头孢他啶/阿维巴坦治疗耐碳青霉烯类肺炎克雷伯菌感染的研究进展
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R515

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国家自然科学基金项目(81960363、82160361);云南省“兴滇英才支持计划”青年人才(XDYC-QNRC-2022-0288);大理大学第一附属医院医学学科建设项目(DFYZD2022-01&DFYGR010)


Advances of ceftazidime/avibactam in the treatment of carbapenem-resis-tant Klebsiella pneumoniae infection
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    摘要:

    近年来,耐碳青霉烯类肺炎克雷伯菌(CRKP)感染的流行已成为全球公共卫生问题。头孢他啶/阿维巴坦(CAZ/AVI)作为一种新型的抗菌药物已批准用于治疗医院获得性肺炎/呼吸机相关肺炎、血流感染、肾移植术后感染和肝硬化合并严重感染。然而,随着CAZ/AVI的使用,CAZ/AVI耐药菌株也随之产生。CAZ/AVI主要耐药机制为blaKPC基因过表达、产β-内酰胺酶及关键位点氨基酸的突变、膜孔蛋白丢失导致的细胞通透性改变和外排泵的过表达。本文将对CAZ/AVI在治疗CRKP感染方面的研究进展进行综述,为临床诊断和治疗提供参考依据。

    Abstract:

    In recent years, the prevalence of carbapenem-resistant Klebsiella pneumoniae (CRKP) infection has become a global public health issue. Ceftazidime/avibactam (CAZ/AVI) has been approved as a novel antimicrobial agent for the treatment of healthcare-associated pneumonia/ventilator-associated pneumonia, bloodstream infection, infection after kidney transplantation, and severe infection combined with liver cirrhosis. However, the use of CAZ/AVI has also led to the emergence of drug-resistant strains. The major mechanisms of drug-resistance include over-expression of blaKPC gene, mutation of β-lactamase and amino acids at key sites, changes in cell permeability caused by loss of membrane porin, and over-expression of efflux pump. This article reviews the research progress of CAZ/AVI in the treatment of CRKP infection, providing reference for clinical diagnosis and treatment.

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赵圆祺,程明璟,熊苗苗,等.头孢他啶/阿维巴坦治疗耐碳青霉烯类肺炎克雷伯菌感染的研究进展[J]. 中国感染控制杂志,2024,23(8):1047-1052. DOI:10.12138/j. issn.1671-9638.20245118.
ZHAO Yuan-qi, CHENG Ming-jing, XIONG Miao-miao, et al. Advances of ceftazidime/avibactam in the treatment of carbapenem-resis-tant Klebsiella pneumoniae infection[J]. Chin J Infect Control, 2024,23(8):1047-1052. DOI:10.12138/j. issn.1671-9638.20245118.

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  • 收稿日期:2023-10-17
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  • 在线发布日期: 2024-08-23
  • 出版日期: 2024-08-28