Relationship between biofilm formation and antibiotic resistance of Klebsiella pneumoniae and updates on antibiofilm therapeutic strategies

Abstract

Klebsiella pneumoniae is a Gram-negative bacterium within the Enterobacteriaceae family that can cause multiple systemic infections, such as respiratory, blood, liver abscesses and urinary systems. Antibiotic resistance is a global health threat and K. pneumoniae warrants special attention due to its resistance to most modern day antibiotics. Biofilm formation is a critical obstruction that enhances the antibiotic resistance of K. pneumoniae. However, knowledge on the molecular mechanisms of biofilm formation and its relation with antibiotic resistance in K. pneumoniae is limited. Understanding the molecular mechanisms of biofilm formation and its correlation with antibiotic resistance is crucial for providing insight for the design of new drugs to control and treat biofilm-related infections. In this review, we summarize recent advances in genes contributing to the biofilm formation of K. pneumoniae, new progress on the relationship between biofilm formation and antibiotic resistance, and new therapeutic strategies targeting biofilms. Finally, we discuss future research directions that target biofilm formation and antibiotic resistance of this priority pathogen.

Keywords: Klebsiella pneumoniae; antibiotic resistance; biofilm formation; regulation mechanisms; therapeutic strategies.

Figure 1

Stages of biofilm formation.

Figure 2

Genes involved in the regulation of K. pneumoniae biofilm formation.

Figure 3

Mechanisms contribute to biofilms related resistance in K. pneumoniae. Bacteria in the floating state can be killed by antibiotics (A), while bacteria in the biofilm state are more resistant to antibiotics (B).

Figure 4

Summary of novel approaches for the treatment of biofilm related infections.