革兰阴性菌对头孢地尔耐药机制的研究进展

Advances in the resistance mechanisms to cefiderocol in Gram-negative bacteria

头孢地尔是一种新型头孢菌素,体外抗菌活性高,在临床疗效和安全性上均有不错表现,对临床常见的碳青霉烯酶稳定,可模拟铁载体进入细菌周质间隙,因此几乎不受膜孔蛋白和外排泵的影响,但也促使细菌进化出各式各样的耐药机制。本文梳理了常见革兰阴性菌对头孢地尔的耐药机制,归纳总结各类细菌的耐药特点,深入探讨头孢地尔耐药的各方面因素,以期为临床应用和相关研究提供参考。

Cefiderocol is a novel cephalosporin with high antibacterial activity in vitro and good performance in clinical efficacy and safety.It is stable for common carbapenemase and can simulate siderophore entering the bacterial periplasmic space,which is almost unaffected by porin proteins and efflux pumps.However,this unique mechanism has also led to the evolution of various resistance mechanisms among bacteria.This review sorted out the resistance mechanisms of common Gram-negative bacteria against cefiderocol,summarized the characteristics of antibiotic resistance in different bacteria,and in-depth analyzed multiple elements of resistance to cefiderocol in hopes of providing a reference for its clinical application and related research.