临床肺炎克雷伯菌的异质性耐药研究进展

Research progress in heteroresistance of Klebsiella pneumoniae to antibiotics

摘要:

肺炎克雷伯菌(Klebsiella pneumoniae)是临床引起感染的常见病原菌之一，常引发肺炎、尿路感染和细菌血症等。近年来，肺炎克雷伯菌的异质性耐药相关研究相继被报道。异质性耐药是指同一菌株中同时存在对某种抗生素耐药和敏感亚群的现象，由于其表型和遗传不稳定，至今尚无标准、低成本和高效的检测方法。本文对肺炎克雷伯菌异质性耐药进行综述，阐明了异质性耐药的定义和检测方法，并结合本团队在铜绿假单胞菌(Pseudomonas aeruginosa)异质性耐药方面的研究工作，深入剖析了肺炎克雷伯菌的异质性耐药机制。本文为全面了解肺炎克雷伯菌异质性耐药机制、优化临床抗菌药物的使用和治疗肺炎克雷伯菌感染提供参考。

Abstract:

Klebsiella pneumoniae (KP), one of the most common pathogens causing clinical infections, often results in pneumonia, urinary tract infection, and bacteremia. In recent years, studies have reported the heteroresistance of K. pneumoniae. Heteroresistance refers to the phenomenon that there are both resistant and susceptible subpopulations of a strain to an antibiotic. Due to the phenotypic and genetic instability of heteroresistance, standard, low-cost, and efficient detection methods remain to be established. This article reviews the research progress in heteroresistance of K. pneumoniae, clarifies the definition and detection methods of heteroresistance, and probes into the heteroresistance mechanism of K. pneumoniae on the basis of our previous studies about the heteroresistance of Pseudomonas aeruginosa. This article will provide a reference for comprehensively understanding the heteroresistance mechanism of K. pneumoniae, optimizing the clinical use of antibiotics, and treating bacterial infections.