拟杆菌对碳青霉烯类抗菌药物耐药性及耐药机制研究进展

Research Progress in Bacteroides Resistance to Carbapenems and Their Resistance Mechanism

拟杆菌是引起机会性内源性感染的重要病原体,碳青霉烯类抗菌药物是目前治疗拟杆菌感染的重要抗菌药物之一,近年来,拟杆菌对碳青霉烯类抗菌药物的耐药情况愈加严峻,在不同地区、不同人群间存在显著差异。耐碳青霉烯类拟杆菌可以通过cfiA基因介导碳青霉烯酶的生成、青霉素结合蛋白的构象改变、外膜蛋白和脂多糖的构成改变、外膜孔蛋白数量的减少或缺失及内源性外排系统突变及过度表达等导致碳青霉烯的耐药。了解耐碳青霉烯类拟杆菌的耐药性及耐药机制,对于防控耐药基因的广泛传播、指导临床用药等方面有重要价值。

Bacteroides is an important pathogen that causes opportunistic endogenous infections, and carbapenems are one of the important antibacterial drugs for the treatment of bacteroides infection. In recent years, the resistance of bacteroides to carbapenems has become increasingly severe, and there are significant differences between different regions and different populations. Carbapenem-resistant Bacteroides can induce carbapenase resistance through cfiA gene mediated generation of carbapenase, conformational change of penicillin-binding protein, composition change of outer membrane protein and lipopolysaccharide, reduction or loss of outer membrane porin, mutation and overexpression of endogenous efflux system, etc. Understanding the drug resistance and mechanism of carbapenem-resistant Bacteroides is of great value for preventing and controlling the widespread spread of drug resistance genes and guiding clinical drug use.