Klebsiella: a long way to go towards understanding this enigmatic jet-setter.
Klebsiella: a long way to go towards understanding this enigmatic jet-setter.
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克莱布斯埃拉（Klebsiella）：要理解这种神秘的喷气机，这是很长的路要走。
DOI：
10.12703/p6-64
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发表时间：
2014
期刊：
影响因子：
--
通讯作者：
Miller VL
中科院分区：
文献类型：
--
作者：
Broberg CA;Palacios M;Miller VL
肺炎克雷伯菌是多种疾病的病原体，包括肺炎、尿路感染、败血症和最近公认的化脓性肝脓肿（PLA）。由于世界范围内越来越多地分离出对广谱抗生素具有耐药性的菌株，已经开始重新努力确定和了解引起疾病所需的细菌决定因素。最近增加的碳青霉烯耐药菌株的分离进一步减少了可用的治疗选择。耐药分离株在地理上的迅速传播和向其他病原体的传播尤其令人担忧。多年来，最具特征的毒力决定因素是胶囊、脂多糖、铁载体和1型和3型菌毛。最近扩大这一列表的努力包括体内筛选和全基因组测序。然而，对于这种细菌是如何致病的，我们仍然知之甚少。最近对肺炎克雷伯菌株的克隆分析表明，存在不同的克隆群，其中一些可能与特定的疾病综合征有关。然而，是什么使一个克隆群更具毒性以及是什么改变了疾病模式尚不清楚，并且仍然是未来的重要问题。
Klebsiella pneumoniae is the causative agent of a variety of diseases, including pneumonia, urinary tract infections, septicemia, and the recently recognized pyogenic liver abscesses (PLA). Renewed efforts to identify and understand the bacterial determinants required to cause disease have come about because of the worldwide increase in the isolation of strains resistant to a broad spectrum of antibiotics. The recent increased isolation of carbapenem-resistant strains further reduces the available treatment options. The rapid geographic spread of the resistant isolates and the spread to other pathogens are of particular concern. For many years, the best characterized virulence determinants were capsule, lipopolysaccharide, siderophores, and types 1 and 3 fimbriae. Recent efforts to expand this list include in vivo screens and whole-genome sequencing. However, we still know little about how this bacterium is able to cause disease. Some recent clonal analyses of K. pneumoniae strains indicate that there are distinct clonal groups, some of which may be associated with specific disease syndromes. However, what makes one clonal group more virulent and what changes the disease pattern are not yet clear and remain important questions for the future.