高毒力肺炎克雷伯菌的毒力因子和耐药机制研究进展

Progress on virulence factors and drug resistance mechanisms of hypervirulent Klebsiella pneumoniae

肺炎克雷伯菌(Klebsiella pneumoniae,KP)为常见的医院获得性和社区获得性感染病原菌。高毒力肺炎克雷伯菌(Hypervivulent Klebsiella pneumoniae,hvKP)又称高黏性肺炎克雷伯菌,是从传统肺炎克雷伯菌中分离出来的具有高毒力、高黏性的侵袭性细菌,其高毒力特性会导致健康人发生侵袭性感染,严重者会危及生命。其毒力影响因素与菌株的荚膜、脂多糖、铁载体等相关,早期研究认为高毒力与耐药性不会在同一hvKP出现,但近期已有hvKP相关菌株耐药甚至多药耐药的报道,耐药性和高毒力的结合可能会成为下一个临床即将面临的重要挑战。笔者对hvKP的毒力和耐药研究进展作一综合阐述。

Klebsiella pneumoniae(KP)is a common hospital-acquired and community-acquired pathogen.Hyper-virulence Klebsiella pneumoniae(hvKP),also known as high viscosity Klebsiella pneumoniae,is isolated from the traditional Klebsiella pneumoniae with a highly virulent,highly viscous invasive bacteria,whose high virulence can cause invasive infections in healthy people and seriously threaten life.The virulence factors are related to the capsule,lipopolysaccharide and siderophores.Early studies have suggested that the high virulence and drug resistance of hvKP did not overlap,but recently there are reports of drug resistance or even multidrug resistance of hvKP-related strains.Combination of drug resistance and high virulence may become the next major clinical challenge to come.The author reviews the research progress of toxicity and drug resistance of hvKP in this paper.