肺炎克雷伯菌对多黏菌素的耐药机制研究进展  

Progress in resistance mechanism of Klebsiella pneumoniae to polymyxin

作　　者：徐特 钱妍[1] 李頔[1] XU Te;QIAN Yan;LI Di(Dept.of Pharmacy,the Second Affiliated Hospital of Chongqing Medical University,Chongqing 400010,China)

机构地区：[1]重庆医科大学附属第二医院药学部,重庆400010

出　　处：《中国药房》2022年第17期2172-2176,共5页China Pharmacy

基　　金：重庆市科卫联合医学科研项目(No.2022GDRC003)。

摘　　要：随着抗生素的大量使用,肺炎克雷伯菌呈现出多药耐药性趋势,尤其是耐碳青霉烯类肺炎克雷伯菌的出现,意味着可用于治疗肺炎克雷伯菌感染的抗生素越来越少。多黏菌素以其独特的抗菌机制已成为治疗耐碳青霉烯类肺炎克雷伯菌感染的最后一道防线,但随着其使用增加,国内外肺炎克雷伯菌耐药株的报道也呈上升趋势,严重危害着患者的生命安全。笔者就肺炎克雷伯菌对多黏菌素的耐药机制进行总结,发现肺炎克雷伯菌对多黏菌素的耐药机制主要包括细菌外膜脂多糖的结构修饰、荚膜多糖的过表达、多药外排泵的过表达等,可为该药的合理使用及耐药肺炎克雷伯菌的防治提供依据。With the massive use of antibiotics, Klebsiella pneumoniae has shown a trend of multiple drug resistance,especially carbapenem-resistant K. pneumoniae,which means that fewer and fewer antibiotics can be used to treat K. pneumoniae infection. Polymyxin has become the last line of defense for the treatment of carbapenem-resistant K. pneumoniae infection due to its unique antibacterial mechanism. However,with the increase of its use,the reports of drug-resistant K. pneumoniae strains at home and abroad are also on the rise,seriously endangering the lives of patients. The author summarizes the resistance mechanism of K. pneumoniae to polymyxin,and find that the resistance mechanism of K. pneumoniae to polymyxin mainly includes the structural modification of lipopolysaccharide in bacterial outer membrane,the overexpression of capsular polysaccharide and the overexpression of multidrug efflux pump,which can provide a basis for the rational use of the drug and the prevention and treatment of drug-resistant K. pneumoniae.

关 键 词：肺炎克雷伯菌 多黏菌素 耐药性 耐药机制 

分 类 号：R965[医药卫生—药理学] R978.1[医药卫生—药学]