鲍曼不动杆菌是革兰阴性杆菌中最常见的条件致病菌之一,近年来对碳青霉烯类抗菌药耐药性逐渐增强,导致较高的发病率和病死率。其耐药机制较为复杂,产碳青霉烯酶是其对碳青霉烯类抗菌药耐药的主要机制。本文主要从三个方面进行阐述:第一,鲍曼不动杆菌对亚胺培南和美罗培南的耐药性;第二,A类、B类和D类碳青霉烯酶及其基因的进展;第三,耐药质粒、转座子、整合子和插入序列介导的耐碳青霉烯类鲍曼不动杆菌的传播形式。
Acinetobacter baumannii(Ab)is one of the most common opportunistic pathogens in gram-negative bacteria, while carbapenem antimicrobial resistance is gradually increasing in recent years. Morbidity and mortality associated withA. baumanniiInfection are increasing. Its resistance mechanism is more complex, and making carbapenemases is the main resistance mechanism ofA. baumanniito carbapenem. This article elaborates mainly from the following three aspects: ifrstly, the antimicrobial resistance ofA. baumanniito imipenem and meropenem; secondly, the progress of class A, Class B and class D carbapenemases and their genes; thirdly, the transmission of carbapenem-resisitantA. baumannii mediated between resistance plasmid, transposon-mediated,integronand insertion sequence.