KLEBSIELLA-PNEUMONIAE - SELECTED VIRULENCE FACTORS THAT CONTRIBUTE TO PATHOGENICITY
KLEBSIELLA-PNEUMONIAE - SELECTED VIRULENCE FACTORS THAT CONTRIBUTE TO PATHOGENICITY
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DOI：
10.1017/s0195941700062640
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发表时间：
1985-01-01
影响因子：
4.5
通讯作者：
JARVIS, WR
中科院分区：
文献类型：
--
作者：
HIGHSMITH, AK;JARVIS, WR
肺炎克雷伯菌感染发生在所有年龄段的人群中，但最高风险群体似乎是婴儿、老年人和免疫功能低下者。一种或多种毒力因素可能导致人类致病性。本文从细胞壁受体、荚膜多糖和内毒素3个可能介导毒力的因素进行综述。首先，细胞壁受体的存在使肺炎克雷伯菌能够附着在宿主细胞上，从而改变细菌表面，从而破坏多形核白细胞和巨噬细胞的吞噬作用，促进对非吞噬性宿主细胞的侵袭。其次，细菌细胞周围的大多糖囊也有利于入侵宿主细胞；此外，这种胶囊起到屏障的作用，保护细菌不被吞噬。肺炎克雷伯菌产生的内毒素似乎与决定受体和荚膜特性的因素无关。物种间内毒素产生的显著差异可能与毒力有关。虽然这些因素中的一些或全部可能最终决定毒力，但这些因素在体内的相互作用使得很难评估这些毒力因素中的任何一个的相对贡献。最终决定毒力的肺炎克雷伯菌致病机制尚不清楚，需要进一步研究。
K. pneumoniae infections occur in humans of all ages, however the highest risk groups appear to be infants, the elderly and the immunocompromised. One or more virulence factors may contribute to pathogenicity in humans. In this article 3 factors that may mediate virulence: cell wall receptors, capsular polysaccharide and endotoxin, were reviewed. First, the presence of cell wall receptors enables K. pneumoniae to attach to the host cell, thereby altering the bacterial surface so that phagocytosis by polymorphonuclear leukocytes and macrophages is impaired and invasion of the non-phagocytic host cell is facilitated. Second, invasion of the host cell is also facilitated by the large polysaccharide capsule surrounding the bacterial cell; in addition this capsule acts as a barrier and protects the bacteria from phagocytosis. K. pneumoniae produces an endotoxin that appears to be independent of factors that determine receptors and capsular characteristics. Marked interspecies differences in endotoxin production may correlate with virulence. Although some or all of these factors may ultimately determine virulence, the interaction of these factors in vivo had made it difficult to assess the relative contribution of any one of these virulence factors. The pathogenic mechanisms of K. pneumoniae that ultimately determine virulence remain unclear and will require further study.