[碳青霉烯耐药肠杆菌科(CRE):对公众的威胁及其耐药性机制]。

The Japanese journal of antibiotics Pub Date : 2016-04-01
Ryuichi Nakano
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引用次数: 0

摘要

耐碳青霉烯肠杆菌科(CRE)的传播对公众健康构成了相当大的威胁。由CRE引起的感染治疗选择有限,且与高死亡率相关。这种抗性主要是碳青霉烯酶基因获得的结果。不同地理区域的基因型最初存在差异,日本疫情与IMP型(B类)相关,而美国疫情与KPC型(A类)相关。由于每种基因型都有特定的筛选方法,因此临床检测碳青霉烯酶产生者仍然存在困难。碳青霉烯酶存在的问题是:一些碳青霉烯酶产生体对碳青霉烯酶敏感,一些碳青霉烯酶产生体不产生碳青霉烯酶,这与孔蛋白丢失或外排异常有关。本文综述了CRE的现状。它将有助于准确检测CRE并找到预防和治疗方法。
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[Carbapenem-resistant Enterobacteriaceae (CRE): a menace to the public and the mechanisms of antimicrobial resistance].

Dissemination of carbapenem-resistant Enterobacteriaceae (CRE) poses a considerable threat to public health. Infections caused by CRE have limited treatment options and have been associated with high mortality rates. This resistance is largely the consequence of acquisition of carbapenemase genes. The genotypes in the geographical areas were initially different, as the Japanese epidemic was related to the IMP type (Class B), whereas the US epidemic was related to the KPC type (Class A). Thus, clinical detection of carbapenemase producers remains difficult based on each genotypes has specific screening method. CRE has many problems: some carbapenemase producers were susceptible to the carbapenems and some CRE were not producing carbapenemase which is associated with porin loss or efflux pomp. This review describes the current situation of CRE. It would facilitate accurate detection of CRE and approaches to prevention and treatment.

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