1. Understanding carbapenem-resistant hypervirulent Klebsiella pneumoniae: Key virulence factors and evolutionary convergence

hLife | 破解耐药高毒力肺炎克雷伯菌：毒力因子与进化机制揭秘

通信作者：肖永红

本文系统阐述了耐碳青霉烯类高毒力肺炎克雷伯菌（CR-hvKP）的关键毒力因子及其进化整合机制。CR-hvKP的毒力相关基因分布于核心基因组（染色体）及辅助基因组（如质粒、整合性接合元件 [ICEKp]）中。这些遗传元件编码荚膜、脂多糖、铁载体、1/3型菌毛及基因毒素柯杆菌素（colibactin）等毒力因子，赋予菌株高致病潜力。    CR-hvKP的形成源于持续的进化压力，以及携带碳青霉烯酶基因或高毒力基因的质粒交换。目前认为，耐药与高毒力表型在同一菌株中汇合的机制主要有三种：（1）碳青霉烯耐药质粒水平转移至高毒力肺炎克雷伯菌；（2）高毒力质粒转移至耐碳青霉烯肺炎克雷伯菌；（3）菌株获得同时携带耐药及毒力基因的嵌合/杂合质粒。目前，耐药与高毒力谱系在单一菌株中的融合现象日益增多，对公共卫生构成严重威胁。CR-hvKP的广泛流行主要归因于其高度可变的基因组，这种可塑性源于点突变、同源重组以及质粒、插入序列、原噬菌体等多种可移动遗传元件的频繁转移。

引用：

Chen T, Ying L, Xiong L, et al. Understanding carbapenem-resistant hypervirulent Klebsiella pneumoniae: Key virulence factors and evolutionary convergence. hLife 2024; 2: 611–624.

2. WHO revised bacterial priority pathogens list to encourage global actions to combat AMR

通信作者：肖永红

The World Health Organization (WHO) has updated its Bacterial Priority Pathogens List (BPPL) for 2024 to combat antimicrobial resistance (AMR), focusing on "One Health" criteria such as treatability, mortality, and resistance trends. The list categorizes pathogens as critical, high, or medium priority, emphasizing the need for new antimicrobials. Notable inclusions are carbapenem-resistant Acinetobacter baumannii (CRAB), carbapenem-resistant Enterobacterales (CRE), and third-generation cephalosporin-resistant Enterobacterales (3GCRE). The AMR crisis, especially with multidrug-resistant gram-negative bacteria, persists, highlighting the urgency for global action, investment, and R&D in diagnostics and therapeutics.

Ma Y, Chen P, Mo Y, et al. WHO revised bacterial priority pathogens list to encourage global actions to combat AMR. hLife 2024; 2: 607–610.

3. Personalized bacteriophage therapy for chronic biliary tract Pseudomonas aeruginosa infections

hLife | 胡必杰与乐率等研究团队合作发现对抗超级细菌的利器！首例超级细菌胆道感染的噬菌体治疗案例！

通信作者：朱同玉，胡必杰，乐率

本研究首次证实了噬菌体疗法在胆道感染中的安全性和有效性，为治疗提供了新的思路。尽管完全清除感染仍具挑战，但噬菌体疗法在缓解症状和减少细菌载量方面效果显著。

Li N, Li L, He B, et al. Personalized bacteriophage therapy for chronic biliary tract Pseudomonas aeruginosa infections. hLife 2025; 3: 275–283.

4. RmpA drives metabolic reprogramming to modulate the phenotypic switch between hypermucoviscosity and biofilm formation in hypervirulent Klebsiella pneumoniae

hLife | 冯婕研究团队揭示RmpA是操控高毒力肺炎克雷伯菌在高粘液性与生物膜间切换的代谢开关

通信作者：冯婕

本文通过在高毒力肺炎克雷伯菌中构建针对rmpA基因的dCas9敲低菌株，结合RNA-seq和ChIP-seq技术，揭示了RmpA作为“代谢中枢调控器”的双重功能。

Yao S, Huang J, Geng J, et al. RmpA drives metabolic reprogramming to modulate the phenotypic switch between hypermucoviscosity and biofilm formation in hypervirulent Klebsiella pneumoniae. hLife 2025; 3: 504–516.

5. Carbapenem-resistant Klebsiella pneumoniae ST11 index from a single strain enhances rapid parallel evolution during persistent infection

hLife | 深圳三院曲久鑫研究团队揭示高毒高耐肺炎克雷伯菌ST11持续感染过程中的宿主内进化

通信作者：曲久鑫

本文通过全基因组测序（WGS）分析了从一名持续感染患者体内时序性分离的一系列肺炎克雷伯菌菌株，揭示并表征了肺炎克雷伯菌基因组、耐药表型和毒力在宿主内分化和适应过程，并呼吁借鉴病毒学，从准种理论的角度认识病原细菌持续性感染。

Li L, Jiang Z, Wang X, et al. Carbapenem-resistant Klebsiella pneumoniae ST11 index from a single strain enhances rapid parallel evolution during persistent infection. hLife 2025; 3: 517–520.

6. Heterogeneity and clinical genomics of bla_KPC-2-producing, carbapenem-resistant Pseudomonas aeruginosa

hLife  | 揭秘产blaKPC-2的碳青霉烯耐药铜绿假单胞菌的异质性与临床基因组学之谜

通信作者：黄曼、冯友军

本文报道了KPC-2耐药质粒在碳青霉烯类耐药铜绿假单胞菌（CRPA）中的分布和遗传特征，为研究我国临床ICU环境中CRPA传播机制提供了重要的基因组学视角。

Huang M, Liu L, Li X, et al. Heterogeneity and clinical genomics of bla_KPC-2-producing, carbapenem-resistant Pseudomonas aeruginosa. hLife 2024; 2: 314–319.

7. Convergence of carbapenem resistance and hypervirulence in Klebsiella pneumoniae: An emerging public health threat

hLife | 高毒高耐肺炎克雷伯菌的全球播散及应对策略

通信作者：王明贵

高耐高毒肺炎克雷伯菌的出现和广泛传播是潜在的公共卫生危机，这类菌株正悄然改变临床感染格局。未来研究和防控策略可聚焦于：基于CRISPR-Cas或毒素-抗毒素系统的去定植研究、针对毒力因子的靶向治疗研究、结合新型分子检测与监测网络的早期预警系统的建立等。只有通过加强基础研究、研发诊断手段、推动多学科协作，才能有效遏制其蔓延，守护临床安全与公共卫生防线。

Jiang J, Zhang J, Sun Z, et al. Convergence of carbapenem resistance and hypervirulence in Klebsiella pneumoniae: An emerging public health threat. hLife 2025; 3: 501–503.

8. Impact of COVID-19-related nonpharmaceutical interventions on diarrheal diseases and zoonotic Salmonella

hLife | COVID-19相关非药物干预措施对急性腹泻和人畜共患沙门菌的影响

通信作者：乐敏

Huang L, Zhou H, Chen J, et al. Impact of COVID-19-related nonpharmaceutical interventions on diarrheal diseases and zoonotic Salmonella. hLife 2024; 2: 246–256.

9. Status and challenges of global antimicrobial resistance control: A dialogue between Professors Yonghong Xiao and Takeshi Nishijima

通信作者：肖永红

Xiao Y, Nishijima T. Status and challenges of global antimicrobial resistance control: A dialogue between Professors Yonghong Xiaoand Takeshi Nishijima. hLife 2024; 2: 47–49.