Quinn J P, Studemeister A E, DiVincenzo C A, Lerner S A
Department of Medicine, Michael Reese Hospital, Chicago, Illinois 60616.
Rev Infect Dis. 1988 Jul-Aug;10(4):892-8. doi: 10.1093/clinids/10.4.892.
Emergence of resistance to imipenem during therapy for Pseudomonas aeruginosa infections is common and may result in treatment failure. Resistance emerges most often during therapy for lower respiratory tract infections. There are several unique features of this resistance to imipenem. First, cross-resistance to other beta-lactam agents is not observed. Second, the mechanism of resistance in most of the isolates studied to date appears to be related to a selective permeability barrier across the bacterial outer membrane, usually associated with discrete alterations in the electrophoretic profiles of outer membrane proteins. These data suggest that imipenem may traverse the outer membrane of P. aeruginosa via a specific porin protein that is not critical for penetration of other beta-lactam antibiotics.
在铜绿假单胞菌感染治疗期间，对亚胺培南产生耐药性很常见，可能导致治疗失败。耐药性最常出现在下呼吸道感染的治疗过程中。这种对亚胺培南的耐药性有几个独特特征。首先，未观察到对其他β-内酰胺类药物的交叉耐药性。其次，迄今为止研究的大多数分离株中的耐药机制似乎与细菌外膜上的选择性通透屏障有关，通常与外膜蛋白电泳图谱的离散变化相关。这些数据表明，亚胺培南可能通过一种特定的孔蛋白穿过铜绿假单胞菌的外膜，而这种孔蛋白对于其他β-内酰胺抗生素的穿透并不关键。
