铜绿假单胞菌对碳青霉烯类药物耐药机制的研究进展

Advances in the Mechanisms of Carbapenem Resistance among Pseudomonas aeruginosa

铜绿假单胞菌(PA)是临床上医院感染常见的条件致病菌。碳青霉烯类药物被认为是铜绿假单胞菌感染的最佳选择。然而,随着药物滥用导致耐碳青霉烯类铜绿假单胞菌的广泛流行,其治疗面临更大的挑战。流行病学研究表明,各地区铜绿假单胞菌对碳青霉烯类的耐药性呈现显著差异。结合近期研究成果,本文阐释了铜绿假单胞菌对碳青霉烯耐药的主要机制,包括碳青霉烯水解酶、通道蛋白的失活、外排泵的过表达。铜绿假单胞菌对碳青霉烯类耐药往往由多种机制介导,各耐药机制间还存在复杂的调控。

Pseudomonas aeruginosa is one of the main opportunistic pathogens causing nosocomial infections in clinical. Carbapenems are presently considered as the most potent agents for the treatment of Pseudomonas aeruginosa infections. However, with the prevalence of carbapenem resistance owing to serious abuse, the treatment of serious Pseudomonas aeruginosa infections becomes more challenging. Epidemiological studies revealed that the prevalence of carbapenem-resistant Pseudomonas aeruginosa differed significantly in different areas. This review has focused on those mechanisms that directly impact the future of carbapenem antibiotics, including the production of inactive enzymes, inactivation ofporin OprD and the overexpression ofRND efflux pumps. Carbapenem resistance in Pseudomonas aeruginosa often relates to interaction of multiple mechanisms.