肠杆菌科细菌是医院感染的重要病原菌,分离率高。碳青霉烯类抗生素对绝大多数β-内酰胺酶稳定,抗菌谱广,抗菌活性强。然而随着碳青霉烯类抗生素的大量使用,全球许多地区出现了碳青霉烯类耐药的肠杆菌科细菌报道,本文就其流行病学现状、耐药机制及检测方法作一综述。
Citation: 刘雅,康梅. 临床分离的耐碳青霉烯类肠杆菌科细菌的研究进展. West China Medical Journal, 2013, 28(4): 631-636. doi: 10.7507/1002-0179.20130199 Copy
1. | 洪秀华, 刘运德, 李向阳, 等. 临床微生物学检验[M]. 北京: 中国医药科技出版社, 2010: 304-306. |
2. | Birgy A, Bidet P, Genel N, et al. Phenotypic screening of carbapenemases and associated β-lactamases in carbapenem-resistant enterobacteriacease[J]. J Olin Microbiol, 2012, 59(4): 1295-1302. |
3. | Naas T, Vandel L, Sougakoff W, et al. Cloning and sequence analysis of the gene for a carbapenem-hydrolyzing class A beta-lactamase, Sme-1, from Serratia marcescens S6[J]. Antimicrob Agents Chemother, 1994, 38(6): 1262-1270. |
4. | Queenan AM, Torres-Viera C, Howard S. Gold, et al. SME-type carbapenem-hydrolyzing class A beta-lactamases from geographically diverse Serratia marcescens strains[J]. Antimicrob Agents Chemother, 2000, 44(11): 3035-3039. |
5. | Yang Y, Wu P, Livermore D. Biochemical characterization of a beta-lactamase that hydrolyzes penems and carbapenems from two Serratia marcescens isolates[J]. Antimicrob Agents Chemotherapy, 1990, 34: 755-758. |
6. | Borgia S, Lastovetska O, Richardson D, et al. Outbreak of carbapenem-resistant enterobacteriaceae containing blaNDM-1, Ontario, Canada[J]. Clin Infect Dis, 2012, 55(11): 109-117. |
7. | Adlera A, Carmelia BY. Dissemination of the Klebsiella pneumonia carbapenemase in the health care settings: tracking the trails of an elusive offender[J]. mBio, 2011, 2(6): 280-291. |
8. | Curcio DJ. Antibiotic prescription in intensive care units in Latin America[J]. Revista Argentina de Microbiología, 2011, 43: 203-211. |
9. | Pfeifer Y, Schlatterer K, Engelmann E, et al. Emergence of OXA-48-type carbapenemase-producing Enterobacteriaceae in German hospitals[J]. Antimicrob Agents Chemother, 2012, 56(4): 2125-2128. |
10. | Agodi A, Voulgari E, Barchitta M, et al. Containment of an outbreak of KPC-3-producing klebsiella pneumoniae in Italy[J]. J Clin Microbiol, 2011, 49(11): 3986-3989. |
11. | Leverstein-van Hall MA, Stuart JC, Voets GM, et al. Carbapenem-resistant Klebsiella pneumoniae following foreign travel[J]. Ned Tijdschr Geneeskd, 2010, 154(37): 1736. |
12. | Us E, Tekeli A, Arikan AO, et al. Molecular epidemiology of carbapenem-resistant Klebsiella pneumoniae strains isolated between 2004-2007 in Ankara University hospital, Turkey[J]. Mikrobiyol Bul, 2010, 44(1): 1-10. |
13. | Shen P, Wei ZQ, Jiang Y, et al. Novel genetic environment of the carbapenem-hydrolyzing β-lactamase KPC-2 among enterobacteriaceae in China[J],Antimicrob Agents Chemotherapy, 2009 , 53(10): 4333-4338. |
14. | Roh KH, Lee CK, Sohn JW, et al. Isolation of a Klebsiella pneumoniae isolate of sequence type 258 producing KPC-2 carbapenemase in Korea[J]. Korean J Lab Med, 2011, 31(4): 298-301. |
15. | Saidani M, Hammami S, Kammoun A, et al. Emergence of carbapenem resistant Enterobacteriaceae producing OXA-48 carbapenemase in Tunisia[J]. J Med Microbiol, 2012, 61(12): 1746-1749. |
16. | Datta P, Gupta V, Garg S, et al. Phenotypic method for differentiation of carbapenemases in enterobacteriaceae: study from north India[J]. Indian J Pathol Microbiol, 2012, 55(3): 357-360. |
17. | Arpin C, Noury P, Boraud D, et al. NDM-1-producing Klebsiella pneumoniae resistant to colistin in a French community patient without history of foreign travel[J]. Antimicrob Agents Chemother, 2012, 56(6): 3432-3434. |
18. | Gaynes RP, Culver DH. Resistance to imipenem among selected gram-negative bacilli in the United States[J]. Infect Control Hosp Epidemiol, 1992, 13(1): 10-14. |
19. | Rhomberg PR, Jones RN, et al. Summary trends for the meropenem yearly susceptibility test information collection program: a 10-year experience in the United States(1999-2008)[J]. Diagn Microbiol Infect Dis , 2009, 65(4): 414-426. |
20. | Hidron AI, Edwards JR, Patel J, et al. NHSN annualupdate: antimicrobial-resistant pathogens associated with ealthcare-associated infections: annual summary of data reported to the National Healthcare Safety Network at the Centers for Disease Control and Prevention[J]. Infect Con Hosp Epidemio, 2008, 29(11): 996-1011. |
21. | 肖永红, 王进, 赵彩云, 等. 2006-2007年Mohnarin细菌耐药监测[J]. 中华医院感染学杂志, 2008, 18(8): 1051-1056. |
22. | 李丽, 田磊, 陈中举, 等. 卫生部全国细菌耐药监测网2010年中南地区细菌耐药性监测[J]. 中国临床药理学杂志, 2011, 27(12): 940-947. |
23. | 徐修礼, 周珊.卫生部全国细菌耐药监测网2010年西北地区细菌耐药性监测[J]. 中国临床药理学杂志, 2011, 27(12): 925-931. |
24. | 张智洁, 王军. 卫生部全国细菌耐药监测网2010年东北地区细菌耐药性监测[J]. 中国临床药理学杂志, 2011, 27(12): 948-975. |
25. | 马序竹, 郑波.卫生部全国细菌耐药监测网2010年北京地区细菌耐药性监测[J]. 中国临床药理学杂志, 2011, 27(12): 919-924. |
26. | 肖书念, 卓超, 钟南山. 卫生部全国细菌耐药监测网2010年广东地区细菌耐药性监测[J].中国临床药理学杂志, 2011, 27(12): 965-971. |
27. | 张纬博, 孙景勇, 倪语星. 卫生部全国细菌耐药监测网2010年华东地区细菌耐药性监测[J].中国临床药理学杂志, 2011, 27(12): 959-964. |
28. | 杨央, 吕火祥, 胡庆丰, 等. 1456株连续分离的肺炎克雷伯菌临床分布及耐药性分析[J].中国卫生检验杂志, 2010, 20(9): 2232-2234. |
29. | 蔡佳昌. 肠杆菌科细菌对碳青霉烯类抗生素耐药机制研究[D]. 浙江:浙江大学博士学位论文. 2010. |
30. | Yigit H, Queenan AM, Anderson GJ, et al. Novel carbapenem-hydrolyzing β-Lactamase, KPC-1, from a carbapenem-resistant strain of Klebsiella pneumoniae[J]. Antimicrob Agents Chemotherapy, 2001, 45(4): 1151-1161. |
31. | Miriagou V, Tzouvelekis LS, Rossiter S, et al. Imipenem resistance in a salmonella clinical strain due to plasmid-mediated class a carbapenemase KPC-2[J]. Antimicrob Agents Chemotherapy, 2003, 47(4): 1297-300. |
32. | Bratu S, Landman D, Alam M, et al. Detection of KPC carbapenem-hydrolyzing enzymes in enterobacterspp. from Brooklyn, New York[J]. Antimicrob Agents Chemother , 2004, 48(12): 4793-4799. |
33. | Woodford N, Tierno PM, Young JrK, et al. Outbreak of klebsiella pneumoniae producing a new carbapenem-hydrolyzing Class A-Lactamase, KPC-3, in a New York Medical Center[J]. Antimicrob Agents Chemother, 2005, 49(2): 776-778. |
34. | Landman D, Babu E, Patel JB, et al. Transmission of carbapenem-resistant pathogens in New York City hospitals: progress and frustrationm[J]. Antimicrob Chemother, 2012, 67(6): 1427-1431. |
35. | Landman D, Bratu S, Kochar S, et al. Evolution of antimicrobial resistance among Pseudomonas aeruginosa, Acinetobacter baumannii and Klebsiella pneumoniae in Brooklyn, NY[J]. J Antimicro Chemother, 2007, 60(1): 78-82. |
36. | Gupta N, Limbago BM, Patel JB, et al. Carbapenem-resistant enterobacteriaceae: epidemiology and prevention[J]. Clin Infect Dis, 2011, 53(1): 60-67. |
37. | Mathers AJ, Cox HL, Kitchel B, et al. Molecular dissection of an outbreak of carbapenem-resistant enterobacteriaceae reveals intergenus kpc carbapenemase transmission through a promiscuous plasmid[J]. mBio, 2011, 2(6): 204-211 . |
38. | Osano E, Arakawa Y, Wacharotayankun R, et al. Molecular characterization of an enterobacterial metallo beta-lactamase found in a clinical isolate of Serratia marcescens that shows imipenem resistance[J]. Antimicrob Agents Chemother, 1994, 38(1): 71-78. |
39. | Miriagou V, Tzelepi E, Gianneli D, et al. Escherichia coli with a self-transferable, multiresistant plasmid coding for metallo-β-Lactamase VIM-1[J]. Antimicrob Agents Chemother, 2003, 47(1): 395-397. |
40. | Yong D, Toleman MA, Giske CG, et al. Characterization of a new metallo-beta-lactamase gene, bla(NDM-1), and a novel erythromycin esterase gene carried on a unique genetic structure in Klebsiella pneumoniae sequence type 14 from India[J]. Antimicrob Agents Chemother, 2009 , 53(12): 5046-54. |
41. | Deshpande LM, Mendes RE, Castanheira M, et al. Dissemination of NDM-1-producing enterobacteriaceae in India [abstract C2-701]. 50th Interscience Conference on Antimicrobial Agents and Chemotherapy[M]. Boston: American Society for Microbiology, 2010. |
42. | Poirel L, Héritier C, Tolün V, et al. Emergence of oxacillinase-mediated resistance to imipenem in Klebsiella pneumoniae[J]. Antimicrob Agents Chemother J, 2004, 48(1) : 15-22 . |
43. | Cre´ met L, Bourigault CL, Lepelletier D, et al. Nosocomial outbreak of carbapenem-resistant Enterobacter cloacae highlighting the interspecies transferability of the blaOXA-48 gene in the gut flora [J]. Antimicrob Chemother, 2012, 67 (4): 1041-1043. |
44. | 李俐, 蒋燕群.大肠埃希菌和肺炎克雷伯菌外膜蛋白与耐药机制的研究进展[J]. 上海交通大学学报·医学版, 2010, 30(11): 1433-1436. |
45. | Sureda LG, Dome´nech-Sa´nchez A, Barbier M, et al. OmpK26, a novel porin associated with carbapenem resistance in Klebsiella pneumoniae[J]. Antimicrob Agents Chemother, 2011, 55(10) : 4742-4747. |
46. | Neuwirth C, Siébor E, Duez JM, et al. Imipenem resistance in clinical isolates of Proteus mirabilis associated with alterations in penicillin-binding proteins[J]. Antimicrob Agents Chemother, 1995, 36 (2): 335-342. |
47. | Lee K, Lim YS, Yong D, et al. Evaluation of the Hodge test and the imipenem-EDTA double disk synergy test for differentiating metallo-β- lactamase-producing isolates of Pseudomonas spp and Acinetobacter spp[J]. J Clin Microbiol, 2003, 41(10): 4623-4629. |
48. | McGettigan SE, Andreacchio K, Edelstein PH. Specificity of ertapenem susceptibility screening for detection of Klebsiella pneumoniae carbapenemases[J]. J Clin Microbiol, 2009, 47(3): 785-786. |
49. | Anderson KF, Lonsway DR, Rasheed JK, et al. Evaluation of methods to identify the Klebsiella pneumoniae carbapenemase in enterobacteriaceae[J]. J Clin Microbiol, 2007, 45(8): 2723-2725. |
50. | Hindiyeh M, Smollan G, Grossman Z, et al. Rapid detection of blaKPC carbapenemase genes by internally controlled real-time pcr assay using[J]. J Clin Microbiol, 2011, 49(7) : 2480-2484 . |
- 1. 洪秀华, 刘运德, 李向阳, 等. 临床微生物学检验[M]. 北京: 中国医药科技出版社, 2010: 304-306.
- 2. Birgy A, Bidet P, Genel N, et al. Phenotypic screening of carbapenemases and associated β-lactamases in carbapenem-resistant enterobacteriacease[J]. J Olin Microbiol, 2012, 59(4): 1295-1302.
- 3. Naas T, Vandel L, Sougakoff W, et al. Cloning and sequence analysis of the gene for a carbapenem-hydrolyzing class A beta-lactamase, Sme-1, from Serratia marcescens S6[J]. Antimicrob Agents Chemother, 1994, 38(6): 1262-1270.
- 4. Queenan AM, Torres-Viera C, Howard S. Gold, et al. SME-type carbapenem-hydrolyzing class A beta-lactamases from geographically diverse Serratia marcescens strains[J]. Antimicrob Agents Chemother, 2000, 44(11): 3035-3039.
- 5. Yang Y, Wu P, Livermore D. Biochemical characterization of a beta-lactamase that hydrolyzes penems and carbapenems from two Serratia marcescens isolates[J]. Antimicrob Agents Chemotherapy, 1990, 34: 755-758.
- 6. Borgia S, Lastovetska O, Richardson D, et al. Outbreak of carbapenem-resistant enterobacteriaceae containing blaNDM-1, Ontario, Canada[J]. Clin Infect Dis, 2012, 55(11): 109-117.
- 7. Adlera A, Carmelia BY. Dissemination of the Klebsiella pneumonia carbapenemase in the health care settings: tracking the trails of an elusive offender[J]. mBio, 2011, 2(6): 280-291.
- 8. Curcio DJ. Antibiotic prescription in intensive care units in Latin America[J]. Revista Argentina de Microbiología, 2011, 43: 203-211.
- 9. Pfeifer Y, Schlatterer K, Engelmann E, et al. Emergence of OXA-48-type carbapenemase-producing Enterobacteriaceae in German hospitals[J]. Antimicrob Agents Chemother, 2012, 56(4): 2125-2128.
- 10. Agodi A, Voulgari E, Barchitta M, et al. Containment of an outbreak of KPC-3-producing klebsiella pneumoniae in Italy[J]. J Clin Microbiol, 2011, 49(11): 3986-3989.
- 11. Leverstein-van Hall MA, Stuart JC, Voets GM, et al. Carbapenem-resistant Klebsiella pneumoniae following foreign travel[J]. Ned Tijdschr Geneeskd, 2010, 154(37): 1736.
- 12. Us E, Tekeli A, Arikan AO, et al. Molecular epidemiology of carbapenem-resistant Klebsiella pneumoniae strains isolated between 2004-2007 in Ankara University hospital, Turkey[J]. Mikrobiyol Bul, 2010, 44(1): 1-10.
- 13. Shen P, Wei ZQ, Jiang Y, et al. Novel genetic environment of the carbapenem-hydrolyzing β-lactamase KPC-2 among enterobacteriaceae in China[J],Antimicrob Agents Chemotherapy, 2009 , 53(10): 4333-4338.
- 14. Roh KH, Lee CK, Sohn JW, et al. Isolation of a Klebsiella pneumoniae isolate of sequence type 258 producing KPC-2 carbapenemase in Korea[J]. Korean J Lab Med, 2011, 31(4): 298-301.
- 15. Saidani M, Hammami S, Kammoun A, et al. Emergence of carbapenem resistant Enterobacteriaceae producing OXA-48 carbapenemase in Tunisia[J]. J Med Microbiol, 2012, 61(12): 1746-1749.
- 16. Datta P, Gupta V, Garg S, et al. Phenotypic method for differentiation of carbapenemases in enterobacteriaceae: study from north India[J]. Indian J Pathol Microbiol, 2012, 55(3): 357-360.
- 17. Arpin C, Noury P, Boraud D, et al. NDM-1-producing Klebsiella pneumoniae resistant to colistin in a French community patient without history of foreign travel[J]. Antimicrob Agents Chemother, 2012, 56(6): 3432-3434.
- 18. Gaynes RP, Culver DH. Resistance to imipenem among selected gram-negative bacilli in the United States[J]. Infect Control Hosp Epidemiol, 1992, 13(1): 10-14.
- 19. Rhomberg PR, Jones RN, et al. Summary trends for the meropenem yearly susceptibility test information collection program: a 10-year experience in the United States(1999-2008)[J]. Diagn Microbiol Infect Dis , 2009, 65(4): 414-426.
- 20. Hidron AI, Edwards JR, Patel J, et al. NHSN annualupdate: antimicrobial-resistant pathogens associated with ealthcare-associated infections: annual summary of data reported to the National Healthcare Safety Network at the Centers for Disease Control and Prevention[J]. Infect Con Hosp Epidemio, 2008, 29(11): 996-1011.
- 21. 肖永红, 王进, 赵彩云, 等. 2006-2007年Mohnarin细菌耐药监测[J]. 中华医院感染学杂志, 2008, 18(8): 1051-1056.
- 22. 李丽, 田磊, 陈中举, 等. 卫生部全国细菌耐药监测网2010年中南地区细菌耐药性监测[J]. 中国临床药理学杂志, 2011, 27(12): 940-947.
- 23. 徐修礼, 周珊.卫生部全国细菌耐药监测网2010年西北地区细菌耐药性监测[J]. 中国临床药理学杂志, 2011, 27(12): 925-931.
- 24. 张智洁, 王军. 卫生部全国细菌耐药监测网2010年东北地区细菌耐药性监测[J]. 中国临床药理学杂志, 2011, 27(12): 948-975.
- 25. 马序竹, 郑波.卫生部全国细菌耐药监测网2010年北京地区细菌耐药性监测[J]. 中国临床药理学杂志, 2011, 27(12): 919-924.
- 26. 肖书念, 卓超, 钟南山. 卫生部全国细菌耐药监测网2010年广东地区细菌耐药性监测[J].中国临床药理学杂志, 2011, 27(12): 965-971.
- 27. 张纬博, 孙景勇, 倪语星. 卫生部全国细菌耐药监测网2010年华东地区细菌耐药性监测[J].中国临床药理学杂志, 2011, 27(12): 959-964.
- 28. 杨央, 吕火祥, 胡庆丰, 等. 1456株连续分离的肺炎克雷伯菌临床分布及耐药性分析[J].中国卫生检验杂志, 2010, 20(9): 2232-2234.
- 29. 蔡佳昌. 肠杆菌科细菌对碳青霉烯类抗生素耐药机制研究[D]. 浙江:浙江大学博士学位论文. 2010.
- 30. Yigit H, Queenan AM, Anderson GJ, et al. Novel carbapenem-hydrolyzing β-Lactamase, KPC-1, from a carbapenem-resistant strain of Klebsiella pneumoniae[J]. Antimicrob Agents Chemotherapy, 2001, 45(4): 1151-1161.
- 31. Miriagou V, Tzouvelekis LS, Rossiter S, et al. Imipenem resistance in a salmonella clinical strain due to plasmid-mediated class a carbapenemase KPC-2[J]. Antimicrob Agents Chemotherapy, 2003, 47(4): 1297-300.
- 32. Bratu S, Landman D, Alam M, et al. Detection of KPC carbapenem-hydrolyzing enzymes in enterobacterspp. from Brooklyn, New York[J]. Antimicrob Agents Chemother , 2004, 48(12): 4793-4799.
- 33. Woodford N, Tierno PM, Young JrK, et al. Outbreak of klebsiella pneumoniae producing a new carbapenem-hydrolyzing Class A-Lactamase, KPC-3, in a New York Medical Center[J]. Antimicrob Agents Chemother, 2005, 49(2): 776-778.
- 34. Landman D, Babu E, Patel JB, et al. Transmission of carbapenem-resistant pathogens in New York City hospitals: progress and frustrationm[J]. Antimicrob Chemother, 2012, 67(6): 1427-1431.
- 35. Landman D, Bratu S, Kochar S, et al. Evolution of antimicrobial resistance among Pseudomonas aeruginosa, Acinetobacter baumannii and Klebsiella pneumoniae in Brooklyn, NY[J]. J Antimicro Chemother, 2007, 60(1): 78-82.
- 36. Gupta N, Limbago BM, Patel JB, et al. Carbapenem-resistant enterobacteriaceae: epidemiology and prevention[J]. Clin Infect Dis, 2011, 53(1): 60-67.
- 37. Mathers AJ, Cox HL, Kitchel B, et al. Molecular dissection of an outbreak of carbapenem-resistant enterobacteriaceae reveals intergenus kpc carbapenemase transmission through a promiscuous plasmid[J]. mBio, 2011, 2(6): 204-211 .
- 38. Osano E, Arakawa Y, Wacharotayankun R, et al. Molecular characterization of an enterobacterial metallo beta-lactamase found in a clinical isolate of Serratia marcescens that shows imipenem resistance[J]. Antimicrob Agents Chemother, 1994, 38(1): 71-78.
- 39. Miriagou V, Tzelepi E, Gianneli D, et al. Escherichia coli with a self-transferable, multiresistant plasmid coding for metallo-β-Lactamase VIM-1[J]. Antimicrob Agents Chemother, 2003, 47(1): 395-397.
- 40. Yong D, Toleman MA, Giske CG, et al. Characterization of a new metallo-beta-lactamase gene, bla(NDM-1), and a novel erythromycin esterase gene carried on a unique genetic structure in Klebsiella pneumoniae sequence type 14 from India[J]. Antimicrob Agents Chemother, 2009 , 53(12): 5046-54.
- 41. Deshpande LM, Mendes RE, Castanheira M, et al. Dissemination of NDM-1-producing enterobacteriaceae in India [abstract C2-701]. 50th Interscience Conference on Antimicrobial Agents and Chemotherapy[M]. Boston: American Society for Microbiology, 2010.
- 42. Poirel L, Héritier C, Tolün V, et al. Emergence of oxacillinase-mediated resistance to imipenem in Klebsiella pneumoniae[J]. Antimicrob Agents Chemother J, 2004, 48(1) : 15-22 .
- 43. Cre´ met L, Bourigault CL, Lepelletier D, et al. Nosocomial outbreak of carbapenem-resistant Enterobacter cloacae highlighting the interspecies transferability of the blaOXA-48 gene in the gut flora [J]. Antimicrob Chemother, 2012, 67 (4): 1041-1043.
- 44. 李俐, 蒋燕群.大肠埃希菌和肺炎克雷伯菌外膜蛋白与耐药机制的研究进展[J]. 上海交通大学学报·医学版, 2010, 30(11): 1433-1436.
- 45. Sureda LG, Dome´nech-Sa´nchez A, Barbier M, et al. OmpK26, a novel porin associated with carbapenem resistance in Klebsiella pneumoniae[J]. Antimicrob Agents Chemother, 2011, 55(10) : 4742-4747.
- 46. Neuwirth C, Siébor E, Duez JM, et al. Imipenem resistance in clinical isolates of Proteus mirabilis associated with alterations in penicillin-binding proteins[J]. Antimicrob Agents Chemother, 1995, 36 (2): 335-342.
- 47. Lee K, Lim YS, Yong D, et al. Evaluation of the Hodge test and the imipenem-EDTA double disk synergy test for differentiating metallo-β- lactamase-producing isolates of Pseudomonas spp and Acinetobacter spp[J]. J Clin Microbiol, 2003, 41(10): 4623-4629.
- 48. McGettigan SE, Andreacchio K, Edelstein PH. Specificity of ertapenem susceptibility screening for detection of Klebsiella pneumoniae carbapenemases[J]. J Clin Microbiol, 2009, 47(3): 785-786.
- 49. Anderson KF, Lonsway DR, Rasheed JK, et al. Evaluation of methods to identify the Klebsiella pneumoniae carbapenemase in enterobacteriaceae[J]. J Clin Microbiol, 2007, 45(8): 2723-2725.
- 50. Hindiyeh M, Smollan G, Grossman Z, et al. Rapid detection of blaKPC carbapenemase genes by internally controlled real-time pcr assay using[J]. J Clin Microbiol, 2011, 49(7) : 2480-2484 .
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