5种铜绿假单胞菌高危克隆的流行及耐药情况

摘要：细菌引起的感染分为社区感染和医院内感染，社区感染的细菌通常对抗生素敏感，较容易控制，而院内感染较难治疗。铜绿假单胞菌(Pseudomonas aeruginosa)是机会性感染的非发酵革兰阴性细菌，一种引起医院内感染的常见细菌，并容易感染术后患者及烧伤患者，影响患者的治疗与恢复。抗生素治疗是人们抵御细菌感染性疾病的有效手段，但是随着抗生素的大量使用，抗生素耐药性细菌不断产生，泛耐药(extensively drug resistant, XDR)甚至是全耐药(pandrug-resistant bacteria, PDR)铜绿假单胞菌已在世界多地医院被检出。而这种广泛的耐药性往往集中在几种特定的铜绿假单胞菌基因型中，如ST111、ST175、ST235、ST308和ST664等；由于无药可用，使得它们所引发的感染异常危险，因此被称为高危克隆。本文就目前国际流行的5种铜绿假单胞菌高危克隆进行系统性综述，包括其流行情况、耐药谱、耐药机制及治疗手段，为高危克隆的甄别和防治提供借鉴。

The prevalence and drug resistance of five Pseudomonas aeruginosa high-risk clones

Abstract Bacteria-induced infections are classified into community-acquired infections and nosocomial infections.Community-infected bacteria are usually sensitive to antibiotics and easier to control, while nosocomial infections aremore difficult to treat. Pseudomonas aeruginosa is an opportunistic non-fermentative Gram-negative bacterium, a commonbacterium that causes nosocomial infections, and can easily infect postoperative patients and burn patients, affecting thetreatment and recovery of patients. Antibiotic treatment is an effective means for people to resist bacterial infectious diseases,but with the massive use of antibiotics, antibiotic-resistant bacteria continue to emerge, and extensively resistant (XDR)even pandrug-resistant bacteria (PDR) Pseudomonas aeruginosa has been detected in many hospitals around the world.Additionally, this extensive drug resistance is often associated with several specific P. aeruginosa genotypes, such as ST111,ST175, ST235, ST308, and ST664; because of no drugs are available, the infection caused by them is extremely dangerous.Therefore, they are called high-risk clones. This article systematically reviews the five high-risk clones of Pseudomonasaeruginosa that are currently popular in the world, including their epidemic situation, drug resistance profile, drug resistancemechanism, and treatment methods, to provide references for the screening and prevention of high-risk