Nordmann P
Hôpitaux de Bicêtre et Antoine Bécleère, Hôpitaux de Paris, Faculté Médecine Paris-Sud, France.
Clin Infect Dis. 1998 Aug;27 Suppl 1:S100-6. doi: 10.1086/514905.
beta-Lactam resistance among Enterobacteriaceae is related primarily to the emergence of novel beta-lactamases. The class A extended-spectrum beta-lactamases hydrolyze extended-spectrum beta-lactams and are inhibited by clavulanic acid. These beta-lactamases are divided in two groups: TEM and SHV derivatives and non-TEM and non-SHV extended-spectrum beta-lactamases (CTX-M1, CTX-M2, MEN-1, PER-1, PER-2, TOHO-1, and VEB-1). The plasmid-mediated cephalosporinases (MIR-1, FOX-1, MOX-1, BIL-1, CMY-1, CMY-2, and LAT-1) hydrolyze extended-spectrum cephalosporins and cephamycins and are not inhibited by clavulanic acid. They have been reported in Europe and in the United States. The 15 inhibitor-resistant penicillinases are TEM derivatives (except for SHV-10) and plasmid mediated, and they are mainly from Escherichia coli isolates. The carbapenemases noted among Enterobacteriaceae are either the chromosomally located penicillinases (Sme-1, NmcA, IMI-1) found in rare Enterobacter cloacae or Serratia marcescens isolates or the plasmid-mediated metalloenzyme IMP-1 that is widespread in Japan. The incidence of resistance among Enterobacteriaceae related to the other more common beta-lactam-resistance mechanisms has continued to rise worldwide.
肠杆菌科细菌对β-内酰胺类抗生素的耐药性主要与新型β-内酰胺酶的出现有关。A类超广谱β-内酰胺酶可水解超广谱β-内酰胺类抗生素，并被克拉维酸抑制。这些β-内酰胺酶分为两组：TEM和SHV衍生物以及非TEM和非SHV超广谱β-内酰胺酶（CTX-M1、CTX-M2、MEN-1、PER-1、PER-2、TOHO-1和VEB-1）。质粒介导的头孢菌素酶（MIR-1、FOX-1、MOX-1、BIL-1、CMY-1、CMY-2和LAT-1）可水解超广谱头孢菌素和头霉素，且不受克拉维酸抑制。它们在欧洲和美国均有报道。15种耐抑制剂青霉素酶是TEM衍生物（SHV-10除外）且由质粒介导，主要来自大肠杆菌分离株。在肠杆菌科细菌中发现的碳青霉烯酶，要么是在罕见的阴沟肠杆菌或粘质沙雷氏菌分离株中发现的染色体定位青霉素酶（Sme-1、NmcA、IMI-1），要么是在日本广泛传播的质粒介导金属酶IMP-1。在全球范围内，与其他更常见的β-内酰胺耐药机制相关的肠杆菌科细菌耐药率持续上升。
