Han Yu-Ling, Wen Xu-Hui, Zhao Wen, Cao Xi-Shan, Wen Jian-Xun, Wang Jun-Rui, Hu Zhi-De, Zheng Wen-Qi
Department of Laboratory Medicine, The Affiliated Hospital of Inner Mongolia Medical University, Hohhot, China.
Department of Parasitology, The Basic Medical College of Inner Mongolia Medical University, Hohhot, China.
Front Microbiol. 2022 Sep 12;13:1003783. doi: 10.3389/fmicb.2022.1003783. eCollection 2022.
Carbapenem-resistant hypervirulent (CR-hvKP), a type of (KP) that exhibits hypervirulence and carbapenem resistance phenotypes, can cause severe infections, both hospital- and community-acquired infections. CR-hvKP has brought great challenges to global public health and is associated with significant morbidity and mortality. There are many mechanisms responsible for the evolution of the hypervirulence and carbapenem resistance phenotypes, such as the horizontal transfer of the plasmid carrying the carbapenem resistance gene to hypervirulent (hvKP) or carbapenemase-producing (CRKP) acquiring a hypervirulence plasmid carrying a virulence-encoding gene. Notably, KP can evolve into CR-hvKP by acquiring a hybrid plasmid carrying both the carbapenem resistance and hypervirulence genes. In this review, we summarize the evolutionary mechanisms of resistance and plasmid-borne virulence as well as the prevalence of CR-hvKP.
耐碳青霉烯类高毒力肺炎克雷伯菌（CR-hvKP）是肺炎克雷伯菌（KP）的一种，表现出高毒力和耐碳青霉烯类表型，可引起严重感染，包括医院获得性感染和社区获得性感染。CR-hvKP给全球公共卫生带来了巨大挑战，并与显著的发病率和死亡率相关。有许多机制导致高毒力和耐碳青霉烯类表型的演变，例如携带耐碳青霉烯类基因的质粒水平转移至高毒力肺炎克雷伯菌（hvKP），或产碳青霉烯酶肺炎克雷伯菌（CRKP）获得携带毒力编码基因的高毒力质粒。值得注意的是，肺炎克雷伯菌可通过获得携带耐碳青霉烯类和高毒力基因的杂合质粒演变为CR-hvKP。在本综述中，我们总结了耐药性和质粒携带毒力的进化机制以及CR-hvKP的流行情况。
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