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Volume 31, Number 10—October 2025

Dispatch

Fatal Pneumocephalus Caused by Hypervirulent Klebsiella pneumoniae, Germany

Nico Gläser1, Nina Schwab1, Yvonne Pfeifer, Anika Wahl, Martin A. Fischer, Anja Osterloh, Thomas F.E. Barth, Armin Imhof, Jochen Breitruck, Andreas Essig, and Jürgen Benjamin HagemannComments to Author 
Author affiliation: Ulm University Hospital, Ulm, Germany (N. Gläser, N. Schwab, A. Osterloh, T.F.E. Barth, A. Imhof, J. Breitruck, A. Essig, J.B. Hagemann); Robert Koch Institute, Wernigerode, Germany (Y. Pfeifer, A. Wahl, M.A. Fischer).

Main Article

Figure 2

Minimum spanning tree generated to evaluate the genetic relationship of 29 Klebsiella pneumoniae-ST23 isolates (capsule types K1 and K57) during study of a fatal pneumocephalus case caused by hypervirulent K. pneumoniae in Germany (Appendix Table). Ridom SeqSphere version 10.0.4 (ridom, https://www.ridom.de) was used to create tree for 29 samples isolated from hospitals in Germany on the basis of 2,358 columns, pairwise ignoring missing values, and logarithmic scale. Distance is on the basis of columns from K. pneumoniae sensu lato core genome multilocus sequence type (2,358 genes). Cluster distance threshold is 15 according to the Ridom Seqsphere. The patient isolates from this case (0354/24 and 0355/24) are labeled as cluster 2. Isolate 0074/24 is another K. pneumoniae ST23-K1 isolate from a patient with liver abscess admitted to the same hospital. Cluster 1 represents K. pneumoniae ST23-K57 isolates with virulence or convergence plasmids that were in part from patients previously hospitalized in Ukraine (3,4). ST, sequence type.

Figure 2. Minimum spanning tree generated to evaluate the genetic relationship of 29 Klebsiella pneumoniae-ST23 isolates (capsule types K1 and K57) during study of a fatal pneumocephalus case caused by hypervirulent K. pneumoniae in Germany (Appendix Table). Ridom SeqSphere version 10.0.4 (ridom, https://www.ridom.de) was used to create tree for 29 samples isolated from hospitals in Germany on the basis of 2,358 columns, pairwise ignoring missing values, and logarithmic scale. Distance is on the basis of columns from K. pneumoniae sensu lato core genome multilocus sequence type (2,358 genes). Cluster distance threshold is 15 according to the Ridom Seqsphere. The patient isolates from this case (0354/24 and 0355/24) are labeled as cluster 2. Isolate 0074/24 is another K. pneumoniae ST23-K1 isolate from a patient with liver abscess admitted to the same hospital. Cluster 1 represents K. pneumoniae ST23-K57 isolates with virulence or convergence plasmids that were in part from patients previously hospitalized in Ukraine (3,4). ST, sequence type.

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1These first authors contributed equally to this article.

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