Resistance of hypervirulent Klebsiella pneumoniae to both intracellular and extracellular killing of neutrophils.

Hypervirulent Klebsiella pneumoniae (HvKP) is hypermucoviscous organism, carrying genes of rmpA and aerobactin, causing serious community-acquired infection and metastatically spread in young healthy hosts. Neutrophils play an important role during innate immune response against bacterial infection by phagocytosis and neutrophil extracellular traps (NETs). Whether neutrophils can effectively defend against HvKP remains unclear. In this study, we observed that the HvKP was significantly more resistant to neutrophil-mediated phagocytosis and intracellular killing than classic Klebsiella pneumoniae (cKP) isolates. Although both HvKP and cKP induced NETs under scanning electron microscopy and confocal microscopy, more cKP than HvKP were trapped in NETs, and the killing by intracellular and extracellular mechanisms of neutrophils was detected only on cKP. Together, our results demonstrated that HvKP resisted to both intracellular and extracellular killing of neutrophils.