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Severe liver abscess infections caused by hypervirulent clonal-group CG23  Klebsiella pneumoniae  have been increasingly reported since the mid-1980s. Strains typically possess several virulence factors including an integrative, conjugative element ICE Kp  encoding the siderophore yersiniabactin and genotoxin colibactin. Here we investigate CG23’s evolutionary history, showing several deep-branching sublineages associated with distinct ICE Kp  acquisitions. Over 80% of liver abscess isolates belong to sublineage CG23-I, which emerged in ~1928 following acquisition of ICE Kp10  (encoding yersiniabactin and colibactin), and then disseminated globally within the human population. CG23-I’s distinguishing feature is the colibactin synthesis locus, which reportedly promotes gut colonisation and metastatic infection in murine models. These data show circulation of CG23  K .  pneumoniae  decades before the liver abscess epidemic was first recognised, and provide a framework for future epidemiological and experimental studies of hypervirulent  K .  pneumoniae . To support such studies we present an open access, completely sequenced CG23-I human liver abscess isolate, SGH10.

Population genomics of hypervirulent Klebsiella pneumoniae clonal-group 23 reveals early emergence and rapid global dissemination