Yiying Ke,1,2 Zhangrui Zeng,2– 4 Jinbo Liu,2– 4 Caihong Ye2– 4 

1Department of Clinical Medicine, Southwest Medical University, Luzhou, People’s Republic of China; 2Department of Laboratory Medicine, The Affiliated Hospital of Southwest Medical University, Luzhou, 646000, People’s Republic of China; 3Sichuan Province Engineering Technology Research Center of Molecular Diagnosis of Clinical Diseases, Luzhou, 646000, People’s Republic of China; 4Molecular Diagnosis of Clinical Diseases Key Laboratory of Luzhou, Luzhou, 646000, People’s Republic of China

Correspondence: Caihong Ye, The Affiliated Hospital of Southwest Medical University, Luzhou, 646000, People’s Republic of China, Tel +86-18281192017, Email yecaihong1997@swmu.edu.cn

Abstract: Klebsiella pneumoniae is a common cause of antimicrobial-resistant opportunistic infections in hospitalized patients. Hypervirulent Klebsiella pneumoniae (hvKP) acquiring exogenous resistance-encoding and hypervirulence-encoding genetic elements tend to develop both high virulence and resistance. The management of hvKP has also been made more difficult. Capsular polysaccharide (CPS) is the most important virulent factor of hvKP. The high degree of heterogeneity of the CPS and its hindering function adds difficulties in finding a general therapeutic approach. Thus, it is imperative to develop effective ways to target the CPS. The development of CPS-targeting phage treatment has spurred scientific interest. CPS relative vaccines show great potential as therapeutic alternatives to the currently ineffective antibiotics. To find out new ideas for clinical practice, we reviewed the molecular pathogenesis of K. pneumoniae, discussed the biological functions and regulatory factors of CPS. We studied the roles of CPS in virulence, drug resistance, and treatment of K. pneumoniae, and preliminarily investigated the viability of CPS as a target for prevention and therapy of K. pneumoniae infection.

Keywords: capsular polysaccharide, hypervirulent, Klebsiella pneumoniae, drug-resistance, bacteriophages