铜绿假单胞菌的耐药与异质性耐药研究进展

Research advance in drug resistance and heteroresistance of Pseudomonas aeruginosa

铜绿假单胞菌(Pseudomonas aeruginosa,PA)作为引起医院感染的常见条件致病菌,常引起免疫力低下及重症患者发生感染,致死率高。PA易发生变异,可对多种抗生素产生耐药,包括固有耐药、获得性耐药和适应性耐药,给临床工作带来了极大挑战。近年来,关于PA异质性耐药的报道也越来越多,异质性耐药是指在体外的药敏实验中,大部分细菌亚群对抗生素表现为敏感,而有一小部分亚群表现为耐药,甚至有极少数的亚群表现出高水平耐药的现象。不同于完全耐药,异质性耐药在临床上不易及时检出,因此会影响选择合适的抗生素实现成功治疗,导致临床应用抗生素的失效,这极大地增加了临床治疗的难度。因此,研究铜绿假单胞菌的耐药以及异质性耐药对于临床治疗细菌感染性疾病具有指导意义,本文就铜绿假单胞菌的耐药与异质性耐药研究的进展进行了综述。

As a common conditional pathogen causing nosocomial infection,Pseudomonas aeruginosa(PA)often causes low immunity and infection in severe patients with high mortality.PA is prone to mutation and can produce resistance to a variety of antibiotics,including inherent drug resistance,acquired drug resistance and adaptive drug resistance,which bring great challenges to clinical work.In recent years,there are more and more reports about heteroresistance of P.aeruginosa.Heteroresistance refers to that in the drug sensitivity test in vitro,most of the bacterial subgroups are sensitive to antibiotics,while a small number of subgroups are drug resistant,and even a few subgroups show high level of drug resistance.Unlike complete drug resistance,heteroresistance is not easy to be detected in time in clinic,and so it will affect the selection of appropriate antibiotics to achieve successful treatment,resulting in the failure of clinical application of antibiotics,which greatly increases the difficulty of clinical treatment.Therefore,the study on resistance and heteroresistance of P.aeruginosa is of guiding significance for the clinical treatment of bacterial infectious diseases.In this paper,the research advance in drug resistance and heteroresistance of P.aeruginosa were reviewed.