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《工程(英文)》 >> 2022年 第11卷 第4期 doi: 10.1016/j.eng.2020.11.004

头孢他啶-阿维巴坦耐药革兰氏阴性菌的流行病学特征及耐药机制

a Shenzhen Institute of Respiratory Diseases, Shenzhen People’s Hospital & 2nd Clinical Medical College of Jinan University & 1st Affiliated Hospital of Southern University of Science and Technology, Shenzhen 518020, China
b State Key Laboratory for Diagnosis and Treatment of Infectious Diseases, Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, The First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou 310003, China

收稿日期: 2020-07-09 修回日期: 2020-11-03 录用日期: 2020-11-09 发布日期: 2021-01-21

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摘要

细菌的碳青霉烯耐药性是全球公共健康面临的一个重大挑战,由碳青霉烯耐药菌(CRO)引起的临床感染通常有很高的发病率和死亡率。头孢他啶-阿维巴坦(CAZ-AVI)是一种新型头孢菌素/β-内酰胺酶抑制剂,为临床治疗CRO感染提供了一项重要选择。据报道,CAZ-AVI 能够抑制Ambler A类、C类以及部分D类酶的活性。然而,这种药物在临床使用后不久,细菌的耐药性就已经出现,并且呈上升趋势。了解细菌对CAZ-AVI 的耐药机制,对于指导开发新型治疗方法、帮助预测潜在的耐药机制至关重要。本文旨在系统总结CAZ-AVI 耐药菌株的流行病学发展过程和最近发现的CAZ-AVI 耐药机制;将重点关注β-内酰胺酶突变体的产生、β-内酰胺酶高表达、细胞表面通透性降低以及药物外排泵的过表达。短时间内多种CAZ-AVI耐药机制的产生,强调了临床合理用药的重要性以及监测CAZ-AVI 耐药性病原体的必要性。

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