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[假单胞菌属中的碳青霉烯酶]

[Carbapenemases in Pseudomonas spp].

作者信息

Juan Nicolau Carlos, Oliver Antonio

机构信息

Hospital Son Dureta, Universitat de les Illes Balears, Institut Universitari d' Investigació en Ciències de la Salut, Palma de Mallorca, España.

出版信息

Enferm Infecc Microbiol Clin. 2010 Jan;28 Suppl 1:19-28. doi: 10.1016/S0213-005X(10)70004-5.


DOI:10.1016/S0213-005X(10)70004-5
PMID:20172419
Abstract

Pseudomonas aeruginosa is one of the most relevant nosocomial pathogens, as well as one of the main causes of chronic respiratory infections in patients with underlying diseases such as cystic fibrosis or chronic obstructive pulmonary disease. The high intrinsic antibiotic resistance of this pathogen, together with its extraordinary capacity for acquiring additional resistances through chromosomal mutations, determines a major threat for antimicrobial therapy in hospitals worldwide. Even more concerning is the increasing detection of multiple antimicrobial resistance determinants in this microorganism, frequently located on integrons, acquired by horizontal transfer through plasmids and/or transposons. Among these mechanisms, the carbapenemases are particularly relevant, due to the wide spectrum of antibiotics affected. This work reviews the epidemiology, impact, and detection of the carbapenemases described so far in the Pseudomonas spp., that mainly include class B enzymes (metallo-beta-lactamases [MBL]: IMP, VIM, SPM, GIM, AIM, or DIM), but also, to a lower extent, class A (GES y KPC) and D (OXA) beta-lactamases. The presence of transferable carbapenemases is not only important in P. aeruginosa, but also in other less clinically-relevant species of the genus, since they can act as reservoires and dispersion vectors of these resistance determinants. The growing prevalence of carbapenemase-producing clinical isolates calls for the implementation of multidisciplinary strategies to optimize the detection and minimize the dissemination of these multidrug resistant strains and the involved transferable genetic elements.

摘要

铜绿假单胞菌是最重要的医院病原体之一,也是患有诸如囊性纤维化或慢性阻塞性肺疾病等基础疾病患者慢性呼吸道感染的主要病因之一。该病原体固有的高抗生素耐药性,以及其通过染色体突变获得额外耐药性的非凡能力,对全球医院的抗菌治疗构成了重大威胁。更令人担忧的是,在这种微生物中越来越多地检测到多种抗菌耐药决定因素,这些因素通常位于整合子上,通过质粒和/或转座子水平转移获得。在这些机制中,碳青霉烯酶尤为重要,因为受影响的抗生素范围广泛。这项工作回顾了迄今为止在假单胞菌属中描述的碳青霉烯酶的流行病学、影响及检测情况,这些酶主要包括B类酶(金属β-内酰胺酶[MBL]:IMP、VIM、SPM、GIM、AIM或DIM),但在较低程度上也包括A类(GES和KPC)和D类(OXA)β-内酰胺酶。可转移碳青霉烯酶的存在不仅在铜绿假单胞菌中很重要,在该属其他临床相关性较低的物种中也很重要,因为它们可作为这些耐药决定因素的储存库和传播载体。产碳青霉烯酶临床分离株的日益流行,要求实施多学科策略,以优化检测并尽量减少这些多重耐药菌株及相关可转移遗传元件的传播。

相似文献

[1]
[Carbapenemases in Pseudomonas spp].

Enferm Infecc Microbiol Clin. 2010-1

[2]
Dissemination and diversity of metallo-beta-lactamases in Latin America: report from the SENTRY Antimicrobial Surveillance Program.

Int J Antimicrob Agents. 2005-1

[3]
Characterization of acquired beta-lactamases and their genetic support in multidrug-resistant Pseudomonas aeruginosa isolates in Taiwan: the prevalence of unusual integrons.

J Antimicrob Chemother. 2006-9

[4]
Metallo-beta-lactamase-producing Pseudomonas putida as a reservoir of multidrug resistance elements that can be transferred to successful Pseudomonas aeruginosa clones.

J Antimicrob Chemother. 2010-1-12

[5]
[Beta-lactamases and their role in resistance. PART 2: beta-lactamases in 21st century].

Lijec Vjesn. 2005

[6]
[Characterization of isolates of carbapenemase-producing Pseudomonas aeruginosa from seven Colombian provinces].

Biomedica. 2014-4

[7]
Dissemination in distinct Brazilian regions of an epidemic carbapenem-resistant Pseudomonas aeruginosa producing SPM metallo-beta-lactamase.

J Antimicrob Chemother. 2003-10

[8]
A highly carbapenem-resistant Pseudomonas aeruginosa isolate with a novel blaVIM-4/blaP1b integron overexpresses two efflux pumps and lacks OprD.

J Antimicrob Chemother. 2007-7

[9]
The beta-lactamase threat in Enterobacteriaceae, Pseudomonas and Acinetobacter.

Trends Microbiol. 2006-9

[10]
Pseudomonas aeruginosa chromosomal beta-lactamase in patients with cystic fibrosis and chronic lung infection. Mechanism of antibiotic resistance and target of the humoral immune response.

APMIS Suppl. 2003

引用本文的文献

[1]
Endemic High-Risk Clone ST277 Is Related to the Spread of SPM-1-Producing during the COVID-19 Pandemic Period in Northern Brazil.

Microorganisms. 2023-8-11

[2]
The Intriguing Carbapenemases of : Current Status, Genetic Profile, and Global Epidemiology.

Yale J Biol Med. 2022-12

[3]
Resistance mechanisms and molecular epidemiology of Pseudomonas aeruginosa strains from patients with bronchiectasis.

J Antimicrob Chemother. 2022-5-29

[4]
Investigation of the prevalence of genes conferring resistance to carbapenems in isolates from burn patients.

Infect Drug Resist. 2019-5-7

[5]
Antibiotic Resistance Patterns of Pseudomonas spp. Isolated from the River Danube.

Front Microbiol. 2016-5-3

[6]
Isolation of VIM-2-producing Pseudomonas monteilii clinical strains disseminated in a tertiary hospital in northern Spain.

Antimicrob Agents Chemother. 2015-2

[7]
Comparison of local features from two Spanish hospitals reveals common and specific traits at multiple levels of the molecular epidemiology of metallo-β-lactamase-producing Pseudomonas spp.

Antimicrob Agents Chemother. 2014

[8]
Hypermutable Pseudomonas aeruginosa in Cystic fibrosis patients from two Brazilian cities.

J Clin Microbiol. 2013-1-9

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