肺炎克雷伯菌毒力因子与耐药机制及其相互影响  

Virulence factors and drug resistance mechanism of Klebsiella pneumoniae and their interaction

作　　者：聂子涵 肖丽生 赵西林[1] 牛建军 Nie Zihan;Xiao Lisheng;Zhao Xilin;Niu Jianjun(State Key Laboratory of Molecular Vaccinology and Molecular Diagnostics,School of Public Health,Xiamen University,Xiamen 361102;Zhongshan Hospital Affiliated to Xiamen University,Xiamen 361004)

机构地区：[1]厦门大学公共卫生学院分子疫苗学和分子诊断学国家重点实验室,厦门361102 [2]厦门大学附属中山医院,厦门361004

出　　处：《中国抗生素杂志》2025年第1期6-14,共9页Chinese Journal of Antibiotics

基　　金：国家自然科学基金(No.82172316)。

摘　　要：肺炎克雷伯菌是一种革兰阴性病原体,常见于社区和医院感染,可引发肺炎、眼内炎和肝脓肿。肺炎克雷伯菌可分为经典型和高毒力型。高毒力肺炎克雷伯菌具有更多种类和数量的毒力因子,能够造成更严重的伤害。最初认为高毒力肺炎克雷伯菌对抗菌药物的治疗较为敏感,但随着抗生素时代的到来,滥用抗生素导致肺炎克雷伯菌出现了耐药性,给临床治疗带来了巨大挑战。细菌获得耐药性通常包括以下两种途径:耐药基因决定簇的水平转移和自身耐药相关基因的突变/缺失。这种获得耐药性的途径通常伴随细菌致病性的变化。本综述主要介绍肺炎克雷伯菌的毒力因子和耐药机制,并综合探讨两者之间的相互影响,为肺炎克雷伯菌的防治提供理论依据和思路。Klebsiella pneumoniae is a Gram-negative pathogen commonly associated with community and nosocomial infections that can cause pneumonia,endophthalmitis and liver abscesses.Klebsiella pneumoniae can be divided into classic and highly virulent types.Highly virulent Klebsiella pneumoniae has a greater variety and quantity of virulence factors and is capable of causing more severe damage.It was initially believed that highly virulent Klebsiella pneumoniae was more sensitive to antibacterial drug treatment.However,with the advent of the antibiotic era,the misuse of antibiotics has led to the emergence of drug resistance in Klebsiella pneumoniae,which has brought huge challenges to clinical treatment.Bacteria usually acquire drug resistance by the following two ways:Horizontal transfer of drug resistance gene determinants and mutation/deletion of their own resistance-related genes.This acquisition of resistance is often accompanied by changes in bacterial pathogenicity.This review mainly introduced the virulence factors and drug resistance mechanisms of Klebsiella pneumoniae,and comprehensively discussed the interaction between the two to provide a theoretical basis and ideas for the prevention and treatment of Klebsiella pneumoniae.

关 键 词：肺炎克雷伯菌 毒力因子 耐药机制 致病机理 耐药进化策略 

分 类 号：R978.1[医药卫生—药品]