CRhvKP的形成是持续进化以及携带碳青霉烯耐药基因或高毒力基因的质粒交换的结果。有三种机制解释了碳青霉烯耐药性和高毒力表型的同时进化：（1）碳青霉烯耐药基因可以通过质粒水平转移到高毒力肺炎克雷伯菌中；（2）含有高毒力编码基因的毒力质粒可以转移到耐碳青霉烯肺炎克雷伯菌中；（3）获得结合了碳青霉烯耐药性和高毒力特性的杂合质粒（图3）。

为解决肺炎链球菌（ Streptococcus pneumoniae ）相关社区获得性肺炎（CAP）在成人中仍高发，且其与鼻咽微生物组关系不明的问题，研究人员开展了对肺炎链球菌性 CAP 患者鼻咽微生物组的研究。结果发现患者感染后鼻咽微生物组有变化，存在独特细菌相互作用。这为呼吸道感染研究和治疗提供新方向。

综述最近四年来的研究文献，本文探讨了诸多生物标志物在儿童肺炎支原体感染中的作用，以及与之相关的临床预测模型。这一探索不仅为临床医生提供了新的思路，也为儿童肺炎支原体感染的诊断和治疗提供了多维度的评价工具。

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