鲍曼不动杆菌异质性耐药研究进展

异质性耐药是指细菌的不同亚群对某种抗菌药物表现出不同的敏感性,多报道于对万古霉素中介的金黄色葡萄球菌。近年来,在以鲍曼不动杆菌、肺炎克雷伯菌和铜绿假单胞菌等为代表的革兰阴性菌中这一现象不断地被揭示,并且被逐渐认识到其可能是导致抗感染治疗失败的原因之一。细菌一旦出现异质性耐药,在抗菌药物选择性压力下,即使是小部分的耐药亚群也可表现出高水平的表型耐药,从而导致临床应用抗菌药物抗感染治疗的失败。异质性耐药体现了细菌群体从部分耐药向完全耐药转变的过程。研究异质性耐药对于认识临床常见病原菌耐药的发展过程,以及评估治疗方案和指导临床使用抗菌药物具有重要的意义。本文对鲍曼不动杆菌异质性耐药的研究现状进行了综述。

Research progress of heteroresistance of Acinetobacter baumannii

Heteroresistance refers to various susceptibility to a particular antimicrobial agents exhibited by different subpopulations of bacteria, which has been reported frequently in the vancomycin-intermediate Staphylococcus aureus. In recent years, this phenomenon has been revealed in gram-negative bacteria, such as Acinetobacter baumannii, Klebsiella pneumoniae and Pseudomonas aeruginosa, and it is gradually recognized that this may be one of the causes for the failure of anti-infective treatment. Once heteroresistance occurs, even a small part of subpopulations of drug-resistant bacteria can exhibit high level phenotypic resistance under the selective pressure of antimicrobial agents, which leads to the failure of clinical antimicrobial anti-infective therapy. Heteroresistance reflects the transformation of bacterial population from partial drug resistance to complete drug resistance. Research on heteroresistance is of great significance for understanding the development process of drug resistance of common clinical pathogens, evaluating treatment options and guiding clinical antimicrobial use. In this paper, the research status of heteroresistance of Acinetobacter baumannii is reviewed.