铜绿假单胞菌对碳青霉烯类抗生素耐药机制研究进展

Research progress of carbapenem resistance mechanisms in Pseudomonas aeruginosa

铜绿假单胞菌(Pseudomonas aeruginosa,PA)是引起医院感染的重要条件致病菌之一。目前,碳青霉烯类是临床上治疗PA感染的最佳选择。然而,临床上对该类药物滥用现象较严重,造成PA对碳青霉烯类抗生素的耐药率迅猛上升。目前国内外对该类抗生素耐药机制的研究非常迫切。PA对碳青霉烯类的耐药机制主要包括:外膜蛋白表达降低;外排泵的过表达;β-内酰胺酶的水解作用(金属β-内酰胺酶和头孢菌素酶);青霉素结合蛋白靶位点的改变以及生物被膜的形成。本文从这五个方面分别阐述铜绿假单胞菌对碳青霉烯类的耐药机制。

P. aeruginosa is one of the main opportunistic pathogens causing nosocomial infections in clinic. Carbapenems are currently the best choice of antibiotics for P. aeruginosa infections. However, carbapenem resistance is increasing because of their serious abuse, and the research of mechanism for carbapenem resistance in P. aeruginosa is extremely urgent. Carbapenem resistance mechanisms has included： decrease in the expression of outer membrane porins; efflux pump overexpression; hydrolysis of β-lactamase（metallon β-lactamase and cephalosporinase）; alteration of penicillin-binding proteins; formation of biofilms. In this paper, the mechanisms of resistance are briefly reviewed from the five asoects resoectivelv.