耐碳青霉烯类肠杆菌科细菌致病机制的研究进展

Research Progress on the Pathogenic Mechanisms of Carbapenem-Resistant Enterobacteriaceae

摘要: 肠杆菌科细菌(Enterobacteriaceae)分布范围广，可在活体或环境中大量寄生，是一群与人类关系密切的革兰阴性无芽孢杆菌，为临床最常见的机会性致病菌，会引起呼吸道感染、胆囊炎、腹膜炎及肺炎等重型疾病。β-内酰胺类药物中的碳青霉烯类，一直以来是治疗这些感染最有效的方案，其广泛使用已促进抗药细菌的产生，被越来越多地确定为与人类健康相关的感染原因。碳青霉烯酶作为代表高传递性耐药的决定因素，导致碳青霉烯和大多数其他种类的抗生素失效，耐碳青霉烯类肠杆菌科细菌(Carbapenem-resistant Enterobacteriaceae, CRE)感染者死亡风险大大提升，因此探究CRE分子机制具有重要现实意义。本文对近年来CRE的毒力因子、耐药及传播机制加以综述，旨在为临床防控和医治提供更深入的基础。

Abstract: Parasitizing in large numbers in living organisms or in the environment with a wide distribution range, Enterobacteriaceae bacteria are groups of Gram-Negative non-bacillus that are closely related to human beings. As the most common clinical opportunistic pathogens, severe diseases such as respiratory infections, cholecystitis, peritonitis, and pneumonia are caused. The carbapenems in β-lactam drugs have always been the most effective treatment for these infections. However, with the wide use of carbapenem antibiotics around the world, resistance to carbepenems among Enterobacteriaceae bacteria is gradually acquired as well as corresponding reports about the resistance, which are increasingly being identified as a cause of human health-related infections. Carbapenase, as a representative determinant of drug resistance with high transmistivity, leads to the failure of carbapenem and most other types of antibiotics. The risk of death for people infected with Carbapenem-resistance Enterobacteriaceae (CRE) is greatly increased. Therefore, it is of great practical significance to explore the molecular mechanism of CRE. In this paper, the virulence factors, drug resistance and transmission mechanism of CRE in recent years are reviewed, aiming to provide a more in-depth basis for clinical prevention, control and treatment.