耐多黏菌素肺炎克雷伯菌的诊治进展  

Advances in the diagnosis and treatment strategy of polymyxin resistant Klebsiella pneumoniae

作　　者：陈彦欣 徐燕萍 朱迎钢[2] 瞿介明[1] Chen Yanxin;Xu Yanping;Zhu Yinggang;Qu Jieming(Department of Respiratory and Critical Care Medicine,Ruijin Hospital Affiliated to the Shanghai Jiao Tong University Medical School,Key Laboratory for Emergency Prevention,Control and Diagnosis of Respiratory Infectious Diseases,Shanghai 200025,China;Department of Respiratory and Critical Care Medicine,Huadong Hospital Affiliated to Fudan University,Shanghai 200040,China)

机构地区：[1]上海交通大学医学院附属瑞金医院呼吸与危重症医学科、呼吸传染病应急防控与诊治重点实验室,上海200025 [2]复旦大学附属华东医院呼吸与危重症医学科,上海200040

出　　处：《中华结核和呼吸杂志》2023年第8期813-818,共6页Chinese Journal of Tuberculosis and Respiratory Diseases

基　　金：国家重点研发项目(2018YFE0102400);上海市临床重点专科(shslczdzk02202);上海市重点实验室建设(20dz2261100)。

摘　　要：近年来,多耐药及泛耐药的肺炎克雷伯菌检出率日益上升,因此,多黏菌素作为对大多数多耐药菌株依然敏感的抗生素,获得了越来越多的关注。然而,多黏菌素的广泛使用可能会对肺炎克雷伯菌产生诱导作用,使其产生耐药性。同时,异质性耐药现象的出现也增加了临床上对耐多黏菌素肺炎克雷伯菌的防治难度。目前临床上除了依赖多黏菌素联合其他抗生素来治疗耐多黏菌素肺炎克雷伯菌感染之外,新型抗菌药物的研发也成为研究的热点。同时探索对多黏菌素耐药性的早期检出方法有助于优化和完善耐多黏菌素肺炎克雷伯菌的诊疗策略。本文综述了近年来有关耐多黏菌素肺炎克雷伯菌的流行现状、产生机制、检出方法及其防治措施。In recent years,the detection rate of multidrug-resistant and pandrug-resistant Klebsiella pneumoniae has increased year on year,so polymyxin has received increasing attention as an antibiotic that is still sensitive to most of the multidrug-resistant strains.However,widespread use of polymyxin is likely to lead to the emergence of polymyxin-resistantKlebsiella pneumoniae.At the same time,the polymyxin hetero-resistance has made clinical prevention and treatment difficult.In addition to relying on the combination of polymyxins with other antibiotics,the search for new antibacterial drugs has also become a research hotspot.Research into early detection methods for polymyxin resistance can also help to optimize and improve the diagnosis and treatment strategies.This article reviewed the epidemic status,mechanism,detection methods and prevention measures of polymyxin-resistant Klebsiella pneumoniae.

关 键 词：多黏菌素 防治难度 肺炎克雷伯菌 流行现状 防治措施 抗生素 耐药性 

分 类 号：R446.5[医药卫生—诊断学]