Klebsiella pneumoniae is a gram-negative bacterial species capable of
occupying a broad range of environmental and clinical habitats. Known as
an opportunistic pathogen, it has recently become a major causative
agent of clinical infections worldwide. Despite growing knowledge about
the highly diverse population of K. pneumoniae, the evolution and
clinical significance of environmental K. pneumoniae, as well as the
relationship between clinical and environmental K. pneumoniae, are
poorly defined. We isolated and sequenced K. pneumoniae from in-patients
in a single hospital in Thailand, as well as hospital sewage, and
surrounding canals and farms within a 20-km radius. Phylogenetic
analysis of 77 K. pneumoniae (48 clinical and 29 non-clinical isolates)
demonstrated that the two groups were intermixed throughout the tree and
in some cases resided in the same clade, suggesting recent divergence
from a common ancestor. Phylogenetic comparison of the 77 Thai genomes
with 286 K. pneumoniae from a global collection showed that Thai
isolates were closely related to the clinical sub-population of the
global collection, indicating that Thai clinical isolates belonged to
globally circulating lineages. Dating of four Thai K. pneumoniae clades
indicated that they emerged between 50 and 150 years ago. Despite their
phylogenetic relatedness, virulence factors and β-lactamase resistance
genes were more numerous in clinical than in environmental isolates. Our
results indicate that clinical and environmental K. pneumoniae are
closely related, but that hospitals may select for isolates with a more
resistant and virulent genotype. These …