耐碳青霉烯类肠杆菌血流感染研究进展

Research progress of carbapenem-resistant Enterobacteriaceae bloodstream infection

耐碳青霉烯类肠杆菌(carbapenem-resistant Enterobacteriaceae,CRE)感染情况日益严重,其血流感染死亡率高,常出现多种抗生素耐药,原因在于多个耐药机制作用,实验室检测在其治疗中发挥较大作用,抗感染治疗与非耐药类细菌感染相比疗效差,治疗方案各有不同且争议颇多。产碳青霉烯酶是临床常见的耐药机制之一,也是最主要的,可以通过实验室检测出具体产酶类型,以便临床医师了解状况,高效应用抗菌药物。参考国内外耐碳青霉烯类肠杆菌血流感染(carbapenem-resistant Enterobacteriaceae bloodstream infection,CRE-BSI)的最新研究进展,本文就它的耐药机制、实验室检测、治疗方面做一综述,以期更好指导临床合理规范用药,优化现有治疗方案。

Infection with carbapenem-resistant Enterobacteriaceae(CRE) is becoming increasingly serious with a high mortality rate in bloodstream infections.Multiple antibiotic resistance is common due to the action of multiple resistance mechanisms.Laboratory tests play an important role in treatment.The efficacy of anti-infection treatment is poor compared with non-drug-resistant bacterial infections,and treatment regimens are variable and controversial.Carbapenemase production is one of the most common mechanisms of drug resistance in clinical practice,and it is also the most important.Certain types of enzyme production can be detected in the laboratory,allowing clinicians to understand the status and effectively use antibacterial drugs.Referring to the recent research progress in carbapenem-resistant Enterobacteriaceae bloodstream infections(CRE-BSI) at home and abroad,this paper examines the resistance mechanism,laboratory investigation and treatment to better guide clinical rational and standardized drug use and optimize the existing treatment plan.