碳青霉烯类抗生素耐药机制的研究进展

Research progress of resistance mechanisms of carbapenem antibiotics

碳青霉烯类抗生素是目前临床上抗菌谱最广、抗菌活性最强的非典型β-内酰胺类抗生素,然而随着碳青霉烯类药物在临床上的广泛应用,细菌对其耐药性不断增加,给临床抗感染治疗带来了新的挑战。为延缓其耐药现象的发展,本文从产生碳青霉烯酶、结合位点改变、外膜孔蛋白缺失或减少、主动外排泵过度表达、细菌生物膜系统等5个方面介绍了碳青霉烯类抗生素的耐药机制,为进行新的药物设计与开发提供依据,同时为临床医师谨慎、合理地应用碳青霉烯类药物提供参考。

Carbapenems are a class of β-1actam antibiotics with a broad spectrum and the strongest of antibacterial activity in currently clinic.However,with the wide-spread use of carbapenems in the clinical, the bacterial resistance to antibiotics is increasing,which has brought new challenges to the clinical treatment of infection.To delay the develop- ment of drug resistance,this text researched five aspects about the mechanisms of carbapenem resistant,which are as fol- lows： the production of carbapenemases,altered binding site,the loss or reduce of outer membrane protein,overexpression of efflux pump system,bacterial biofilm system in this article.To can provide the basis for the design and development of new drugs,and provide reference for the clinicians to use the drug carefully and reasonably.