水解碳青霉烯类OXA型β-内酰胺酶的研究进展  

Advances in carbapenem-hydrolyzing OXA-typeβ-lactamases

作　　者：姜雪琪 李娟[1] JIANG Xue-qi;LI Juan(Bacterial Resistance Control Department,National Institute for Communicable Disease Control and Prevention,Chinese Center for Disease Control and Prevention,State Key Laboratory for Communicable Diseases Prevention and Control,Beijing 102206,China)

机构地区：[1]中国疾病预防控制中心传染病预防控制所细菌耐药控制室,传染病预防控制国家重点实验室,北京102206

出　　处：《中国感染控制杂志》2023年第9期1121-1128,共8页Chinese Journal of Infection Control

基　　金：国家自然科学基金项目(81861138053)。

摘　　要：苯唑西林酶(OXA酶)属于D类β-内酰胺酶,因其对苯唑西林具有较高的水解活性而得名。OXA型β-内酰胺酶定位于染色体或质粒,并由质粒、转座子等可移动元件介导其在菌株间的水平转移,现已衍生出一千余种变体。近年来,水解碳青霉烯类药物的OXA酶出现并在菌株间传播,给临床抗感染治疗带来巨大挑战。2001年土耳其从1株肺炎克雷伯菌中发现了OXA-48酶,这是在肠杆菌目菌株中第一次发现可水解碳青霉烯类药物的OXA酶。随后,又发现了OXA-48酶多种变体,统称为OXA-48-like酶,其不仅水解青霉素类药物能力强,还可以水解厄他培南、美罗培南等碳青霉烯类药物,介导对包括碳青霉烯类在内的多种β-内酰胺类药物耐药。希瓦氏菌被认为是blaOXA-48-like基因的起源,现已报道12个起源于希瓦氏菌的OXA-48-like。为全面掌握可水解碳青霉烯类OXA酶的特征和分布,本文就水解碳青霉烯类药物的OXA酶的来源、分布现状、流行特点及发展趋势进行综述。Oxacillinase(OXA)belongs to class Dβ-lactamase,named for its high hydrolytic activity on oxacillin.OXA-typeβ-lactamases locate on chromosomes or plasmids,and their horizontal transfer among strains is mediated by mobile elements such as plasmids and transposons.Over a thousand variants have been derived to date.In recent years,carbapenem-hydrolyzing OXA have emerged and spread among strains,posing a huge challenge to clinical anti-infection treatment.In 2001,OXA-48 was found in a strain of Klebsiella pneumoniae in Turkey,which was the firstly reported carbapenem-hydrolyzing OXA in Enterobacterales.Subsequently,various variants of OXA-48 enzyme were identified and nominated as OXA-48-like enzymes.These enzymes not only have strong hydrolytic activity against penicillin,but also hydrolyze carbapenems such as ertapenem and meropenem,mediating resistance to variousβ-lactam antimicrobial agents,including carbapenems.Shewanella spp.is considered to be the origin of the bla OXA-48-like gene,and 12 OXA-48-like genes derived from Shewanella spp.have been reported.In order to comprehensively understand the characteristics and distribution of carbapenem-hydrolyzing OXA enzymes,this article reviews the origin,distribution status,epidemiological characteristics,and development trends of carbapenem-hydrolyzing OXA.

关 键 词：OXA酶 碳青霉烯酶类药物 水平转移 希瓦氏菌 Β-内酰胺酶 

分 类 号：R363.14[医药卫生—病理学]