Podschun R, Ullmann U
Department of Medical Microbiology and Virology, University of Kiel, Kiel, Germany.
Clin Microbiol Rev. 1998 Oct;11(4):589-603. doi: 10.1128/CMR.11.4.589.
Bacteria belonging to the genus Klebsiella frequently cause human nosocomial infections. In particular, the medically most important Klebsiella species, Klebsiella pneumoniae, accounts for a significant proportion of hospital-acquired urinary tract infections, pneumonia, septicemias, and soft tissue infections. The principal pathogenic reservoirs for transmission of Klebsiella are the gastrointestinal tract and the hands of hospital personnel. Because of their ability to spread rapidly in the hospital environment, these bacteria tend to cause nosocomial outbreaks. Hospital outbreaks of multidrug-resistant Klebsiella spp., especially those in neonatal wards, are often caused by new types of strains, the so-called extended-spectrum-beta-lactamase (ESBL) producers. The incidence of ESBL-producing strains among clinical Klebsiella isolates has been steadily increasing over the past years. The resulting limitations on the therapeutic options demand new measures for the management of Klebsiella hospital infections. While the different typing methods are useful epidemiological tools for infection control, recent findings about Klebsiella virulence factors have provided new insights into the pathogenic strategies of these bacteria. Klebsiella pathogenicity factors such as capsules or lipopolysaccharides are presently considered to be promising candidates for vaccination efforts that may serve as immunological infection control measures.
克雷伯氏菌属细菌经常引发人类医院感染。特别是医学上最重要的克雷伯氏菌物种——肺炎克雷伯菌，在医院获得性尿路感染、肺炎、败血症和软组织感染中占很大比例。克雷伯氏菌传播的主要致病源是胃肠道和医院工作人员的手。由于这些细菌在医院环境中传播迅速，它们往往会引发医院感染暴发。多重耐药克雷伯氏菌属的医院感染暴发，尤其是新生儿病房的感染暴发，通常由新型菌株引起，即所谓的超广谱β-内酰胺酶（ESBL）产生菌。在过去几年中，临床克雷伯氏菌分离株中产ESBL菌株的发生率一直在稳步上升。由此导致的治疗选择受限，需要采取新的措施来管理克雷伯氏菌医院感染。虽然不同的分型方法是感染控制有用的流行病学工具，但最近关于克雷伯氏菌毒力因子的研究结果为这些细菌的致病策略提供了新的见解。克雷伯氏菌的致病因子，如荚膜或脂多糖，目前被认为是疫苗接种努力的有希望的候选物，这些疫苗接种可作为免疫感染控制措施。
