Jones B L, Wilcox M H
Clinical Microbiology and Public Health Laboratory, Addenbrooke's Hospital, Cambridge, UK.
J Antimicrob Chemother. 1995 Apr;35(4):453-61. doi: 10.1093/jac/35.4.453.
With advances in the identification and molecular taxonomy of Aeromonas spp., these organisms, which are widely distributed in the environment, are increasingly being recognised as human pathogens. Clinical infections include gastroenteritis, skin and soft tissue infections and bacteraemia. Antibiotic resistance poses a potential problem in the antimicrobial therapy of infections cased by Aeromonas spp. While most strains are susceptible to chloramphenicol, ciprofloxacin, co-trimoxazole and the aminoglycosides, the activity of amoxycillin/clavulanate and the acylureidopenicillins is inconsistent. Addition of a beta-lactamase inhibitor does not significantly enhance the activity of the acylureidopenicillins. Aztreonam and the carbapenems, imipenem and meropenem remain highly active. Although resistance to the first and second generation cephalosporins is variable, more than 90% of Aeromonas spp. are susceptible to the third generation agents. Of potential significance is the identification of chromosomally-encoded inducible beta-lactamases, associated with resistance to extended spectrum penicillins, cephalosporins, monobactams and carbapenems, in clinical isolates of Aeromonas spp. Two distinct enzymes are produced: the A1 enzyme, a serine beta-lactamase behaving as a group 1 cephalosporinase, and the A2 enzyme, a metallo beta-lactamase which hydrolyses a wide range of beta-lactam agents including the carbapenems. The clinical relevance of these enzymes in Aeromonas spp. is unclear.
随着气单胞菌属细菌鉴定和分子分类学的进展，这些广泛分布于环境中的微生物越来越被认为是人类病原体。临床感染包括肠胃炎、皮肤和软组织感染以及菌血症。抗生素耐药性在气单胞菌属细菌所致感染的抗菌治疗中构成潜在问题。虽然大多数菌株对氯霉素、环丙沙星、复方新诺明和氨基糖苷类敏感，但阿莫西林/克拉维酸和酰脲基青霉素的活性并不一致。添加β-内酰胺酶抑制剂并不能显著增强酰脲基青霉素的活性。氨曲南以及碳青霉烯类药物亚胺培南和美罗培南仍保持高活性。虽然对第一代和第二代头孢菌素的耐药性各不相同，但超过90%的气单胞菌属细菌对第三代药物敏感。在气单胞菌属细菌的临床分离株中，已鉴定出与对广谱青霉素、头孢菌素、单环β-内酰胺类和碳青霉烯类耐药相关的染色体编码诱导型β-内酰胺酶，这可能具有重要意义。可产生两种不同的酶：A1酶，一种表现为1组头孢菌素酶的丝氨酸β-内酰胺酶；A2酶，一种可水解包括碳青霉烯类在内的多种β-内酰胺类药物的金属β-内酰胺酶。这些酶在气单胞菌属细菌中的临床相关性尚不清楚。
