2021 年第 9 期 第 16 卷

革兰阴性杆菌对碳青霉烯类抗菌药物的耐药机制及研究进展

Resistance mechanism and research progress of gram-negative bacilli to carbapenem antimicrobials

作者：孙磊1张敏敏1冀凯1张荻1丁艳娇1明颢2

英文作者：Sun Lei1 Zhang Minmin1 Ji Kai1 Zhang Di1 Ding Yanjiao1 Ming Hao2

单位：1山东省第二人民医院药学部，济南250022；2山东省第二人民医院麻醉科，济南250022

英文单位：1Department of Pharmacy Shandong Second Provincial General Hospital Jinan 250022 China; 2Department of Anesthesiology Shandong Second Provincial General Hospital Jinan 250022 China

关键词：革兰阴性杆菌；碳青霉烯类；耐药机制

英文关键词：Gram-negativebacilli;Carbapenems;Resistancemechanism 

• 摘要：

• 碳青霉烯类抗菌药物是一类抗菌谱广、抗菌活性强、不良反应少的β内酰胺类抗菌药物。但是近年来，由于多重耐药菌感染患者的增多和碳青霉烯类药物在临床上的过度使用，使得细菌对其耐药性呈现逐年上升的趋势。迄今为止，碳青霉烯类药物的耐药性问题已经成为世界性的难题，导致患者发病率和死亡率的增加。鉴于革兰阴性杆菌耐药形势严峻，本文在总结了耐药性较高的铜绿假单胞菌、肺炎克雷伯菌以及鲍曼不动杆菌等细菌耐药机制的基础上，重点介绍了革兰阴性杆菌对碳青霉烯类药物的耐药机制及最新的研究进展，从而为临床上科学合理的使用碳青霉烯药物治疗细菌感染性疾病提供一定的理论基础，并对临床合理用药起到一定的促进作用。

• Carbapenem antimicrobials are a kind of β-lactam antibiotics with a broad antibacterial spectrum, strong antibacterial activity, and fewer adverse reactions. But in recent years, with the increase of patients infected by multi-drug-resistant bacteria and the abuse of carbapenem drugs in clinical, the resistance of bacteria to carbapenem drugs shows an upward trend year by year. To date, the resistance of carbapenem drugs becomes a worldwide problem, leading to morbidity and mortality increase of patients. Therefore, in the context of severe drug resistance of gram-negative bacilli, this article summarizes the drug resistance mechanisms of bacteria with high drug resistance, such as Pseudomonas aeruginosa, Klebsiella pneumoniae, and Acinetobacter baumannii. On this basis, we focus on elaborate the resistance mechanism of gram-negative bacilli to carbapenems and the latest research progress, thereby provide a certain theoretical basis for the scientific and rational use of carbapenems in the treatment of bacterial infectious diseases and effectively promote clinical rational drug use.