Abstract：
Hypervirulent Klebsiella pneumoniae (hvKP) typically causes severe invasive infections affecting multiple sites in healthy individuals. In the past, hvKP was characterized by a hypermucoviscosity phenotype, susceptibility to antimicrobial agents, and its tendency to cause invasive infections in healthy individuals within the community. However, there has been an alarming increase in reports of multidrug-resistant hvKP, particularly carbapenem-resistant strains, causing nosocomial infections in critically ill or immunocompromised patients. This presents a significant challenge for clinical treatment. Early identification of hvKP is crucial for timely infection control. Notably, identifying hvKP has become confusing due to its prevalence in nosocomial settings and the limited predictive specificity of the hypermucoviscosity phenotype. Novel virulence predictors for hvKP have been discovered through animal models or machine learning algorithms, while standardization of identification criteria is still necessary. Timely source control and antibiotic therapy have been widely employed for the treatment of hvKP infections. Additionally, phage therapy is a promising alternative approach due to escalating antibiotic resistance. In summary, this narrative review highlights the latest research progress in the development, virulence factors, identification, epidemiology of hvKP, and treatment options available for hvKP infection.
摘要：
高毒力肺炎克雷伯菌（hvKP）通常会导致严重的侵袭性感染，影响健康个体的多个部位。在过去,hvKP的特征是高粘膜粘度表型，对抗菌剂的敏感性，以及它在社区内健康个体中引起侵入性感染的趋势。然而,耐多药hvKP的报告令人震惊地增加，特别是碳青霉烯类耐药菌株，在危重或免疫功能低下的患者中引起医院感染。这对临床治疗提出了重大挑战。早期识别hvKP对于及时控制感染至关重要。值得注意的是,由于hvKP在医院环境中的流行以及高粘膜粘度表型的预测特异性有限，因此鉴定hvKP变得令人困惑。已经通过动物模型或机器学习算法发现了用于hvKP的新型毒力预测因子，而鉴定标准的标准化仍然是必要的。及时的源控制和抗生素治疗已被广泛用于治疗hvKP感染。此外,由于不断升级的抗生素耐药性，噬菌体疗法是一种有前途的替代方法。总之,这篇叙事综述突出了发展中的最新研究进展，毒力因子，identification,hvKP的流行病学，和可用于hvKP感染的治疗选择。
