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Fenotipo hipermucoviscoso de Klebsiella pneumoniae hipervirulenta: Lo nuevo de un viejo enemigo
Resumen
El incremento de los aislamientos de la variante emergente de Klebsiella pneumoniae hipervirulenta (Kphv) la ha convertido en una especie bacteriana de gran interés clínico-epidemiológico, debido a su capacidad de causar infecciones severas y potencialmente mortales en pacientes sanos e inmunocompetentes, se asocia a neumonías, infecciones del tracto urinario, bacteriemias, abscesos hepáticos, endoftalmitis entre otras infecciones. El éxito patogénico de Kphv se debe la presencia de factores de virulencia como sistemas de captación de hierro, vías del metabolismo de la alantoína, porinas, sistemas de expulsión, fimbrias kpc, producción de polisacárido capsular y lipopolisacárido, además de la adquisición de genes que median la resistencia a los antimicrobianos. El fenotipo hipermucoviscoso de Kphv se caracteriza por la presencia de cápsula y lipopolisacárido como elementos de virulencia de gran importancia, los cuales favorecen el incremento de material capsular y la producción de biopelícula permitiéndole al microorganismo evadir de manera efectiva el sistema inmunológico del hospedero susceptible. La correlación del polisacárido capsular con el lipopolisacárido juega un rol fundamental en la virulencia y patogenicidad de Kphv, aunado a estos la convergencia de genes que median la resistencia antimicrobiana hace imperiosamente necesaria la vigilancia, el análisis y desarrollo de blancos terapéuticos a fin de evitar la dispersión de clones hipervirulentos y multirresistentes asociados a altas tasas de morbi-mortalidad.
Recibido: 29 de Septiembre del 2019 / Aceptado: 01 de Enero del 2020
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