铜绿假单胞菌对碳青霉烯类抗生素异质性耐药的研究进展

 异质性耐药指同一克隆菌株中同时存在对某种抗菌药物耐药及敏感亚群的现象。碳青霉烯类抗生素是临床治疗铜绿假单胞菌感染的常用药物，随着其使用增加，碳青霉烯类异质性耐药铜绿假单胞菌（CHPA）的检出率日益增高。但是，至今没有标准、高效、低成本的CHPA检测方法应用于临床，常导致CHPA漏检和临床治疗失败。本文对异质性耐药的定义、检测方法、CHPA的耐药机制、临床及流行病学特征进行综述，为临床诊断和治疗CHPA感染提供参考。

Research progress of heteroresistance to carbapenems in Pseudomonas aeruginosa

Heteroresistance refers to the co-existence of bacterial resistance and sensitivity to certain antimicrobial agents in the same clone. Carbapenems are the preferred drugs for the treatment of infection caused by Pseudomonas aeruginosa. With the increasing use of carbapenems, isolation rate of carbapenem-heteroresistant Pseudomonas aeruginosa (CHPA) gradually increased. However, there is no standard, efficient and low-cost detection method for CHPA that can be applied in clinical practice, leading to the failure of detection and treatment for CHPA infection. This paper reviewed the definition and detection methods of heteroresistance, as well as resistance mechanism, clinical and epidemiological characteristics of CHPA, provide references for clinical diagnosis and treatment of CHPA infection.