碳青霉烯类耐药高毒力肺炎克雷伯菌的研究进展
Research Progress of Carbapenem-Resistant Hypervirulent Klebsiella pneumoniae
DOI: 10.12677/acm.2024.14123242, PDF,   
作者: 上官小容：山东大学齐鲁医学院公共卫生学院职业与环境健康学系，山东 济南
关键词: 肺炎克雷伯菌；高毒力；碳青霉烯类耐药；Klebsiella pneumoniae； Hypervirulence； Carbapenem-Resistance
摘要: 高毒力和碳青霉烯类耐药已成为肺炎克雷伯菌(KP)的两个不同的进化方向，在临床环境中构成巨大威胁。然而，近年来发现越来越多的KP菌株整合了这两种表型，导致了毁灭性的临床结果。碳青霉烯耐药高毒力肺炎克雷伯菌(CR-hvKP)出现在2010年代初期，此后变得越来越普遍。CR-hvKP主要流行于亚洲，尤其是中国，但世界各地都有报道。CR-hvKP出现的机制可以总结为三种模式：1) 获得碳青霉烯类耐药表型的高毒力肺炎克雷伯菌(hvKP)；2) 耐碳青霉烯类肺炎克雷伯菌(CRKP)获得高毒力表型；3) 肺炎克雷伯菌获得碳青霉烯类耐药和高毒力的融合质粒。随着CR-hvKP的全球传播，应更加重视对CR-hvKP的持续监测。
Abstract: High virulence and carbapenem resistance have become two different evolutionary directions of Klebsiella pneumoniae (KP), posing a great threat in clinical settings. However, in recent years, more and more KP strains have been found to integrate these two phenotypes, leading to devastating clinical outcomes. Carbapenem-resistant hypervirulent Klebsiella pneumoniae (CR-hvKP) emerged in the early 2010s and has since become more common. CR-hvKP is mainly prevalent in Asia, especially China, but has been reported around the world. The mechanism of the emergence of CR-hvKP can be summarized into three patterns: 1) Hypervirulent Klebsiella pneumoniae (hvKP) which obtained carbapenem-resistant phenotype; 2) Carbapenem-resistant Klebsiella pneumoniae (CRKP) obtained a hypervirulent phenotype; 3) Klebsiella pneumoniae obtained carbapenem-resistance and high virulence fusion plasmid. With the global spread of CR-hvKP, more attention should be paid to the continuous monitoring of CR-hvKP.
文章引用：上官小容. 碳青霉烯类耐药高毒力肺炎克雷伯菌的研究进展[J]. 临床医学进展, 2024, 14(12): 1479-1486. https://doi.org/10.12677/acm.2024.14123242

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