Karampatakis Theodoros, Tsergouli Katerina, Behzadi Payam
Microbiology Department, Papanikolaou General Hospital, 57010 Thessaloniki, Greece.
Microbiology Department, Agios Pavlos General Hospital, 55134 Thessaloniki, Greece.
Antibiotics (Basel). 2023 Jan 21;12(2):234. doi: 10.3390/antibiotics12020234.
is a Gram-negative opportunistic pathogen responsible for a variety of community and hospital infections. Infections caused by carbapenem-resistant (CRKP) constitute a major threat for public health and are strongly associated with high rates of mortality, especially in immunocompromised and critically ill patients. Adhesive fimbriae, capsule, lipopolysaccharide (LPS), and siderophores or iron carriers constitute the main virulence factors which contribute to the pathogenicity of . Colistin and tigecycline constitute some of the last resorts for the treatment of CRKP infections. Carbapenemase production, especially carbapenemase (KPC) and metallo-β-lactamase (MBL), constitutes the basic molecular mechanism of CRKP emergence. Knowledge of the mechanism of CRKP appearance is crucial, as it can determine the selection of the most suitable antimicrobial agent among those most recently launched. Plazomicin, eravacycline, cefiderocol, temocillin, ceftolozane-tazobactam, imipenem-cilastatin/relebactam, meropenem-vaborbactam, ceftazidime-avibactam and aztreonam-avibactam constitute potent alternatives for treating CRKP infections. The aim of the current review is to highlight the virulence factors and molecular pathogenesis of CRKP and provide recent updates on the molecular epidemiology and antimicrobial treatment options.
是一种革兰氏阴性机会致病菌,可导致多种社区和医院感染。耐碳青霉烯类肺炎克雷伯菌(CRKP)引起的感染对公共卫生构成重大威胁,且与高死亡率密切相关,尤其是在免疫功能低下和重症患者中。黏附菌毛、荚膜、脂多糖(LPS)以及铁载体构成了有助于肺炎克雷伯菌致病性的主要毒力因子。黏菌素和替加环素是治疗CRKP感染的一些最后手段。碳青霉烯酶的产生,尤其是KPC碳青霉烯酶和金属β-内酰胺酶(MBL),是CRKP出现的基本分子机制。了解CRKP出现的机制至关重要,因为它可以决定在最近推出的抗菌药物中选择最合适的抗菌剂。普拉唑米星、依拉环素、头孢地尔、替莫西林、头孢洛扎坦-他唑巴坦、亚胺培南-西司他丁/瑞来巴坦、美罗培南-瓦博巴坦、头孢他啶-阿维巴坦和氨曲南-阿维巴坦是治疗CRKP感染的有效替代药物。本综述的目的是强调CRKP的毒力因子和分子发病机制,并提供分子流行病学和抗菌治疗选择的最新进展。