Advances in mechanisms of resistance and virulence factors of Klebsiella pneumoniae
Klebsiella pneumoniae(K.pneumoniae)is an opportunistic pathogen where parasitizes the skin,respiratory and intestine of humans and other animals,and it has high-grade pathogenic,with the urinary tract,respiratory system,or bloodstream,even septicemia and meningoencephalitis.K.pneumoniae is classified into classical K.pneumoniae(cKP)and hypervirulent K.pneumoniae(hvKP),which can cause more severe and aggressive infection.Currently,the drug resistance on K.pneumoniae has shown an obvious upward trend,global and diverse epidemiological trends have attracted widespread attention.There are many mechanisms through which K.pneumoniae develop resistance to antimicrobial agents besides efflux pumps,and are capable of rapid spread with mobile genetic elements.The mechanisms of antibiotics resistance in K.pneumoniae,including to β-lactams,quinolones,aminoglycosides,tigecycline and colistin,were described in detail in this paper.The virulence factors of K.pneumoniae include capsule,lipopolysaccharide,adhesin,PEG-344,siderophores(enterobactin,salmochelin,yersiniabactin,and aerobactin)and outer membrane proteins.The research on K.pneumoniae antimicrobial resistance and pathogenicity has become more and more in depth,and treatment is continuously advancing.The main strategies involve new uses of old drugs,nano-antibiotics,novel antimicrobial research and development,bacteriophage therapy,and antibody therapy.This review provides a systematic review of resistance mechanism and virulence factors of K.pneumoniae may be helpful as a reference for the prevention,control,and clinical treatment.Further researches of biological properties,precise diagnosis,the mechanism of interaction with host tissue cells and host immune response,and mechanisms of K.pneumoniae are still required.
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