Klebsiella pneumoniae-induced pneumonia: Pathogenesis, immune interactions, and antimicrobial resistance in a global context.

IF 3.4 4区生物学 Q3 MICROBIOLOGY

Research in microbiology Pub Date : 2025-11-13 DOI:10.1016/j.resmic.2025.104353

Tasmia Jahin Mim, Amjad Islam Aqib, Abdullah Al Noman, Aqsa Iqbal, Munaza Aman, Anusha Ahmed Soomro, Saima Talib

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引用次数: 0

Abstract

Klebsiella pneumoniae is a Gram-negative bacterium and an important pathogen implicated in both hospital- and community-acquired pneumonia. K. pneumoniae strains are either classical, hypervirulent (hvKp), or antibiotic-resistant. There are several virulence factors of K. pneumoniae that helps immune evasion and survivability within the host. This review emphasizes the host immune interactions of K. pneumoniae. Evasion strategies of the pathogen and complex risk factors of the infection have been explained. Different diagnostic approaches, such as computed tomography, PCR, and Lateral Flow Immunoassay (LF), have been used for the diagnosis of K. pneumoniae. Multidrug-resistant Klebsiella pneumoniae (MDRKP) has emerged as a significant global public health concern, with higher cases of carbapenem-resistant K. pneumoniae (CRKP). CRKP caused more than 7000 deaths annually in Europe. Although K.pneumoniae has several mechanisms of antibiotic resistance, resistance to β-lactams, specifically carbapenems, causes a notable difference. Newer β-lactam/β-lactamase inhibitor combinations, such as ceftazidime-avibactam and cefiderocol are preferred for KPC-producing infections. This review emphasizes the ongoing challenges in translating therapeutic advancements into successful clinical outcomes, as well as the persisting complications in K. pneumoniae research, including the unsolved differences between hypervirulent and classical strains. Alternative methods, including bacteriophage therapy, antimicrobial peptides, and immunotherapy, are being studied for tackling CRKP. This review addresses recent advances in understanding Klebsiella pneumoniae-induced pneumonia, emphasizing how virulence factors interact with immune defences. Additionally, we highlight key challenges in antimicrobial resistance, current therapeutic strategies, K. pneumoniae's implications for infection control and antibiotic stewardship. Overall, this review aims to contribute to a deeper understanding of K. pneumoniae and to guide future interventions for effective prevention, control, and treatment strategies.

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肺炎克雷伯菌引起的肺炎：全球背景下的发病机制、免疫相互作用和抗菌素耐药性。

肺炎克雷伯菌是一种革兰氏阴性菌，是医院和社区获得性肺炎的重要病原体。肺炎克雷伯菌菌株要么是经典的、高毒力的（hvKp），要么是耐抗生素的。肺炎克雷伯菌的几个毒力因子有助于免疫逃避和宿主内的生存。本文就肺炎克雷伯菌的宿主免疫相互作用作一综述。阐明了病原菌的逃避策略和感染的复杂危险因素。不同的诊断方法，如计算机断层扫描，PCR和侧流免疫测定（LF），已被用于诊断肺炎克雷伯菌。耐多药肺炎克雷伯菌（MDRKP）已成为一个重大的全球公共卫生问题，耐碳青霉烯肺炎克雷伯菌（CRKP）病例较多。CRKP每年在欧洲造成7000多人死亡。尽管肺炎克雷伯菌具有多种抗生素耐药机制，但对β-内酰胺类，特别是碳青霉烯类的耐药引起显著差异。较新的β-内酰胺/β-内酰胺酶抑制剂组合，如头孢他啶-阿维巴坦和头孢地罗是kpc产生感染的首选。这篇综述强调了将治疗进展转化为成功的临床结果的持续挑战，以及肺炎克雷伯菌研究中持续存在的并发症，包括未解决的高毒性菌株和经典菌株之间的差异。目前正在研究替代方法，包括噬菌体治疗、抗菌肽和免疫治疗，以治疗CRKP。本文综述了了解肺炎克雷伯菌引起的肺炎的最新进展，强调了毒力因子如何与免疫防御相互作用。此外，我们还强调了抗菌素耐药性、当前治疗策略、肺炎克雷伯菌对感染控制和抗生素管理的影响等方面的关键挑战。综上所述，本综述旨在有助于加深对肺炎克雷伯菌的了解，并指导未来有效的预防、控制和治疗策略。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Research in microbiology 生物-微生物学

CiteScore

4.10

自引率

3.80%

发文量

审稿时长

16 days

期刊介绍： Research in Microbiology is the direct descendant of the original Pasteur periodical entitled Annales de l''Institut Pasteur, created in 1887 by Emile Duclaux under the patronage of Louis Pasteur. The Editorial Committee included Chamberland, Grancher, Nocard, Roux and Straus, and the first issue began with Louis Pasteur''s "Lettre sur la Rage" which clearly defines the spirit of the journal:"You have informed me, my dear Duclaux, that you intend to start a monthly collection of articles entitled "Annales de l''Institut Pasteur". You will be rendering a service that will be appreciated by the ever increasing number of young scientists who are attracted to microbiological studies. In your Annales, our laboratory research will of course occupy a central position, but the work from outside groups that you intend to publish will be a source of competitive stimulation for all of us."That first volume included 53 articles as well as critical reviews and book reviews. From that time on, the Annales appeared regularly every month, without interruption, even during the two world wars. Although the journal has undergone many changes over the past 100 years (in the title, the format, the language) reflecting the evolution in scientific publishing, it has consistently maintained the Pasteur tradition by publishing original reports on all aspects of microbiology.