Department of Infectious Diseases, The Alfred Hospital, Melbourne, VIC, Australia.
Expert Rev Anti Infect Ther. 2013 Apr;11(4):395-409. doi: 10.1586/eri.13.21.
Unprecedented levels of antimicrobial resistance in bacterial isolates have prompted great concerns globally. In 2012 the WHO released a publication outlining the evolving threat of antimicrobial resistance in order to raise awareness and to stimulate coordinated international efforts. The carbapenem class of antibiotics is largely considered as an antibiotic of last-resort when treating infections. Now carbapenem resistance further limits treatment options. In this article the authors discuss carbapenem resistance in Acinetobacter baumannii, a bacterial isolate often implicated in nosocomial infections. Virulence factors, intrinsic and acquired resistance mechanisms, together with laboratory challenges in the detection and antibiotic susceptibility testing of A. baumannii make this a truly problematic isolate. Therapeutic options are exceedingly limited, relying on polymyxins in combinations with other antibiotics, with few, if any, new active agents in the pipeline.
细菌分离株中前所未有的抗微生物药物耐药性水平引起了全球的极大关注。2012 年，世界卫生组织发布了一份出版物，概述了抗微生物药物耐药性不断演变的威胁，以提高认识并激发协调一致的国际努力。碳青霉烯类抗生素被广泛认为是治疗感染时的最后一道抗生素防线。现在，碳青霉烯类耐药性进一步限制了治疗选择。本文作者讨论了鲍曼不动杆菌中的碳青霉烯类耐药性，鲍曼不动杆菌常与医院感染有关。毒力因子、内在和获得性耐药机制，以及在检测和药敏试验中对鲍曼不动杆菌的实验室挑战，使得这种细菌成为一个真正有问题的分离株。治疗选择极为有限，依赖于多粘菌素与其他抗生素的联合应用，而在研的新型有效药物却寥寥无几。
