Abstract: OBJECTIVE To analyze the molecular epidemiological characteristics of Klebsiella pneumoniae from different specimens in patients with liver abscess in Lianyungang, Jiangsu. METHODS Pus, blood and stool specimens were collected from liver abscess patients hospitalized at the First People's Hospital of Lianyungang between Jan. 1, 2021, and Apr. 30, 2023, and K. pneumoniae strains were isolated from these specimens. Antimicrobial susceptibility testing was performed through VITEK2-Compact,and the hypermucoviscous phenotype was detected via the string test.Whole-genome sequencing was conducted via the NovaSeq 6000 high-throughput sequencing platform, and genome annotation was performed through Prokka (v1.14.5). Drug resistance genes, virulence genes and capsular serotypes were analyzed by Kleborate v2.0.4.The ST typing of K. pneumoniae was identified by MLST v2.18.1 via the PubMLST database. RESULTS The detection rates of hypervirulent and hypermucoviscous strains in pus and blood specimens were higher than those in stool specimens (P<0.001). In pus and blood specimens, the predominant capsular serotypes were KL1 (54.64%) and KL2 (24.74%), and the predominant ST types were ST23 (41.24%) and ST65 (9.28%), with higher detection rates of KL1 and ST23 compared to stool specimens (P<0.05). Except for entD, the carriage rates of virulence genes in pus and blood specimens were higher than those in stool (P<0.001). Strains isolated from pus and blood exhibited high susceptibility to commonly used antimicrobial agents, with susceptibility rates reaching 97.89% for four drugs, including piperacillin/tazobactam. No hypervirulent and highly drug-resistant K. pneumoniae strains were detected. CONCLUSIONS Hypervirulent K. pneumoniae is a common pathogen in bacterial liver abscesses in this region. The molecular characteristics of K. pneumoniae from pus, blood and stool specimens exhibit genetic diversity. The high susceptibility of K. pneumoniae to commonly used antimicrobial agents provides a basis for rational antibiotic use.