高毒力肺炎克雷伯菌(hvKP)碳青霉烯类耐药机制及防控研究进展
Research Progress on Carbapenem Resistance Mechanisms and Prevention and Control of Hypervirulent Klebsiella pneumoniae (hvKP)
DOI: 10.12677/jcpm.2025.46475, PDF,    科研立项经费支持
作者: 张 越, 王艺蓉：济宁医学院临床医学院(附属医院)，山东 济宁；孟秀娟*：济宁医学院附属医院感染科，山东 济宁
关键词: 高毒力肺炎克雷伯菌；耐药机制；毒力因子；防控措施；Hypervirulent Klebsiella pneumoniae； Drug Resistance Mechanism； Virulence Factor； Prevention and Control Measures
摘要: 肺炎克雷伯菌(Klebsiella pneumoniae, KP)是一种常见的革兰阴性杆菌，通常定植于人体肠道，是社区获得性和医疗机构相关性感染的常见病原体。高毒力肺炎克雷伯菌(hypervirulent Klebsiella pneumoniae, hvKP)因携带多种毒力基因而具备较强致病性，常引起严重的社区获得性感染，并可并发眼内炎、败血症等多部位感染。传统观点认为hvKP较少携带耐药基因，对抗菌药物普遍敏感。然而，近年来由于广谱抗菌药物的广泛使用，碳青霉烯类耐药高毒力肺炎克雷伯菌(Carbapenem-Resistant hvKP, CR-hvKP)的检出率逐渐升高。这类兼具高毒力与高耐药表型的菌株为临床治疗带来了严峻挑战。本文就hvKP的定义与分类、毒力基因机制、CR-hvKP的耐药机制及其流行病学特征做一综述，旨在为CR-hvKP的防控和治疗提供理论依据与研究参考。
Abstract: Klebsiella pneumoniae is a common Gram-negative bacillus that typically colonizes the human gastrointestinal tract and is a prevalent pathogen responsible for both community-acquired and healthcare-associated infections. The hypervirulent strain of Klebsiella pneumoniae (hvKP), characterized by the presence of multiple virulence genes, exhibits enhanced pathogenicity and often leads to severe community-acquired infections. These may be complicated by conditions such as endophthalmitis and sepsis involving multiple organ systems. Traditionally, hvKP has been considered to carry few resistance genes and thus remains generally susceptible to antimicrobial agents. However, in recent years, the widespread use of broad-spectrum antibiotics has led to a rising detection rate of carbapenem-resistant hypervirulent K. pneumoniae (CR-hvKP). These strains, which combine both hypervirulence and multidrug resistance phenotypes, pose a significant challenge for clinical treatment. This review aims to summarize the current understanding of hvKP in terms of its definition and classification, virulence gene mechanisms, resistance mechanisms of CR-hvKP, and its epidemiological characteristics, providing a theoretical basis and research reference for the prevention and treatment of CR-hvKP.
文章引用：张越, 王艺蓉, 孟秀娟. 高毒力肺炎克雷伯菌(hvKP)碳青霉烯类耐药机制及防控研究进展[J]. 临床个性化医学, 2025, 4(6): 37-49. https://doi.org/10.12677/jcpm.2025.46475

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