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Molecular Epidemiology of Hypervirulent K. pneumoniae and Problems of Health-Care Associated Infections
A V Tutelyan1, D S Shlykova2, Sh L Voskanyan1
1Central Research Institute of Epidemiology, Federal Service for Surveillance on Consumer Rights Protection and Human Wellbeing, Moscow, Russia.
Abstract:
The review describes virulence factors of hypervirulent K. pneumoniae (hvKp) including genes determining its virulence and discusses their role in the development of health-care associated infections. The contribution of individual virulence factors and their combination to the development of the hypervirulence and the prospects of using these factors as biomarkers and therapeutic targets are described. Virulence factors of hvKp and "classical" K. pneumoniae strains (cKp) with no hypervirulence genes were compared. The mechanisms of biofilm formation by hvKp and high incidence of its antibiotic resistance are of particular importance for in health care institutions. Therefore, the development of methods for hvKp identification allowing early prevention of severe hvKp infection and novel approaches to abrogate its spreading are new challenges for epidemiology, infection diseases, and critical care medicine. New technologies including bacteriological and molecular studies make it possible to develop innovative strategies to diagnose and treat infection caused by hvKp. These include monitoring of both genetic biomarkers of hvKp and resistance plasmid that carry of virulence genes and antibiotic resistance genes, creation of immunological agents for the prevention and therapy of hvKp (vaccines, monoclonal antibodies) as well as personalized hvKp-specific phage therapies and pharmaceuticals enhancing the effect of antibiotics. A variety of approaches can reliably prepare our medicine for a new challenge: spreading of life-threatening health-care associated infections caused by antibiotic-resistant hvKp strains.
Insights
Hypervirulent Klebsiella pneumoniae (hvKp) possess unique virulence factors driving severe healthcare-associated infections. Understanding these factors is crucial for developing new diagnostics, therapies, and prevention strategies against antibiotic-resistant strains.
Area of Science:
- Microbiology
- Infectious Diseases
- Genetics
Background:
- Hypervirulent Klebsiella pneumoniae (hvKp) strains cause severe healthcare-associated infections.
- hvKp strains exhibit distinct virulence factors and mechanisms compared to classical K. pneumoniae (cKp).
- Antibiotic resistance and biofilm formation are significant challenges posed by hvKp in clinical settings.
Purpose of the Study:
- To review and describe the virulence factors of hvKp.
- To discuss the role of these factors in healthcare-associated infections.
- To explore the potential of virulence factors as biomarkers and therapeutic targets.
Main Methods:
- Comparative analysis of virulence factors between hvKp and cKp strains.
- Review of mechanisms underlying hvKp hypervirulence, including biofilm formation.
- Examination of genetic and molecular studies for diagnostic and therapeutic innovations.
Main Results:
- hvKp possesses specific virulence factors contributing to hypervirulence.
- Biofilm formation and high antibiotic resistance are key concerns for hvKp.
- Virulence factors offer potential as biomarkers and therapeutic targets.
Conclusions:
- Early identification and novel therapeutic strategies are needed to combat hvKp infections.
- Developing vaccines, monoclonal antibodies, phage therapies, and enhanced pharmaceuticals are promising approaches.
- Integrated strategies are essential to prepare for the spread of antibiotic-resistant hvKp.
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