肠杆菌科细菌中OXA-48-like碳青霉烯酶特征及检测方法研究进展  

Research progress in the characterization and detection methods of OXA-48-like carbapenemase in Enterobacteriaceae

作　　者：黄平平 袁军 Huang Pingping;Yuan Jun(School of Clinical Laboratory Science,Guizhou Medical University,Guiyang 550004,China;Department of Clinical Laboratory,Liupanshui City People′s Hospital,Liupangshui 553000,China;Department of Clinical Laboratory,Jinyang Hospital Affiliated to Guizhou Medical University,Guiyang 550023,China)

机构地区：[1]贵州医科大学检验学院,贵阳550004 [2]六盘水市人民医院检验科,六盘水553000 [3]贵州医科大学附属医院金阳医院检验科,贵阳550023

出　　处：《中华微生物学和免疫学杂志》2024年第11期999-1004,共6页Chinese Journal of Microbiology and Immunology

摘　　要：耐碳青霉烯类肠杆菌科细菌被称为"超级细菌",是全球性的公共卫生问题。其最重要的耐药机制就是产碳青霉烯酶,编码碳青霉烯酶的基因可随质粒传播,是造成医院感染和耐药性蔓延的主要原因。虽然A类酶一直以来都被认为是最重要的碳青霉烯酶,但OXA-48-like碳青霉烯酶的隐匿性传播同样是不容忽视的威胁。OXA-48-like碳青霉烯酶家族成员构成复杂,对β-内酰胺类药物水解活性多变,并且对碳青霉烯类水解活性普遍较弱,在检测中易出现漏检,给临床诊疗以及医院感染防控带来巨大挑战。本文将从OXA-48-like碳青霉烯酶家族组成、流行病学特征、水解活性和晶体结构、传播方式及检测方法5个方面进行阐述。Carbapenem-resistant enterobacteriaceae(CRE),also known as"super bacteria",has been emerging for several years as a major public-health concern worldwide.The production of carbapenemases is the most crucial resistance mechanism in CRE.The genes encoding carbapenemases can be transmitted by via plasmids,representing a primary cause of nosocomial infections and the widespread proliferation of antibiotic resistance.Carbapenemases,particularly the class Aβ-lactamases,have long been considered the most crucial resistance mechanism.However,the stealthy dissemination of OXA-48-like carbapenemases presents a more significant threat.OXA-48-like carbapenemases family members have complex composition,with variable hydrolytic activities againstβ-lactam drugs.They generally demonstrate weaker hydrolytic activity against carbapenems,leading to challenges in detection,which pose significant obstacles in clinical diagnosis,treatment,infection control.Therefore,this review focuses on the OXA-48-like carbapenemases family composition,epidemiology,hydrolytic activity,crystal structure,transmission mode and detection method.

关 键 词：耐碳青霉烯类肠杆菌科细菌 碳青霉烯酶 OXA-48-like 

分 类 号：R446.5[医药卫生—诊断学]