糖尿病患者易感高毒力肺炎克雷伯菌机制的研究进展  

Progress in the mechanisms of susceptibility to hypervirulent Klebsiella pneumoniae in diabetic patients

作　　者：蒋璐 王锐英[1] 魏双 刘先胜[1,2] Jiang Lu;Wang Ruiying;Wei Shuang;Liu Xiansheng(Department of Respiratory and Critical Care Medicine,the Third Hospital of Shanxi Medical University(Shanxi Bethune Hospital,Shanxi Academy of Medical Sciences,Tongji Shanxi Hospital),Taiyuan 030032,China;Department of Respiratory and Critical Care Medicine,Tongji Hospital,Huazhong University of Science and Technology,Wuhan 430030,China)

机构地区：[1]山西医科大学第三医院(山西白求恩医院,山西医学科学院,同济山西医院)呼吸与危重症医学科,太原030032 [2]华中科技大学同济医学院附属同济医院呼吸与危重症医学科,武汉430030

出　　处：《中华微生物学和免疫学杂志》2024年第6期560-564,共5页Chinese Journal of Microbiology and Immunology

基　　金：山西省健康委新冠科研项目(2023XG001,2023XG005)。

摘　　要：高毒力肺炎克雷伯菌(hvKP)是经典型肺炎克雷伯菌高毒力变种,易造成全身侵袭性感染,全球感染率持续上升。糖尿病尤其血糖控制不佳者是hvKP感染高危人群。糖尿病患者hvKP感染发病率逐年增高,进展快,病死率高,糖尿病患者对hvKP的易感机制包括高血糖引起肠道定植易位增加、内皮-上皮屏障损伤、免疫逃避、高滴度血症、微血栓形成及hvKP碳源/铁代谢调节毒力等。深入了解糖尿病患者hvKP的易感机制对进一步提高临床的认识与关注,以及早期预防及有效诊治具有重要意义。本文拟对近年来糖尿病患者hvKP易感机制的研究进展进行综述。Hypervirulent Klebsiella pneumoniae(hvKP)is a highly virulent variant of Klebsiella pneumoniae and can cause systemic invasive infection.The worldwide prevalence of hvKP infection continues to increase.Diabetic patients,especially those with poor glucose control,are at a higher risk for hvKP infection.The infection of hvKP in diabetic patients is characterized by high incidence,rapid progression and high fatality rate.The mechanisms underlying the susceptibility to hvKP in patients with diabetes include hyperglycemia-induced bacterial translocation,endothelial-epithelial barrier damage,immune evasion,high-load bacteremia,microthrombosis and hvKP carbon/iron metabolism-based regulation of virulence.A thorough understanding of the mechanisms underlying the susceptibility to hvKP in diabetic patients will be great significant to further improve clinical understanding and attention,and provide early prevention and effective diagnosis and treatment.This article summarizes the progress in the mechanisms of susceptibility to hvKP in diabetic patients in recent years.

关 键 词：高毒力肺炎克雷伯菌 糖尿病 发病机制 

分 类 号：R587.1[医药卫生—内分泌] R515[医药卫生—内科学]