耐碳青霉烯类肺炎克雷伯菌对多黏菌素耐药性的研究进展  

Research progress in mechanisms of polymyxin resistance in carbapenem-resistanct Klebsiella pneumoniae

作　　者：张鑫迪(综述) 牛敏(审校)[1] 杜艳(审校)[1] ZHANG Xin-di;NIU Min;DU Yan(Department of Clinical Laboratory,the First Affiliated Hospital of Kunming Medical University,Yunnan Key Laboratory of Laboratory Medicine,Yunnan Innovation Team of Clinical Laboratory and Diagnosis,First Affiliated Hospital of Kunming Medical University,Kunming 650032,Yunnan Province,China)

机构地区：[1]昆明医科大学第一附属医院医学检验科云南省检验医学重点实验室昆明医科大学第一附属医院临床检验诊断省创新团队,云南昆明650032

出　　处：《微生物学免疫学进展》2022年第1期98-102,共5页Progress In Microbiology and Immunology

基　　金：云南省科技厅应用基础研究联合专项(202001AY070001-037)。

摘　　要：多黏菌素是目前临床治疗耐碳青霉烯类肺炎克雷伯菌(carbapenem-resistant Klebsiella pneumoniae,CRKP)感染为数不多的抗生素。近年来,对多黏菌素耐药的CRKP显著增加,为临床抗感染治疗带来前所未有的挑战。目前,CRKP对多黏菌素耐药的可能机制主要包括表达质粒介导的mcr基因、激活双组分调节系统等。现就CRKP的流行现状、多黏菌素的作用特点、CRKP对多黏菌素耐药机制和临床治疗等作一概述,旨在探讨CRKP对多黏菌素的耐药进展,有效指导临床合理用药。Polymyxin is currently one of the few antibacterial drugs for the clinical treatment of carbapenem-resistant Klebsiella pneumoniae(CRKP)infections.In recent years,polymyxin-resistant CRKP has increased obviously,which undoubtedly brings unprecedented challenges to clinical anti-infective treatment.At present,the possible mechanisms of CRKP resistance to polymyxin mainly include expression of plasmid-mediated mcr gene and activation of two-component regulatory system.This article reviews the prevalence of CRKP,action characteristics of polymyxin,mechanisms of polymyxin resistance in CRKP and clinical treatment of CRKP,aiming to explore the progress of CRKP resistance to polymyxin and effectively guide the clinical rational drug use.

关 键 词：耐碳青霉烯类肺炎克雷伯菌 多黏菌素 耐药机制 

分 类 号：R446.5[医药卫生—诊断学]