Klebsiella pneumoniae represents a major concern within antimicrobial resistance and chemotherapy, driven by the simultaneous advance of hypervirulent strains (hvKP) and multidrug-resistant (MDR-KP) phenotypes. Over recent decades, this pathogen has become increasingly associated with both severe community and healthcare-associated infections, notably pyogenic liver abscess, but also extending to pneumonia, bacteremia, urinary tract infections, meningitis, and widespread metastatic disease. While antibiotics offered effective treatment, the rapid proliferation of extended-spectrum beta-lactamase (ESBL) and carbapenem-resistant (CRKP) isolates has resulted in fewer therapeutic options, delayed appropriate therapy, and higher morbidity and mortality. The convergence of hypervirulence and antimicrobial resistance remains insufficiently understood and poses a substantial threat to clinical management and infection control.

This Research Topic aims to propel multidisciplinary exploration of the biological, clinical, and therapeutic complexities seen in hvKP and MDR-KP. Our objective is to clarify the molecular pathways and genetic determinants responsible for virulence–resistance convergence, dissect host–pathogen interactions, and identify diagnostic or therapeutic strategies that can overcome current limitations in care. By encouraging contributions from basic science, translational research, and clinical practice, we seek to illuminate actionable approaches to robust antimicrobial stewardship, rapid detection of resistant pathogens, and precision chemotherapeutic interventions.

This Research Topic focuses on integrating cutting-edge evidence on the antimicrobial resistance mechanisms, virulence factors, chemotherapeutic outcomes, and diagnostic innovations relevant to K. pneumoniae, with an emphasis on pyogenic liver abscess and other clinically significant infections. Submissions are expected to address challenges and advancements that enhance the management, detection, and understanding of hvKP and MDR-KP infections.

To gather further insights in these critical domains, we welcome articles addressing, but not limited to, the following themes:
- Molecular mechanisms underlying antimicrobial resistance and acquisition of virulence in K. pneumoniae.
- Epidemiological trends and clinical impact of hvKP and MDR-KP.
- Host immune responses and pathogenesis in severe and invasive infections.
- Development and clinical evaluation of rapid diagnostics that inform therapeutic decision-making.
- Novel antimicrobial agents, anti-virulence compounds, phage therapy, and combination regimens.
- Strategies for infection control, resistance containment, and antimicrobial stewardship.

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Hypervirulent and Multidrug-resistant <i>Klebsiella pneumoniae</i>: Pathogenesis, Antimicrobial Resistance, and Therapeutic Challenges