Lam</surname><given-names>M. M. C.</given-names></name> <name><surname>Gomi</surname><given-names>R.</given-names></name> <etal/></person-group>. (<year>2022</year>). <article-title>Genomic dissection of <italic>Klebsiella pneumoniae</italic> infections in hospital patients reveals insights into an opportunistic pathogen</article-title>. <source>Nat. Commun.</source> <volume>13</volume>:<fpage>3017</fpage>. doi: <pub-id pub-id-type="doi">10.1038/s41467-022-30717-6</pub-id>, PMID: <pub-id pub-id-type="pmid">35641522</pub-id></citation></ref>
<ref id="ref31"><citation citation-type="journal"><person-group person-group-type="author"><name><surname>Gu</surname><given-names>D.</given-names></name> <name><surname>Dong</surname><given-names>N.</given-names></name> <name><surname>Zheng</surname><given-names>Z.</given-names></name> <name><surname>Lin</surname><given-names>D.</given-names></name> <name><surname>Huang</surname><given-names>M.</given-names></name> <name><surname>Wang</surname><given-names>L.</given-names></name> <etal/></person-group>. (<year>2018</year>). <article-title>A fatal outbreak of ST11 carbapenem-resistant hypervirulent <italic>Klebsiella pneumoniae</italic> in a Chinese hospital: a molecular epidemiological study</article-title>. <source>Lancet Infect. Dis.</source> <volume>18</volume>, <fpage>37</fpage>&#x2013;<lpage>46</lpage>. doi: <pub-id pub-id-type="doi">10.1016/S1473-3099(17)30489-9</pub-id>, PMID: <pub-id pub-id-type="pmid">28864030</pub-id></citation></ref>
<ref id="ref32"><citation citation-type="journal"><person-group person-group-type="author"><name><surname>Heiden</surname><given-names>S. E.</given-names></name> <name><surname>H&#x00FC;bner</surname><given-names>N. O.</given-names></name> <name><surname>Bohnert</surname><given-names>J. A.</given-names></name> <name><surname>Heidecke</surname><given-names>C. D.</given-names></name> <name><surname>Kramer</surname><given-names>A.</given-names></name> <name><surname>Balau</surname><given-names>V.</given-names></name> <etal/></person-group>. (<year>2020</year>). <article-title>A <italic>Klebsiella pneumoniae</italic> ST307 outbreak clone from Germany demonstrates features of extensive drug resistance, hypermucoviscosity, and enhanced iron acquisition</article-title>. <source>Genome Med.</source> <volume>12</volume>, <fpage>113</fpage>&#x2013;<lpage>115</lpage>. doi: <pub-id pub-id-type="doi">10.1186/s13073-020-00814-6</pub-id>, PMID: <pub-id pub-id-type="pmid">33298160</pub-id></citation></ref>
<ref id="ref33"><citation citation-type="journal"><person-group person-group-type="author"><name><surname>Holt</surname><given-names>K. E.</given-names></name> <name><surname>Wertheim</surname><given-names>H.</given-names></name> <name><surname>Zadoks</surname><given-names>R. N.</given-names></name> <name><surname>Baker</surname><given-names>S.</given-names></name> <name><surname>Whitehouse</surname><given-names>C. A.</given-names></name> <name><surname>Dance</surname><given-names>D.</given-names></name> <etal/></person-group>. (<year>2015</year>). <article-title>Genomic analysis of diversity, population structure, virulence, and antimicrobial resistance in <italic>Klebsiella pneumoniae</italic>, an urgent threat to public health</article-title>. <source>Proc. Natl. Acad. Sci. USA</source> <volume>112</volume>, <fpage>E3574</fpage>&#x2013;<lpage>E3581</lpage>. doi: <pub-id pub-id-type="doi">10.1073/pnas.1501049112</pub-id>, PMID: <pub-id pub-id-type="pmid">26100894</pub-id></citation></ref>
<ref id="ref34"><citation citation-type="journal"><person-group person-group-type="author"><name><surname>Hudson</surname><given-names>A. W.</given-names></name> <name><surname>Barnes</surname><given-names>A. J.</given-names></name> <name><surname>Bray</surname><given-names>A. S.</given-names></name> <name><surname>Ammar Zafar</surname><given-names>M.</given-names></name></person-group> (<year>2022</year>). <article-title><italic>Klebsiella pneumoniae</italic> L-fucose metabolism promotes gastrointestinal colonization and modulates its virulence determinants</article-title>. <source>Infect. Immun.</source> <volume>67</volume>, <fpage>186</fpage>&#x2013;<lpage>192</lpage>. doi: <pub-id pub-id-type="doi">10.1128/iai.00206-22</pub-id></citation></ref>
<ref id="ref35"><citation citation-type="journal"><person-group person-group-type="author"><name><surname>Huerta-Cepas</surname><given-names>J.</given-names></name> <name><surname>Szklarczyk</surname><given-names>D.</given-names></name> <name><surname>Heller</surname><given-names>D.</given-names></name> <name><surname>Hern&#x00E1;ndez-Plaza</surname><given-names>A.</given-names></name> <name><surname>Forslund</surname><given-names>S. K.</given-names></name> <name><surname>Cook</surname><given-names>H.</given-names></name> <etal/></person-group>. (<year>2019</year>). <article-title>eggNOG 5.0: a hierarchical, functionally and phylogenetically annotated orthology resource based on 5090 organisms and 2502 viruses</article-title>. <source>Nucleic Acids Res.</source> <volume>47</volume>, <fpage>D309</fpage>&#x2013;<lpage>D314</lpage>. doi: <pub-id pub-id-type="doi">10.1093/nar/gky1085</pub-id>, PMID: <pub-id pub-id-type="pmid">30418610</pub-id></citation></ref>
<ref id="ref36"><citation citation-type="journal"><person-group person-group-type="author"><name><surname>Imai</surname><given-names>K.</given-names></name> <name><surname>Ishibashi</surname><given-names>N.</given-names></name> <name><surname>Kodana</surname><given-names>M.</given-names></name> <name><surname>Tarumoto</surname><given-names>N.</given-names></name> <name><surname>Sakai</surname><given-names>J.</given-names></name> <name><surname>Kawamura</surname><given-names>T.</given-names></name> <etal/></person-group>. (<year>2019</year>). <article-title>Clinical characteristics in blood stream infections caused by <italic>Klebsiella pneumoniae</italic>, <italic>Klebsiella variicola</italic>, and <italic>Klebsiella quasipneumoniae</italic>: a comparative study, Japan, 2014-2017</article-title>. <source>BMC Infect. Dis.</source> <volume>19</volume>, <fpage>1</fpage>&#x2013;<lpage>10</lpage>. doi: <pub-id pub-id-type="doi">10.1186/s12879-019-4498-x</pub-id>, PMID: <pub-id pub-id-type="pmid">31703559</pub-id></citation></ref>
<ref id="ref37"><citation citation-type="journal"><person-group person-group-type="author"><name><surname>Ipe</surname><given-names>D. S.</given-names></name> <name><surname>Ulett</surname><given-names>G. C.</given-names></name></person-group> (<year>2016</year>). <article-title>Evaluation of the in vitro growth of urinary tract infection-causing gram-negative and gram-positive bacteria in a proposed synthetic human urine (SHU) medium</article-title>. <source>J. Microbiol. Methods</source> <volume>127</volume>, <fpage>164</fpage>&#x2013;<lpage>171</lpage>. doi: <pub-id pub-id-type="doi">10.1016/j.mimet.2016.06.013</pub-id>, PMID: <pub-id pub-id-type="pmid">27312379</pub-id></citation></ref>
<ref id="ref38"><citation citation-type="journal"><person-group person-group-type="author"><name><surname>Ivan</surname><given-names>P.</given-names></name> <name><surname>Ramos</surname><given-names>P.</given-names></name> <name><surname>Pic&#x00E3;o</surname><given-names>R. C.</given-names></name> <name><surname>Gonzaga</surname><given-names>L.</given-names></name> <name><surname>Almeida</surname><given-names>P.</given-names><prefix>De</prefix></name> <name><surname>Lima</surname><given-names>N. C. B.</given-names></name> <etal/></person-group>. (<year>2014</year>). <article-title>Comparative analysis of the complete genome of KPC-2-producing <italic>Klebsiella pneumoniae</italic> Kp13 reveals remarkable genome plasticity and a wide repertoire of virulence and resistance mechanisms</article-title>. <source>BMC Genomics</source>, <volume>15</volume>, <fpage>1</fpage>&#x2013;<lpage>16</lpage>. doi: <pub-id pub-id-type="doi">10.1186/1471-2164-15-54</pub-id></citation></ref>
<ref id="ref39"><citation citation-type="journal"><person-group person-group-type="author"><name><surname>Jarvisa</surname><given-names>C.</given-names></name> <name><surname>Hana</surname><given-names>Z.</given-names></name> <name><surname>Kalasb</surname><given-names>V.</given-names></name> <name><surname>Kleinb</surname><given-names>R.</given-names></name> <name><surname>Pinknerb</surname><given-names>J. S.</given-names></name> <name><surname>Fordb</surname><given-names>B.</given-names></name> <etal/></person-group>. (<year>2016</year>). <article-title>Antivirulence Isoquinolone Mannosides: optimization of the Biaryl Aglycone for FimH lectin binding affinity and efficacy in the treatment of chronic UTI</article-title>. <source>Chem. Med. Chem.</source> <volume>11</volume>, <fpage>367</fpage>&#x2013;<lpage>373</lpage>. doi: <pub-id pub-id-type="doi">10.1002/cmdc.201600006.Antivirulence</pub-id></citation></ref>
<ref id="ref40"><citation citation-type="journal"><person-group person-group-type="author"><name><surname>Joseph</surname><given-names>L.</given-names></name> <name><surname>Merciecca</surname><given-names>T.</given-names></name> <name><surname>Forestier</surname><given-names>C.</given-names></name> <name><surname>Balestrino</surname><given-names>D.</given-names></name> <name><surname>Miquel</surname><given-names>S.</given-names></name></person-group> (<year>2021</year>). <article-title>From <italic>Klebsiella pneumoniae</italic> colonization to dissemination: an overview of studies implementing murine models</article-title>. <source>Microorganisms</source> <volume>9</volume>:<fpage>1282</fpage>. doi: <pub-id pub-id-type="doi">10.3390/microorganisms9061282</pub-id>, PMID: <pub-id pub-id-type="pmid">34204632</pub-id></citation></ref>
<ref id="ref41"><citation citation-type="journal"><person-group person-group-type="author"><name><surname>Kanehisa</surname><given-names>M.</given-names></name> <name><surname>Furumichi</surname><given-names>M.</given-names></name> <name><surname>Sato</surname><given-names>Y.</given-names></name> <name><surname>Kawashima</surname><given-names>M.</given-names></name> <name><surname>Ishiguro-Watanabe</surname><given-names>M.</given-names></name></person-group> (<year>2023</year>). <article-title>KEGG for taxonomy-based analysis of pathways and genomes</article-title>. <source>Nucleic Acids Res.</source> <volume>51</volume>, <fpage>D587</fpage>&#x2013;<lpage>D592</lpage>. doi: <pub-id pub-id-type="doi">10.1093/nar/gkac963</pub-id>, PMID: <pub-id pub-id-type="pmid">36300620</pub-id></citation></ref>
<ref id="ref42"><citation citation-type="journal"><person-group person-group-type="author"><name><surname>Kinsella</surname><given-names>M.</given-names></name> <name><surname>Monk</surname><given-names>C.</given-names></name> <name><surname>Rohmer</surname><given-names>L.</given-names></name> <name><surname>Hocquet</surname><given-names>D.</given-names></name> <name><surname>Miller</surname><given-names>S. I.</given-names></name></person-group> (<year>2011</year>). <article-title>Are pathogenic bacteria just looking for food? Metabolism and microbial pathogenesis</article-title>. <source>Trends Microbiol.</source> <volume>19</volume>, <fpage>341</fpage>&#x2013;<lpage>348</lpage>. doi: <pub-id pub-id-type="doi">10.1016/j.tim.2011.04.003</pub-id></citation></ref>
<ref id="ref43"><citation citation-type="journal"><person-group person-group-type="author"><name><surname>Knothe</surname><given-names>H.</given-names></name> <name><surname>Shah</surname><given-names>P.</given-names></name> <name><surname>Krcmery</surname><given-names>V.</given-names></name> <name><surname>Antal</surname><given-names>M.</given-names></name> <name><surname>Mitsuhashi</surname><given-names>S.</given-names></name></person-group> (<year>1983</year>). <article-title>Transferable resistance to cefotaxime, cefoxitin, cefamandole and cefuroxime in clinical isolates of Klebsiella pneumoniae and <italic>Serratia marcescens</italic></article-title>. <source>Infection</source> <volume>11</volume>, <fpage>315</fpage>&#x2013;<lpage>317</lpage>. doi: <pub-id pub-id-type="doi">10.1007/BF01641355</pub-id>, PMID: <pub-id pub-id-type="pmid">6321357</pub-id></citation></ref>
<ref id="ref44"><citation citation-type="journal"><person-group person-group-type="author"><name><surname>Ko</surname><given-names>W.</given-names></name> <name><surname>Paterson</surname><given-names>D. L.</given-names></name> <name><surname>Sagnimeni</surname><given-names>A. J.</given-names></name> <name><surname>Hansen</surname><given-names>D. S.</given-names></name> <name><surname>Von Gottberg</surname><given-names>A.</given-names></name> <name><surname>Mohapatra</surname><given-names>S.</given-names></name> <etal/></person-group>. (<year>2002</year>). <article-title>Community-acquired <italic>Klebsiella pneumoniae</italic> bacteremia: global differences in clinical patterns</article-title>. <source>Emerg. Infect. Dis.</source> <volume>8</volume>, <fpage>160</fpage>&#x2013;<lpage>166</lpage>. doi: <pub-id pub-id-type="doi">10.3201/eid0802.010025</pub-id></citation></ref>
<ref id="ref45"><citation citation-type="journal"><person-group person-group-type="author"><name><surname>Kochan</surname><given-names>T. J.</given-names></name> <name><surname>Nozick</surname><given-names>S. H.</given-names></name> <name><surname>Medernach</surname><given-names>R. L.</given-names></name> <name><surname>Cheung</surname><given-names>B. H.</given-names></name> <name><surname>Gatesy</surname><given-names>S. W. M.</given-names></name> <name><surname>Lebrun-Corbin</surname><given-names>M.</given-names></name> <etal/></person-group>. (<year>2022</year>). <article-title>Genomic surveillance for multidrug-resistant or hypervirulent <italic>Klebsiella pneumoniae</italic> among United States bloodstream isolates</article-title>. <source>BMC Infect. Dis.</source> <volume>22</volume>, <fpage>603</fpage>&#x2013;<lpage>621</lpage>. doi: <pub-id pub-id-type="doi">10.1186/s12879-022-07558-1</pub-id>, PMID: <pub-id pub-id-type="pmid">35799130</pub-id></citation></ref>
<ref id="ref46"><citation citation-type="journal"><person-group person-group-type="author"><name><surname>Kolmogorov</surname><given-names>M.</given-names></name> <name><surname>Yuan</surname><given-names>J.</given-names></name> <name><surname>Lin</surname><given-names>Y.</given-names></name> <name><surname>Pevzner</surname><given-names>P. A.</given-names></name></person-group> (<year>2019</year>). <article-title>Assembly of long, error-prone reads using repeat graphs</article-title>. <source>Nat. Biotechnol.</source> <volume>37</volume>, <fpage>540</fpage>&#x2013;<lpage>546</lpage>. doi: <pub-id pub-id-type="doi">10.1038/s41587-019-0072-8</pub-id>, PMID: <pub-id pub-id-type="pmid">30936562</pub-id></citation></ref>
<ref id="ref47"><citation citation-type="journal"><person-group person-group-type="author"><name><surname>Kong</surname><given-names>L.</given-names></name> <name><surname>Guo</surname><given-names>X.</given-names></name> <name><surname>Wang</surname><given-names>Z.</given-names></name> <name><surname>Gao</surname><given-names>Y.</given-names></name> <name><surname>Jia</surname><given-names>B.</given-names></name> <name><surname>Liu</surname><given-names>S.</given-names></name> <etal/></person-group>. (<year>2017</year>). <article-title>Whole genome sequencing of an ExPEC that caused fatal pneumonia at a pig farm in Changchun, China</article-title>. <source>BMC Vet Res</source> <volume>13</volume>, <fpage>1</fpage>&#x2013;<lpage>8</lpage>. doi: <pub-id pub-id-type="doi">10.1186/s12917-017-1093-5</pub-id></citation></ref>
<ref id="ref48"><citation citation-type="journal"><person-group person-group-type="author"><name><surname>Kwon</surname><given-names>Y. K.</given-names></name> <name><surname>Higgins</surname><given-names>M. B.</given-names></name> <name><surname>Rabinowitz</surname><given-names>J. D.</given-names></name></person-group> (<year>2010</year>). <article-title>Antifolate-induced depletion of intracellular glycine and purines inhibits thymineless death in <italic>E. coli</italic></article-title>. <source>ACS Chem. Biol.</source> <volume>5</volume>, <fpage>787</fpage>&#x2013;<lpage>795</lpage>. doi: <pub-id pub-id-type="doi">10.1021/cb100096f</pub-id>, PMID: <pub-id pub-id-type="pmid">20553049</pub-id></citation></ref>
<ref id="ref49"><citation citation-type="journal"><person-group person-group-type="author"><name><surname>Lam</surname><given-names>M. M. C.</given-names></name> <name><surname>Wick</surname><given-names>R. R.</given-names></name> <name><surname>Watts</surname><given-names>S. C.</given-names></name> <name><surname>Cerdeira</surname><given-names>L. T.</given-names></name> <name><surname>Wyres</surname><given-names>K. L.</given-names></name> <name><surname>Holt</surname><given-names>K. E.</given-names></name></person-group> (<year>2021</year>). <article-title>A genomic surveillance framework and genotyping tool for Klebsiella pneumoniae and its related species complex</article-title>. <source>Nat. Commun.</source> <volume>12</volume>:<fpage>4188</fpage>. doi: <pub-id pub-id-type="doi">10.1038/s41467-021-24448-3</pub-id>, PMID: <pub-id pub-id-type="pmid">34234121</pub-id></citation></ref>
<ref id="ref50"><citation citation-type="journal"><person-group person-group-type="author"><name><surname>Langmead</surname><given-names>B.</given-names></name> <name><surname>Salzberg</surname><given-names>S. L.</given-names></name></person-group> (<year>2012</year>). <article-title>Fast gapped-read alignment with bowtie 2</article-title>. <source>Nat. Methods</source> <volume>9</volume>, <fpage>357</fpage>&#x2013;<lpage>359</lpage>. doi: <pub-id pub-id-type="doi">10.1038/nmeth.1923</pub-id>, PMID: <pub-id pub-id-type="pmid">22388286</pub-id></citation></ref>
<ref id="ref51"><citation citation-type="journal"><person-group person-group-type="author"><name><surname>Lau</surname><given-names>W. Y. V.</given-names></name> <name><surname>Taylor</surname><given-names>P. K.</given-names></name> <name><surname>Brinkman</surname><given-names>F. S. L.</given-names></name> <name><surname>Lee</surname><given-names>A. H. Y.</given-names></name></person-group> (<year>2023</year>). <article-title>Pathogen-associated gene discovery workflows for novel antivirulence therapeutic development</article-title>. <source>EBioMedicine</source> <volume>88</volume>:<fpage>104429</fpage>. doi: <pub-id pub-id-type="doi">10.1016/j.ebiom.2022.104429</pub-id>, PMID: <pub-id pub-id-type="pmid">36628845</pub-id></citation></ref>
<ref id="ref52"><citation citation-type="journal"><person-group person-group-type="author"><name><surname>Lechner</surname><given-names>M.</given-names></name> <name><surname>Findei&#x00DF;</surname><given-names>S.</given-names></name> <name><surname>Steiner</surname><given-names>L.</given-names></name> <name><surname>Marz</surname><given-names>M.</given-names></name> <name><surname>Stadler</surname><given-names>P. F.</given-names></name> <name><surname>Prohaska</surname><given-names>S. J.</given-names></name></person-group> (<year>2011</year>). <article-title>Proteinortho: detection of (co-) orthologs in large-scale analysis</article-title>. <source>BMC Bioinformatics</source> <volume>12</volume>:<fpage>124</fpage>. doi: <pub-id pub-id-type="doi">10.1186/1471-2105-12-124</pub-id>, PMID: <pub-id pub-id-type="pmid">21526987</pub-id></citation></ref>
<ref id="ref53"><citation citation-type="journal"><person-group person-group-type="author"><name><surname>Li</surname><given-names>W.</given-names></name> <name><surname>Sun</surname><given-names>G.</given-names></name> <name><surname>Yu</surname><given-names>Y.</given-names></name> <name><surname>Li</surname><given-names>N.</given-names></name> <name><surname>Chen</surname><given-names>M.</given-names></name> <name><surname>Jin</surname><given-names>R.</given-names></name> <etal/></person-group>. (<year>2014</year>). <article-title>Increasing occurrence of antimicrobial- resistant Hypervirulent (Hypermucoviscous) <italic>Klebsiella pneumoniae</italic> isolates in China</article-title>. <source>Clin. Infect. Dis.</source> <volume>58</volume>, <fpage>225</fpage>&#x2013;<lpage>232</lpage>. doi: <pub-id pub-id-type="doi">10.1093/cid/cit675</pub-id>, PMID: <pub-id pub-id-type="pmid">24099919</pub-id></citation></ref>
<ref id="ref54"><citation citation-type="journal"><person-group person-group-type="author"><name><surname>Liao</surname><given-names>Y.</given-names></name> <name><surname>Smyth</surname><given-names>G. K.</given-names></name> <name><surname>Shi</surname><given-names>W.</given-names></name></person-group> (<year>2014</year>). <article-title>FeatureCounts: an efficient general purpose program for assigning sequence reads to genomic features</article-title>. <source>Bioinformatics</source> <volume>30</volume>, <fpage>923</fpage>&#x2013;<lpage>930</lpage>. doi: <pub-id pub-id-type="doi">10.1093/bioinformatics/btt656</pub-id>, PMID: <pub-id pub-id-type="pmid">24227677</pub-id></citation></ref>
<ref id="ref55"><citation citation-type="journal"><person-group person-group-type="author"><name><surname>Lowy</surname><given-names>I.</given-names></name> <name><surname>Molrine</surname><given-names>D. C.</given-names></name> <name><surname>Leav</surname><given-names>B. A.</given-names></name> <name><surname>Blair</surname><given-names>B.</given-names></name> <name><surname>Baxter</surname><given-names>R.</given-names></name> <name><surname>Gerding</surname><given-names>D. N.</given-names></name> <etal/></person-group>. (<year>2010</year>). <article-title>Treatment with monoclonal antibodies against <italic>Clostridium difficile</italic> toxins</article-title>. <source>N. Engl. J. Med.</source> <volume>365</volume>, <fpage>687</fpage>&#x2013;<lpage>696</lpage>. doi: <pub-id pub-id-type="doi">10.1056/NEJMoa0907635</pub-id></citation></ref>
<ref id="ref56"><citation citation-type="journal"><person-group person-group-type="author"><name><surname>Lu</surname><given-names>Y.</given-names></name> <name><surname>Feng</surname><given-names>Y.</given-names></name> <name><surname>McNally</surname><given-names>A.</given-names></name> <name><surname>Zong</surname><given-names>Z.</given-names></name></person-group> (<year>2018</year>). <article-title>Occurrence of colistin-resistant hypervirulent <italic>Klebsiella variicola</italic></article-title>. <source>J. Antimicrob. Chemother.</source> <volume>73</volume>, <fpage>3001</fpage>&#x2013;<lpage>3004</lpage>. doi: <pub-id pub-id-type="doi">10.1093/jac/dky301</pub-id>, PMID: <pub-id pub-id-type="pmid">30060219</pub-id></citation></ref>
<ref id="ref57"><citation citation-type="journal"><person-group person-group-type="author"><name><surname>Magill</surname><given-names>S. S.</given-names></name> <name><surname>Edwards</surname><given-names>J. R.</given-names></name> <name><surname>Bamberg</surname><given-names>W.</given-names></name> <name><surname>Beldavs</surname><given-names>Z. G.</given-names></name> <name><surname>Dumyati</surname><given-names>G.</given-names></name> <name><surname>Kainer</surname><given-names>M. A.</given-names></name> <etal/></person-group>. (<year>2014</year>). <article-title>Multistate point-prevalence survey of health care&#x2013;associated infections</article-title>. <source>N. Engl. J. Med.</source> <volume>370</volume>, <fpage>1198</fpage>&#x2013;<lpage>1208</lpage>. doi: <pub-id pub-id-type="doi">10.1056/NEJMoa1306801</pub-id>, PMID: <pub-id pub-id-type="pmid">24670166</pub-id></citation></ref>
<ref id="ref58"><citation citation-type="journal"><person-group person-group-type="author"><name><surname>Martin</surname><given-names>R. M.</given-names></name> <name><surname>Bachman</surname><given-names>M. A.</given-names></name></person-group> (<year>2018</year>). <article-title>Colonization, infection, and the accessory genome of <italic>Klebsiella pneumoniae</italic></article-title>. <source>Front. Cell. Infect. Microbiol.</source> <volume>8</volume>, <fpage>1</fpage>&#x2013;<lpage>15</lpage>. doi: <pub-id pub-id-type="doi">10.3389/fcimb.2018.00004</pub-id></citation></ref>
<ref id="ref59"><citation citation-type="journal"><person-group person-group-type="author"><name><surname>Mathers</surname><given-names>A. J.</given-names></name> <name><surname>Peirano</surname><given-names>G.</given-names></name> <name><surname>Pitout</surname><given-names>J. D. D.</given-names></name></person-group> (<year>2015</year>). <article-title><italic>Escherichia coli</italic> ST131: the quintessential example of anInternational multiresistant high-risk clone</article-title>. <source>Adv. Appl. Microbiol.</source> <volume>90</volume>, <fpage>109</fpage>&#x2013;<lpage>154</lpage>. doi: <pub-id pub-id-type="doi">10.1016/bs.aambs.2014.09.002</pub-id></citation></ref>
<ref id="ref60"><citation citation-type="journal"><person-group person-group-type="author"><name><surname>Matsuda</surname><given-names>N.</given-names></name> <name><surname>Aung</surname><given-names>M. S.</given-names></name> <name><surname>Urushibara</surname><given-names>N.</given-names></name> <name><surname>Kawaguchiya</surname><given-names>M.</given-names></name> <name><surname>Ohashi</surname><given-names>N.</given-names></name> <name><surname>Taniguchi</surname><given-names>K.</given-names></name> <etal/></person-group>. (<year>2023</year>). <article-title>Prevalence, clonal diversity, and antimicrobial resistance of hypervirulent Klebsiella pneumoniae and <italic>Klebsiella variicola</italic> clinical isolates in northern Japan</article-title>. <source>J. Glob. Antimicrob. Resist.</source> <volume>35</volume>, <fpage>11</fpage>&#x2013;<lpage>18</lpage>. doi: <pub-id pub-id-type="doi">10.1016/j.jgar.2023.08.009</pub-id>, PMID: <pub-id pub-id-type="pmid">37604276</pub-id></citation></ref>
<ref id="ref61"><citation citation-type="journal"><person-group person-group-type="author"><name><surname>Mendes</surname><given-names>G.</given-names></name> <name><surname>Ramalho</surname><given-names>J. F.</given-names></name> <name><surname>Bruschy-fonseca</surname><given-names>A.</given-names></name> <name><surname>Lito</surname><given-names>L.</given-names></name> <name><surname>Duarte</surname><given-names>A.</given-names></name> <name><surname>Melo-cristino</surname><given-names>J.</given-names></name> <etal/></person-group>. (<year>2022</year>). <article-title>Whole-genome sequencing enables molecular characterization of non-clonal group 258 high-risk clones (ST13, ST17, ST147 and ST307) among Carbapenem-resistant <italic>Klebsiella pneumoniae</italic> from a tertiary University Hospital Centre in Portugal</article-title>. <source>Microorganisms</source> <volume>10</volume>:<fpage>416</fpage>. doi: <pub-id pub-id-type="doi">10.3390/microorganisms10020416</pub-id>, PMID: <pub-id pub-id-type="pmid">35208876</pub-id></citation></ref>
<ref id="ref62"><citation citation-type="journal"><person-group person-group-type="author"><name><surname>Meyer</surname><given-names>M.</given-names></name> <name><surname>Dimroth</surname><given-names>P.</given-names></name> <name><surname>Bott</surname><given-names>M.</given-names></name></person-group> (<year>2001</year>). <article-title>Catabolite repression of the citrate fermentation genes in <italic>Klebsiella pneumoniae</italic>: evidence for involvement of the cyclic AMP receptor protein</article-title>. <source>J. Bacteriol.</source> <volume>183</volume>, <fpage>5248</fpage>&#x2013;<lpage>5256</lpage>. doi: <pub-id pub-id-type="doi">10.1128/JB.183.18.5248-5256.2001</pub-id>, PMID: <pub-id pub-id-type="pmid">11514506</pub-id></citation></ref>
<ref id="ref63"><citation citation-type="journal"><person-group person-group-type="author"><name><surname>Moraes</surname><given-names>A. N. S.</given-names></name> <name><surname>Tatara</surname><given-names>J. M.</given-names></name> <name><surname>da Rosa</surname><given-names>R. L.</given-names></name> <name><surname>Siqueira</surname><given-names>F. M.</given-names></name> <name><surname>Domingues</surname><given-names>G.</given-names></name> <name><surname>Berger</surname><given-names>M.</given-names></name> <etal/></person-group>. (<year>2024</year>). <article-title>Metabolic reprogramming of <italic>Klebsiella pneumoniae</italic> exposed to serum and its potential implications in host immune system evasion and resistance</article-title>. <source>J. Proteome Res.</source> <volume>23</volume>, <fpage>4896</fpage>&#x2013;<lpage>4906</lpage>. doi: <pub-id pub-id-type="doi">10.1021/acs.jproteome.4c00286</pub-id>, PMID: <pub-id pub-id-type="pmid">39360742</pub-id></citation></ref>
<ref id="ref64"><citation citation-type="journal"><person-group person-group-type="author"><name><surname>Mu</surname><given-names>A.</given-names></name> <name><surname>Klare</surname><given-names>W. P.</given-names></name> <name><surname>Baines</surname><given-names>S. L.</given-names></name> <name><surname>Ignatius Pang</surname><given-names>C. N.</given-names></name> <name><surname>Gu&#x00E9;rillot</surname><given-names>R.</given-names></name> <name><surname>Harbison-Price</surname><given-names>N.</given-names></name> <etal/></person-group>. (<year>2023</year>). <article-title>Integrative omics identifies conserved and pathogen-specific responses of sepsis-causing bacteria</article-title>. <source>Nat. Commun.</source> <volume>14</volume>:<fpage>1530</fpage>. doi: <pub-id pub-id-type="doi">10.1038/s41467-023-37200-w</pub-id>, PMID: <pub-id pub-id-type="pmid">36934086</pub-id></citation></ref>
<ref id="ref65"><citation citation-type="journal"><person-group person-group-type="author"><name><surname>Murima</surname><given-names>P.</given-names></name> <name><surname>McKinney</surname><given-names>J. D.</given-names></name> <name><surname>Pethe</surname><given-names>K.</given-names></name></person-group> (<year>2014</year>). <article-title>Targeting bacterial central metabolism for drug development</article-title>. <source>Chem. Biol.</source> <volume>21</volume>, <fpage>1423</fpage>&#x2013;<lpage>1432</lpage>. doi: <pub-id pub-id-type="doi">10.1016/j.chembiol.2014.08.020</pub-id>, PMID: <pub-id pub-id-type="pmid">25442374</pub-id></citation></ref>
<ref id="ref66"><citation citation-type="journal"><person-group person-group-type="author"><name><surname>Murray</surname><given-names>C. J.</given-names></name> <name><surname>Ikuta</surname><given-names>K. S.</given-names></name> <name><surname>Sharara</surname><given-names>F.</given-names></name> <name><surname>Swetschinski</surname><given-names>L.</given-names></name> <name><surname>Robles Aguilar</surname><given-names>G.</given-names></name> <name><surname>Gray</surname><given-names>A.</given-names></name> <etal/></person-group>. (<year>2022</year>). <article-title>Global burden of bacterial antimicrobial resistance in 2019: a systematic analysis</article-title>. <source>Lancet</source> <volume>399</volume>, <fpage>629</fpage>&#x2013;<lpage>655</lpage>. doi: <pub-id pub-id-type="doi">10.1016/S0140-6736(21)02724-0</pub-id>, PMID: <pub-id pub-id-type="pmid">35065702</pub-id></citation></ref>
<ref id="ref67"><citation citation-type="journal"><person-group person-group-type="author"><name><surname>Nicolas</surname><given-names>P.</given-names></name> <name><surname>M&#x00E4;der</surname><given-names>U.</given-names></name> <name><surname>Dervyn</surname><given-names>E.</given-names></name> <name><surname>Rochat</surname><given-names>T.</given-names></name> <name><surname>Leduc</surname><given-names>A.</given-names></name> <name><surname>Pigeonneau</surname><given-names>N.</given-names></name> <etal/></person-group>. (<year>2012</year>). <article-title>Condition-dependent transcriptome reveals high-level regulatory architecture in <italic>Bacillus subtilis</italic></article-title>. <source>Science</source> <volume>335</volume>, <fpage>1103</fpage>&#x2013;<lpage>1106</lpage>. doi: <pub-id pub-id-type="doi">10.1126/science.1206848</pub-id></citation></ref>
<ref id="ref68"><citation citation-type="journal"><person-group person-group-type="author"><name><surname>Nordmann</surname><given-names>P.</given-names></name> <name><surname>Cuzon</surname><given-names>G.</given-names></name> <name><surname>Naas</surname><given-names>T.</given-names></name></person-group> (<year>2009</year>). <article-title>The real threat of <italic>Klebsiella pneumoniae</italic> carbapenemase</article-title>. <source>Lancet Infect. Dis.</source> <volume>9</volume>, <fpage>228</fpage>&#x2013;<lpage>236</lpage>. doi: <pub-id pub-id-type="doi">10.1016/S1473-3099(09)70054-4</pub-id></citation></ref>
<ref id="ref69"><citation citation-type="journal"><person-group person-group-type="author"><name><surname>O&#x2019;Brien</surname><given-names>B.</given-names></name> <name><surname>Yushchenko</surname><given-names>A.</given-names></name> <name><surname>Suh</surname><given-names>J.</given-names></name> <name><surname>Jung</surname><given-names>D.</given-names></name> <name><surname>Cai</surname><given-names>Z.</given-names></name> <name><surname>Nguyen</surname><given-names>N. S.</given-names></name> <etal/></person-group>. (<year>2025</year>). <article-title>Subtle genomic differences in <italic>Klebsiella pneumoniae</italic> sensu stricto isolates indicate host adaptation</article-title>. <source>One Heal.</source> <volume>20</volume>:<fpage>100970</fpage>. doi: <pub-id pub-id-type="doi">10.1016/j.onehlt.2025.100970</pub-id></citation></ref>
<ref id="ref70"><citation citation-type="journal"><person-group person-group-type="author"><name><surname>O&#x2019;Donnell</surname><given-names>S. T.</given-names></name> <name><surname>Ross</surname><given-names>R. P.</given-names></name> <name><surname>Stanton</surname><given-names>C.</given-names></name></person-group> (<year>2020</year>). <article-title>The progress of multi-omics technologies: determining function in lactic acid bacteria using a systems level approach</article-title>. <source>Front. Microbiol.</source> <volume>10</volume>, <fpage>1</fpage>&#x2013;<lpage>17</lpage>. doi: <pub-id pub-id-type="doi">10.3389/fmicb.2019.03084</pub-id></citation></ref>
<ref id="ref71"><citation citation-type="journal"><person-group person-group-type="author"><name><surname>Oliveira</surname><given-names>R.</given-names></name> <name><surname>Castro</surname><given-names>J.</given-names></name> <name><surname>Silva</surname><given-names>S.</given-names></name> <name><surname>Oliveira</surname><given-names>H.</given-names></name> <name><surname>Saavedra</surname><given-names>M. J.</given-names></name> <name><surname>Azevedo</surname><given-names>N. F.</given-names></name> <etal/></person-group>. (<year>2022</year>). <article-title>Exploring the antibiotic resistance profile of clinical <italic>Klebsiella pneumoniae</italic> isolates in Portugal</article-title>. <source>Antibiotics</source> <volume>11</volume>, <fpage>1</fpage>&#x2013;<lpage>14</lpage>. doi: <pub-id pub-id-type="doi">10.3390/antibiotics11111613</pub-id>, PMID: <pub-id pub-id-type="pmid">36421258</pub-id></citation></ref>
<ref id="ref72"><citation citation-type="journal"><person-group person-group-type="author"><name><surname>Paczosa</surname><given-names>M. K.</given-names></name> <name><surname>Mecsas</surname><given-names>J.</given-names></name></person-group> (<year>2016</year>). <article-title><italic>Klebsiella pneumoniae</italic>: going on the offense with a strong Defens</article-title>. <source>Microbiol. Mol. Biol. Rev.</source> <volume>80</volume>, <fpage>629</fpage>&#x2013;<lpage>661</lpage>. doi: <pub-id pub-id-type="doi">10.1128/MMBR.00078-15</pub-id>, PMID: <pub-id pub-id-type="pmid">27307579</pub-id></citation></ref>
<ref id="ref73"><citation citation-type="journal"><person-group person-group-type="author"><name><surname>Perez-Riverol</surname><given-names>Y.</given-names></name> <name><surname>Csordas</surname><given-names>A.</given-names></name> <name><surname>Bai</surname><given-names>J.</given-names></name> <name><surname>Bernal-Llinares</surname><given-names>M.</given-names></name> <name><surname>Hewapathirana</surname><given-names>S.</given-names></name> <name><surname>Kundu</surname><given-names>D. J.</given-names></name> <etal/></person-group>. (<year>2019</year>). <article-title>The PRIDE database and related tools and resources in 2019: improving support for quantification data</article-title>. <source>Nucleic Acids Res.</source> <volume>47</volume>, <fpage>D442</fpage>&#x2013;<lpage>D450</lpage>. doi: <pub-id pub-id-type="doi">10.1093/nar/gky1106</pub-id>, PMID: <pub-id pub-id-type="pmid">30395289</pub-id></citation></ref>
<ref id="ref74"><citation citation-type="journal"><person-group person-group-type="author"><name><surname>Podschun</surname><given-names>R.</given-names></name> <name><surname>Ullmann</surname><given-names>U.</given-names></name></person-group> (<year>1998</year>). <article-title><italic>Klebsiella</italic> spp. as nosocomial pathogens: epidemiology, taxonomy, typing methods, and pathogenicity factors</article-title>. <source>Clin. Microbiol. Rev.</source> <volume>11</volume>, <fpage>589</fpage>&#x2013;<lpage>603</lpage>. doi: <pub-id pub-id-type="doi">10.1128/cmr.11.4.589</pub-id>, PMID: <pub-id pub-id-type="pmid">9767057</pub-id></citation></ref>
<ref id="ref75"><citation citation-type="journal"><person-group person-group-type="author"><name><surname>Poehlein</surname><given-names>A.</given-names></name> <name><surname>Najdenski</surname><given-names>H.</given-names></name> <name><surname>Simeonova</surname><given-names>D. D.</given-names></name></person-group> (<year>2017</year>). <article-title>Draft genome sequence of <italic>Klebsiella pneumoniae</italic> subsp. <italic>pneumoniae</italic> ATCC 9621</article-title>. <source>Genome Announc.</source> <volume>5</volume>, <fpage>1</fpage>&#x2013;<lpage>3</lpage>. doi: <pub-id pub-id-type="doi">10.1128/genomeA.01718-16</pub-id></citation></ref>
<ref id="ref76"><citation citation-type="journal"><person-group person-group-type="author"><name><surname>Prjibelski</surname><given-names>A.</given-names></name> <name><surname>Antipov</surname><given-names>D.</given-names></name> <name><surname>Meleshko</surname><given-names>D.</given-names></name> <name><surname>Lapidus</surname><given-names>A.</given-names></name> <name><surname>Korobeynikov</surname><given-names>A.</given-names></name></person-group> (<year>2020</year>). <article-title>Using SPAdes de novo assembler</article-title>. <source>Curr. Protoc. Bioinform.</source> <volume>70</volume>:<fpage>102</fpage>. doi: <pub-id pub-id-type="doi">10.1002/cpbi.102</pub-id>, PMID: <pub-id pub-id-type="pmid">32559359</pub-id></citation></ref>
<ref id="ref77"><citation citation-type="journal"><person-group person-group-type="author"><name><surname>Ramos</surname><given-names>P. I. P.</given-names></name> <name><surname>Fern&#x00E1;ndez Do Porto</surname><given-names>D.</given-names></name> <name><surname>Lanzarotti</surname><given-names>E.</given-names></name> <name><surname>Sosa</surname><given-names>E. J.</given-names></name> <name><surname>Burguener</surname><given-names>G.</given-names></name> <name><surname>Pardo</surname><given-names>A. M.</given-names></name> <etal/></person-group>. (<year>2018</year>). <article-title>An integrative, multi-omics approach towards the prioritization of <italic>Klebsiella pneumoniae</italic> drug targets</article-title>. <source>Sci. Rep.</source> <volume>8</volume>, <fpage>1</fpage>&#x2013;<lpage>19</lpage>. doi: <pub-id pub-id-type="doi">10.1038/s41598-018-28916-7</pub-id></citation></ref>
<ref id="ref78"><citation citation-type="journal"><person-group person-group-type="author"><name><surname>Reder</surname><given-names>A.</given-names></name> <name><surname>Hentschker</surname><given-names>C.</given-names></name> <name><surname>Steil</surname><given-names>L.</given-names></name> <name><surname>Gesell Salazar</surname><given-names>M.</given-names></name> <name><surname>Hammer</surname><given-names>E.</given-names></name> <name><surname>Dhople</surname><given-names>V. M.</given-names></name> <etal/></person-group>. (<year>2023</year>). <article-title>Massspecpreppy &#x2014; an end-to-end solution for automated protein concentration determination and flexible sample digestion for proteomics applications</article-title>. <source>Proteomics</source> <volume>24</volume>, <fpage>1</fpage>&#x2013;<lpage>13</lpage>. doi: <pub-id pub-id-type="doi">10.1002/pmic.202300294</pub-id>, PMID: <pub-id pub-id-type="pmid">37772677</pub-id></citation></ref>
<ref id="ref79"><citation citation-type="journal"><person-group person-group-type="author"><name><surname>Reinelt</surname><given-names>S.</given-names></name> <name><surname>Hofmann</surname><given-names>E.</given-names></name> <name><surname>Gerharz</surname><given-names>T.</given-names></name> <name><surname>Bott</surname><given-names>M.</given-names></name> <name><surname>Madden</surname><given-names>D. R.</given-names></name></person-group> (<year>2003</year>). <article-title>The structure of the periplasmic ligand-binding domain of the sensor kinase CitA reveals the first extracellular pas domain</article-title>. <source>J. Biol. Chem.</source> <volume>278</volume>, <fpage>39189</fpage>&#x2013;<lpage>39196</lpage>. doi: <pub-id pub-id-type="doi">10.1074/jbc.M305864200</pub-id>, PMID: <pub-id pub-id-type="pmid">12867417</pub-id></citation></ref>
<ref id="ref80"><citation citation-type="journal"><person-group person-group-type="author"><name><surname>Rodr&#x00ED;guez-Medina</surname><given-names>N.</given-names></name> <name><surname>Rodr&#x00ED;guez-Santiago</surname><given-names>J.</given-names></name> <name><surname>Alvarado-Delgado</surname><given-names>A.</given-names></name> <name><surname>Sagal-Prado</surname><given-names>A.</given-names></name> <name><surname>Silva-S&#x00E1;nchez</surname><given-names>J.</given-names></name> <name><surname>De la Cruz</surname><given-names>M. A.</given-names></name> <etal/></person-group>. (<year>2024</year>). <article-title>Comprehensive study reveals phenotypic heterogeneity in <italic>Klebsiella pneumoniae</italic> species complex isolates</article-title>. <source>Sci. Rep.</source> <volume>14</volume>, <fpage>5876</fpage>&#x2013;<lpage>5812</lpage>. doi: <pub-id pub-id-type="doi">10.1038/s41598-024-55546-z</pub-id>, PMID: <pub-id pub-id-type="pmid">38467675</pub-id></citation></ref>
<ref id="ref81"><citation citation-type="journal"><person-group person-group-type="author"><name><surname>Rosenblueth</surname><given-names>M.</given-names></name> <name><surname>Mart&#x00ED;nez</surname><given-names>L.</given-names></name> <name><surname>Silva</surname><given-names>J.</given-names></name> <name><surname>Mart&#x00ED;nez-Romero</surname><given-names>E.</given-names></name></person-group> (<year>2004</year>). <article-title><italic>Klebsiella variicola</italic>, a novel species with clinical and plant-associated isolates</article-title>. <source>Syst. Appl. Microbiol.</source> <volume>27</volume>, <fpage>27</fpage>&#x2013;<lpage>35</lpage>. doi: <pub-id pub-id-type="doi">10.1078/0723-2020-00261</pub-id>, PMID: <pub-id pub-id-type="pmid">15053318</pub-id></citation></ref>
<ref id="ref82"><citation citation-type="journal"><person-group person-group-type="author"><name><surname>Rouli</surname><given-names>L.</given-names></name> <name><surname>Merhej</surname><given-names>V.</given-names></name> <name><surname>Fournier</surname><given-names>P. E.</given-names></name> <name><surname>Raoult</surname><given-names>D.</given-names></name></person-group> (<year>2015</year>). <article-title>The bacterial pangenome as a new tool for analysing pathogenic bacteria</article-title>. <source>New Microbes New Infect.</source> <volume>7</volume>, <fpage>72</fpage>&#x2013;<lpage>85</lpage>. doi: <pub-id pub-id-type="doi">10.1016/j.nmni.2015.06.005</pub-id>, PMID: <pub-id pub-id-type="pmid">26442149</pub-id></citation></ref>
<ref id="ref83"><citation citation-type="journal"><person-group person-group-type="author"><name><surname>Rouquet</surname><given-names>G.</given-names></name> <name><surname>Porcheron</surname><given-names>G.</given-names></name> <name><surname>Barra</surname><given-names>C.</given-names></name> <name><surname>R&#x00E9;p&#x00E9;rant</surname><given-names>M.</given-names></name> <name><surname>Chanteloup</surname><given-names>N. K.</given-names></name> <name><surname>Schouler</surname><given-names>C.</given-names></name> <etal/></person-group>. (<year>2009</year>). <article-title>A metabolic operon in extraintestinal pathogenic <italic>Escherichia coli</italic> promotes fitness under stressful conditions and invasion of eukaryotic cells</article-title>. <source>J. Bacteriol.</source> <volume>191</volume>, <fpage>4427</fpage>&#x2013;<lpage>4440</lpage>. doi: <pub-id pub-id-type="doi">10.1128/JB.00103-09</pub-id>, PMID: <pub-id pub-id-type="pmid">19376853</pub-id></citation></ref>
<ref id="ref84"><citation citation-type="journal"><person-group person-group-type="author"><name><surname>Rozanova</surname><given-names>S.</given-names></name> <name><surname>Barkovits</surname><given-names>K.</given-names></name> <name><surname>Nikolov</surname><given-names>M.</given-names></name> <name><surname>Schmidt</surname><given-names>C.</given-names></name> <name><surname>Urlaub</surname><given-names>H.</given-names></name> <name><surname>Marcus</surname><given-names>K.</given-names></name></person-group> (<year>2021</year>). <article-title>Quantitative mass spectrometry-based proteomics: an overview</article-title>. <source>Methods Mol. Biol.</source> <volume>2228</volume>, <fpage>85</fpage>&#x2013;<lpage>116</lpage>. doi: <pub-id pub-id-type="doi">10.1007/978-1-0716-1024-4_8</pub-id>, PMID: <pub-id pub-id-type="pmid">33950486</pub-id></citation></ref>
<ref id="ref85"><citation citation-type="journal"><person-group person-group-type="author"><name><surname>Russo</surname><given-names>T. A.</given-names></name> <name><surname>Olson</surname><given-names>R.</given-names></name> <name><surname>Fang</surname><given-names>C.-T.</given-names></name> <name><surname>Stoesser</surname><given-names>N.</given-names></name> <name><surname>Miller</surname><given-names>M.</given-names></name> <name><surname>MacDonald</surname><given-names>U.</given-names></name> <etal/></person-group>. (<year>2018</year>). <article-title>Identification of biomarkers for differentiation of Hypervirulent <italic>Klebsiella pneumoniae</italic> from Classical <italic>K. pneumoniae</italic></article-title>. <source>J. Clin. Microbiol.</source> <volume>56</volume>, <fpage>e00776</fpage>&#x2013;<lpage>e00718</lpage>. doi: <pub-id pub-id-type="doi">10.1128/jcm.00776-18</pub-id>, PMID: <pub-id pub-id-type="pmid">29925642</pub-id></citation></ref>
<ref id="ref86"><citation citation-type="journal"><person-group person-group-type="author"><name><surname>Sarigul</surname><given-names>N.</given-names></name> <name><surname>Korkmaz</surname><given-names>F.</given-names></name> <name><surname>Kurultak</surname><given-names>&#x0130;.</given-names></name></person-group> (<year>2019</year>). <article-title>A new artificial urine protocol to better imitate human urine</article-title>. <source>Sci. Rep.</source> <volume>9</volume>, <fpage>20159</fpage>&#x2013;<lpage>20111</lpage>. doi: <pub-id pub-id-type="doi">10.1038/s41598-019-56693-4</pub-id>, PMID: <pub-id pub-id-type="pmid">31882896</pub-id></citation></ref>
<ref id="ref87"><citation citation-type="journal"><person-group person-group-type="author"><name><surname>Sayers</surname><given-names>E. W.</given-names></name> <name><surname>Bolton</surname><given-names>E. E.</given-names></name> <name><surname>Brister</surname><given-names>J. R.</given-names></name> <name><surname>Canese</surname><given-names>K.</given-names></name> <name><surname>Chan</surname><given-names>J.</given-names></name> <name><surname>Comeau</surname><given-names>D. C.</given-names></name> <etal/></person-group>. (<year>2022</year>). <article-title>Database resources of the national center for biotechnology information</article-title>. <source>Nucleic Acids Res.</source> <volume>50</volume>, <fpage>D20</fpage>&#x2013;<lpage>D26</lpage>. doi: <pub-id pub-id-type="doi">10.1093/nar/gkab1112</pub-id>, PMID: <pub-id pub-id-type="pmid">34850941</pub-id></citation></ref>
<ref id="ref88"><citation citation-type="journal"><person-group person-group-type="author"><name><surname>Schaefler</surname><given-names>S.</given-names></name> <name><surname>Malamy</surname><given-names>A.</given-names></name></person-group> (<year>1969</year>). <article-title>Taxonomic investigations on expressed and cryptic phospho-beta-glucosidases in Enterobacteriaceae</article-title>. <source>J. Bacteriol.</source> <volume>99</volume>, <fpage>422</fpage>&#x2013;<lpage>433</lpage>. doi: <pub-id pub-id-type="doi">10.1128/jb.99.2.422-433.1969</pub-id>, PMID: <pub-id pub-id-type="pmid">4897109</pub-id></citation></ref>
<ref id="ref89"><citation citation-type="journal"><person-group person-group-type="author"><name><surname>Schaufler</surname><given-names>K.</given-names></name> <name><surname>Echelmeyer</surname><given-names>T.</given-names></name> <name><surname>Schwabe</surname><given-names>M.</given-names></name> <name><surname>Guenther</surname><given-names>S.</given-names></name> <name><surname>Bohnert</surname><given-names>J. A.</given-names></name> <name><surname>Becker</surname><given-names>K.</given-names></name> <etal/></person-group>. (<year>2023</year>). <article-title>Convergent <italic>Klebsiella pneumoniae</italic> strains belonging to a sequence type 307 outbreak clone combine cefiderocol and carbapenem resistance with hypervirulence</article-title>. <source>Emerg. Microbes Infect.</source> <volume>12</volume>:<fpage>1096</fpage>. doi: <pub-id pub-id-type="doi">10.1080/22221751.2023.2271096</pub-id>, PMID: <pub-id pub-id-type="pmid">37842870</pub-id></citation></ref>
<ref id="ref90"><citation citation-type="journal"><person-group person-group-type="author"><name><surname>Schneider</surname><given-names>G.</given-names></name> <name><surname>Dobrindt</surname><given-names>U.</given-names></name> <name><surname>Br&#x00FC;ggemann</surname><given-names>H.</given-names></name> <name><surname>Nagy</surname><given-names>G.</given-names></name> <name><surname>Janke</surname><given-names>B.</given-names></name> <name><surname>Blum-Oehler</surname><given-names>G.</given-names></name> <etal/></person-group>. (<year>2004</year>). <article-title>The pathogenicity island-associated K15 capsule determinant exhibits a novel genetic structure and correlates with virulence in uropathogenic <italic>Escherichia coli</italic> strain 536</article-title>. <source>Infect. Immun.</source> <volume>72</volume>, <fpage>5993</fpage>&#x2013;<lpage>6001</lpage>. doi: <pub-id pub-id-type="doi">10.1128/IAI.72.10.5993-6001.2004</pub-id>, PMID: <pub-id pub-id-type="pmid">15385503</pub-id></citation></ref>
<ref id="ref91"><citation citation-type="journal"><person-group person-group-type="author"><name><surname>Seemann</surname><given-names>T.</given-names></name></person-group> (<year>2014</year>). <article-title>Prokka: rapid prokaryotic genome annotation</article-title>. <source>Bioinformatics</source> <volume>30</volume>, <fpage>2068</fpage>&#x2013;<lpage>2069</lpage>. doi: <pub-id pub-id-type="doi">10.1093/bioinformatics/btu153</pub-id>, PMID: <pub-id pub-id-type="pmid">24642063</pub-id></citation></ref>
<ref id="ref92"><citation citation-type="journal"><person-group person-group-type="author"><name><surname>Shon</surname><given-names>A. S.</given-names></name> <name><surname>Bajwa</surname><given-names>R. P. S.</given-names></name> <name><surname>Russo</surname><given-names>T. A.</given-names></name></person-group> (<year>2013</year>). <article-title>Hypervirulent (hypermucoviscous) <italic>Klebsiella pneumoniae</italic></article-title>. <source>Virulence</source> <volume>4</volume>, <fpage>107</fpage>&#x2013;<lpage>118</lpage>. doi: <pub-id pub-id-type="doi">10.4161/viru.22718</pub-id>, PMID: <pub-id pub-id-type="pmid">23302790</pub-id></citation></ref>
<ref id="ref93"><citation citation-type="journal"><person-group person-group-type="author"><name><surname>Snel</surname><given-names>B.</given-names></name> <name><surname>Lehmann</surname><given-names>G.</given-names></name> <name><surname>Bork</surname><given-names>P.</given-names></name> <name><surname>Huynen</surname><given-names>M. A.</given-names></name></person-group> (<year>2000</year>). <article-title>String: a web-server to retrieve and display the repeatedly occurring neighbourhood of a gene</article-title>. <source>Nucleic Acids Res.</source> <volume>28</volume>, <fpage>3442</fpage>&#x2013;<lpage>3444</lpage>. doi: <pub-id pub-id-type="doi">10.1093/nar/28.18.3442</pub-id>, PMID: <pub-id pub-id-type="pmid">10982861</pub-id></citation></ref>
<ref id="ref94"><citation citation-type="journal"><person-group person-group-type="author"><name><surname>Suomi</surname><given-names>T.</given-names></name> <name><surname>Elo</surname><given-names>L. L.</given-names></name></person-group> (<year>2017</year>). <article-title>Enhanced differential expression statistics for data-independent acquisition proteomics</article-title>. <source>Sci. Rep.</source> <volume>7</volume>, <fpage>5869</fpage>&#x2013;<lpage>5868</lpage>. doi: <pub-id pub-id-type="doi">10.1038/s41598-017-05949-y</pub-id>, PMID: <pub-id pub-id-type="pmid">28724900</pub-id></citation></ref>
<ref id="ref95"><citation citation-type="journal"><person-group person-group-type="author"><name><surname>Szklarczyk</surname><given-names>D.</given-names></name> <name><surname>Gable</surname><given-names>A. L.</given-names></name> <name><surname>Nastou</surname><given-names>K. C.</given-names></name> <name><surname>Lyon</surname><given-names>D.</given-names></name> <name><surname>Kirsch</surname><given-names>R.</given-names></name> <name><surname>Pyysalo</surname><given-names>S.</given-names></name> <etal/></person-group>. (<year>2021</year>). <article-title>Erratum: the STRING database in 2021: customizable protein&#x2013;protein networks, and functional characterization of user-uploaded gene/measurement sets (nucleic acids research)</article-title>. <source>Nucleic Acids Res.</source> <volume>49</volume>:<fpage>10800</fpage>. doi: <pub-id pub-id-type="doi">10.1093/nar/gkab835</pub-id></citation></ref>
<ref id="ref96"><citation citation-type="journal"><person-group person-group-type="author"><name><surname>Tacconelli</surname><given-names>E.</given-names></name> <name><surname>Carrara</surname><given-names>E.</given-names></name> <name><surname>Savoldi</surname><given-names>A.</given-names></name> <name><surname>Harbarth</surname><given-names>S.</given-names></name> <name><surname>Mendelson</surname><given-names>M.</given-names></name> <name><surname>Monnet</surname><given-names>D. L.</given-names></name> <etal/></person-group>. (<year>2018</year>). <article-title>Discovery, research, and development of new antibiotics: the WHO priority list of antibiotic-resistant bacteria and tuberculosis</article-title>. <source>Lancet Infect. Dis.</source> <volume>18</volume>, <fpage>318</fpage>&#x2013;<lpage>327</lpage>. doi: <pub-id pub-id-type="doi">10.1016/S1473-3099(17)30753-3</pub-id>, PMID: <pub-id pub-id-type="pmid">29276051</pub-id></citation></ref>
<ref id="ref97"><citation citation-type="journal"><person-group person-group-type="author"><name><surname>Tettelin</surname><given-names>H.</given-names></name> <name><surname>Riley</surname><given-names>D.</given-names></name> <name><surname>Cattuto</surname><given-names>C.</given-names></name> <name><surname>Medini</surname><given-names>D.</given-names></name></person-group> (<year>2008</year>). <article-title>Comparative genomics: the bacterial pan-genome</article-title>. <source>Curr. Opin. Microbiol.</source> <volume>11</volume>, <fpage>472</fpage>&#x2013;<lpage>477</lpage>. doi: <pub-id pub-id-type="doi">10.1016/j.mib.2008.09.006</pub-id>, PMID: <pub-id pub-id-type="pmid">19086349</pub-id></citation></ref>
<ref id="ref98"><citation citation-type="journal"><person-group person-group-type="author"><name><surname>Thorpe</surname><given-names>H. A.</given-names></name> <name><surname>Booton</surname><given-names>R.</given-names></name> <name><surname>Kallonen</surname><given-names>T.</given-names></name> <name><surname>Gibbon</surname><given-names>M. J.</given-names></name> <name><surname>Couto</surname><given-names>N.</given-names></name> <name><surname>Passet</surname><given-names>V.</given-names></name> <etal/></person-group>. (<year>2022</year>). <article-title>A large-scale genomic snapshot of Klebsiella spp. isolates in northern Italy reveals limited transmission between clinical and non-clinical settings</article-title>. <source>Nat. Microbiol.</source> <volume>7</volume>, <fpage>2054</fpage>&#x2013;<lpage>2067</lpage>. doi: <pub-id pub-id-type="doi">10.1038/s41564-022-01263-0</pub-id>, PMID: <pub-id pub-id-type="pmid">36411354</pub-id></citation></ref>
<ref id="ref99"><citation citation-type="journal"><person-group person-group-type="author"><name><surname>Vaser</surname><given-names>R.</given-names></name> <name><surname>&#x0160;iki&#x0107;</surname><given-names>M.</given-names></name></person-group> (<year>2021</year>). <article-title>Time- and memory-efficient genome assembly with Raven</article-title>. <source>Nat. Comput. Sci.</source> 1, 332&#x2013;336. doi: <pub-id pub-id-type="doi">10.1038/s43588-021-00073-4</pub-id></citation></ref>
<ref id="ref100"><citation citation-type="journal"><person-group person-group-type="author"><name><surname>Vornhagen</surname><given-names>J.</given-names></name> <name><surname>Sun</surname><given-names>Y.</given-names></name> <name><surname>Breen</surname><given-names>P.</given-names></name> <name><surname>Forsyth</surname><given-names>V.</given-names></name> <name><surname>Zhao</surname><given-names>L.</given-names></name> <name><surname>Mobley</surname><given-names>H. L. T.</given-names></name> <etal/></person-group>. (<year>2019</year>). <article-title>The <italic>Klebsiella pneumoniae</italic> citrate synthase gene, gltA, influences site specific fitness during infection</article-title>. <source>PLoS Pathog.</source> <volume>15</volume>, <fpage>e1008010</fpage>&#x2013;<lpage>e1008025</lpage>. doi: <pub-id pub-id-type="doi">10.1371/journal.ppat.1008010</pub-id>, PMID: <pub-id pub-id-type="pmid">31449551</pub-id></citation></ref>
<ref id="ref101"><citation citation-type="journal"><person-group person-group-type="author"><name><surname>Wick</surname><given-names>R. R.</given-names></name> <name><surname>Holt</surname><given-names>K. E.</given-names></name></person-group> (<year>2022</year>). <article-title>PLOS COMPUTATIONAL BIOLOGY Polypolish: short-read polishing of long-read bacterial genome assemblies</article-title>. <source>PLoS Comput. Biol.</source> <volume>18</volume>, <fpage>e1009802</fpage>&#x2013;<lpage>e1009813</lpage>. doi: <pub-id pub-id-type="doi">10.1371/journal.pcbi.1009802</pub-id>, PMID: <pub-id pub-id-type="pmid">35073327</pub-id></citation></ref>
<ref id="ref102"><citation citation-type="journal"><person-group person-group-type="author"><name><surname>Wick</surname><given-names>R. R.</given-names></name> <name><surname>Holt</surname><given-names>K. E.</given-names></name></person-group> (<year>2023</year>). <article-title>Benchmarking of long-read assemblers for prokaryote whole genome sequencing [version 4; peer review: 4 approved]</article-title>. <source>F1000Res</source> <volume>8</volume>, <fpage>1</fpage>&#x2013;<lpage>23</lpage>. doi: <pub-id pub-id-type="doi">10.12688/f100research.217824</pub-id></citation></ref>
<ref id="ref103"><citation citation-type="journal"><person-group person-group-type="author"><name><surname>Wick</surname><given-names>R. R.</given-names></name> <name><surname>Judd</surname><given-names>L. M.</given-names></name> <name><surname>Cerdeira</surname><given-names>L. T.</given-names></name> <name><surname>Hawkey</surname><given-names>J.</given-names></name> <name><surname>M&#x00E9;ric</surname><given-names>G.</given-names></name> <name><surname>Vezina</surname><given-names>B.</given-names></name> <etal/></person-group>. (<year>2021</year>). <article-title>Trycycler: consensus long-read assemblies for bacterial genomes</article-title>. <source>Genome Biol.</source> <volume>22</volume>, <fpage>266</fpage>&#x2013;<lpage>217</lpage>. doi: <pub-id pub-id-type="doi">10.1186/s13059-021-02483-z</pub-id>, PMID: <pub-id pub-id-type="pmid">34521459</pub-id></citation></ref>
<ref id="ref104"><citation citation-type="journal"><person-group person-group-type="author"><name><surname>Wick</surname><given-names>R. R.</given-names></name> <name><surname>Judd</surname><given-names>L. M.</given-names></name> <name><surname>Gorrie</surname><given-names>C. L.</given-names></name> <name><surname>Holt</surname><given-names>K. E.</given-names></name></person-group> (<year>2017</year>). <article-title>Unicycler: resolving bacterial genome assemblies from short and long sequencing reads</article-title>. <source>PLoS Comput. Biol.</source> <volume>13</volume>, <fpage>e1005595</fpage>&#x2013;<lpage>e1005522</lpage>. doi: <pub-id pub-id-type="doi">10.1371/journal.pcbi.1005595</pub-id>, PMID: <pub-id pub-id-type="pmid">28594827</pub-id></citation></ref>
<ref id="ref105"><citation citation-type="book"><person-group person-group-type="author"><collab id="coll3">World Health Organization</collab></person-group> (<year>2024</year>). <source>WHO bacterial priority pathogens list, 2024: bacterial pathogens of public health importance to guide research, development and strategies to prevent and control antimicrobial resistance</source>. <publisher-loc>Geneva</publisher-loc>: <publisher-name>World Health Organization</publisher-name>.</citation></ref>
<ref id="ref106"><citation citation-type="journal"><person-group person-group-type="author"><name><surname>Wu</surname><given-names>M. C.</given-names></name> <name><surname>Chen</surname><given-names>Y. C.</given-names></name> <name><surname>Lin</surname><given-names>T. L.</given-names></name> <name><surname>Hsieh</surname><given-names>P. F.</given-names></name> <name><surname>Wang</surname><given-names>J. T.</given-names></name></person-group> (<year>2012</year>). <article-title>Cellobiose-specific phosphotransferase system of Klebsiella pneumoniae and its importance in biofilm formation and virulence</article-title>. <source>Infect. Immun.</source> <volume>80</volume>, <fpage>2464</fpage>&#x2013;<lpage>2472</lpage>. doi: <pub-id pub-id-type="doi">10.1128/IAI.06247-11</pub-id>, PMID: <pub-id pub-id-type="pmid">22566508</pub-id></citation></ref>
<ref id="ref107"><citation citation-type="journal"><person-group person-group-type="author"><name><surname>Wyres</surname><given-names>K. L.</given-names></name> <name><surname>Holt</surname><given-names>K. E.</given-names></name></person-group> (<year>2018</year>). <article-title><italic>Klebsiella pneumoniae</italic> as a key trafficker of drug resistance genes from environmental to clinically important bacteria</article-title>. <source>Curr. Opin. Microbiol.</source> <volume>45</volume>, <fpage>131</fpage>&#x2013;<lpage>139</lpage>. doi: <pub-id pub-id-type="doi">10.1016/j.mib.2018.04.004</pub-id>, PMID: <pub-id pub-id-type="pmid">29723841</pub-id></citation></ref>
<ref id="ref108"><citation citation-type="journal"><person-group person-group-type="author"><name><surname>Wyres</surname><given-names>K. L.</given-names></name> <name><surname>Lam</surname><given-names>M. M. C.</given-names></name> <name><surname>Holt</surname><given-names>K. E.</given-names></name></person-group> (<year>2020a</year>). <article-title>Population genomics of <italic>Klebsiella pneumoniae</italic></article-title>. <source>Nat. Rev. Microbiol.</source> <volume>18</volume>, <fpage>344</fpage>&#x2013;<lpage>359</lpage>. doi: <pub-id pub-id-type="doi">10.1038/s41579-019-0315-1</pub-id>, PMID: <pub-id pub-id-type="pmid">32055025</pub-id></citation></ref>
<ref id="ref109"><citation citation-type="journal"><person-group person-group-type="author"><name><surname>Wyres</surname><given-names>K. L.</given-names></name> <name><surname>Nguyen</surname><given-names>T. N. T.</given-names></name> <name><surname>Lam</surname><given-names>M. M. C.</given-names></name> <name><surname>Judd</surname><given-names>L. M.</given-names></name> <name><surname>Van Vinh Chau</surname><given-names>N.</given-names></name> <name><surname>Dance</surname><given-names>D. A. B.</given-names></name> <etal/></person-group>. (<year>2020b</year>). <article-title>Genomic surveillance for hypervirulence and multi-drug resistance in invasive <italic>Klebsiella pneumoniae</italic> from south and Southeast Asia</article-title>. <source>Genome Med.</source> <volume>12</volume>, <fpage>11</fpage>&#x2013;<lpage>16</lpage>. doi: <pub-id pub-id-type="doi">10.1186/s13073-019-0706-y</pub-id>, PMID: <pub-id pub-id-type="pmid">31948471</pub-id></citation></ref>
<ref id="ref110"><citation citation-type="journal"><person-group person-group-type="author"><name><surname>Wyres</surname><given-names>K. L.</given-names></name> <name><surname>Wick</surname><given-names>R. R.</given-names></name> <name><surname>Judd</surname><given-names>L. M.</given-names></name> <name><surname>Froumine</surname><given-names>R.</given-names></name> <name><surname>Tokolyi</surname><given-names>A.</given-names></name> <name><surname>Gorrie</surname><given-names>C. L.</given-names></name> <etal/></person-group>. (<year>2019</year>). <article-title>Distinct evolutionary dynamics of horizontal gene transfer in drug resistant and virulent clones of <italic>Klebsiella pneumoniae</italic></article-title>. <source>PLoS Genet.</source> <volume>15</volume>, <fpage>e1008114</fpage>&#x2013;<lpage>e1008125</lpage>. doi: <pub-id pub-id-type="doi">10.1371/journal.pgen.1008114</pub-id>, PMID: <pub-id pub-id-type="pmid">30986243</pub-id></citation></ref>
</ref-list>
<glossary>
<def-list>
<title>Glossary</title>
<def-item>
<term>ACN</term>
<def>
<p>Acetonitrile</p>
</def>
</def-item>
<def-item>
<term>AMR</term>
<def>
<p>Antimicrobial resistance</p>
</def>
</def-item>
<def-item>
<term>BR</term>
<def>
<p>Biological replicates</p>
</def>
</def-item>
<def-item>
<term>cKp</term>
<def>
<p>Classical <italic>K. pneumoniae</italic></p>
</def>
</def-item>
<def-item>
<term>COG</term>
<def>
<p>Cluster of orthologous groups</p>
</def>
</def-item>
<def-item>
<term>log<sub>10</sub></term>
<def>
<p>Decimal logarithm</p>
</def>
</def-item>
<def-item>
<term>ESBL</term>
<def>
<p>Extended-spectrum <italic>&#x03B2;</italic>-lactamases</p>
</def>
</def-item>
<def-item>
<term>GM</term>
<def>
<p>Genomic markers from pangenome</p>
</def>
</def-item>
<def-item>
<term>GM-L</term>
<def>
<p>Genomic markers from homologous clustering</p>
</def>
</def-item>
<def-item>
<term>hvKp</term>
<def>
<p>Hypervirulent <italic>K. pneumoniae</italic></p>
</def>
</def-item>
<def-item>
<term>iBAQ</term>
<def>
<p>Intensity-based absolute quantification</p>
</def>
</def-item>
<def-item>
<term>K</term>
<def>
<p>
<italic>Klebsiella</italic>
</p>
</def>
</def-item>
<def-item>
<term>KP</term>
<def>
<p>
<italic>Klebsiella pneumoniae</italic>
</p>
</def>
</def-item>
<def-item>
<term>KpSC</term>
<def>
<p><italic>Klebsiella pneumoniae</italic> species complex</p>
</def>
</def-item>
<def-item>
<term>KQ</term>
<def>
<p>
<italic>Klebsiella quasipneumoniae</italic>
</p>
</def>
</def-item>
<def-item>
<term>KV</term>
<def>
<p>
<italic>Klebsiella variicola</italic>
</p>
</def>
</def-item>
<def-item>
<term>KEGG</term>
<def>
<p>Kyoto Encyclopedia of Genes and Genomes</p>
</def>
</def-item>
<def-item>
<term>L2FC</term>
<def>
<p>log2 fold change</p>
</def>
</def-item>
<def-item>
<term>MDR</term>
<def>
<p>Multidrug-resistant</p>
</def>
</def-item>
<def-item>
<term>MLST</term>
<def>
<p>Multi-locus sequence typing</p>
</def>
</def-item>
<def-item>
<term>NRC</term>
<def>
<p>Normalized read counts</p>
</def>
</def-item>
<def-item>
<term>OD<sub>600</sub></term>
<def>
<p>Optical density of 0.05 at <italic>&#x03BB;</italic>&#x202F;=&#x202F;600&#x202F;nm</p>
</def>
</def-item>
<def-item>
<term>PM</term>
<def>
<p>Proteomic markers</p>
</def>
</def-item>
<def-item>
<term>PTS</term>
<def>
<p>Phosphotransferase system</p>
</def>
</def-item>
<def-item>
<term>SDS</term>
<def>
<p>Sodium dodecyl sulfate</p>
</def>
</def-item>
<def-item>
<term>ST</term>
<def>
<p>Sequence type</p>
</def>
</def-item>
<def-item>
<term>SP3</term>
<def>
<p>Single pot solid-phase enhanced sample preparation</p>
</def>
</def-item>
<def-item>
<term>SHU</term>
<def>
<p>Synthetic human urine</p>
</def>
</def-item>
<def-item>
<term>TM</term>
<def>
<p>Transcriptomic markers</p>
</def>
</def-item>
<def-item>
<term>UTI</term>
<def>
<p>Urinary tract infection</p>
</def>
</def-item>
</def-list>
</glossary>
</back>
</article>