.160.WorldNotesonAntibiotics,2023,Vol.44,No5产KPC酶肺炎克雷伯菌对头孢他啶/阿维巴坦耐药机制研究进展郑媚"，匡徐"，李甫豪，冯可莹²，于洋1（1华南农业大学，广州510642；2菲鹏生物股份有限公司，东莞523808)摘要：头孢他啶/阿维巴坦(Ceftazidime/Avibactam，CZA)是头孢他啶和一种新型β-内酰胺酶抑制剂(阿维巴坦)的组合，已被美国食品药品监督管理局和国家市场监督管理总局批准，主要用于治疗复杂的腹部和尿道感染、医院获得性细菌性肺炎和呼吸机相关的细菌性肺炎，特别是由肺炎克雷伯菌引起的感染和炎症。然而，CZA临床应用导致了多重耐药肺炎克雷伯菌的出现。其耐药机制主要有三种：blakpc基因的突变、细菌细胞膜孔蛋白突变和KPC酶的表达量增加。本文就耐CZA的肺炎克雷伯菌流行情况和耐药机制进行综述，旨在为临床防治CZA的耐药菌株提供科学依据，并为新药开发提供指导。关键词：产KPC酶肺炎克雷伯菌；头孢他啶；阿维巴坦；耐药机制；作用机理；突变中图分类号：R978.1文献标志码：A文章编号：1001-8751(2023)03-0160-06ResearchProgressontheResistanceMechanismofKPC-ProducingKlebsiellapneumoniaetoCeftazidime/AvibactamZhengMeil,KuangXu',LiFu-hao',FengKe-ying’,YuYang'(1SouthChinaAgriculturalUniversity，Guangzhou510642;2FeipengBiotechnologyCo.,Ltd,Dongguan523808)Abstract:Ceftazidime/avibactam(CZA)isacombinationofceftazidimeandanovelβ-lactamaseinhibitor(avibactam)approvedbytheU.S.FoodandDrugAdministrationandtheStateAdministrationofChinaforthetreatmentofcomplexabdominalandurinarytractinfections,hospital-acquiredbacterialpneumonia,andventilator-associatedbacterialpneumonia,particularlythosecausedbyKlebsiellapneumoniae.However,theclinicaluseofCZAhasledtotheemergenceofmultidrug-resistantKlebsiellapneumoniae.Therearethreemainmechanismsofdrugresistance:mutationofblakpc,mutationofcellmembraneporeprotein,andincreasedexpressionofKPCenzyme.ThearticlereviewstheprevalenceandmechanismofKlebsiellapneumoniaeresistanttoCZA,aimingtoprovidescientificbasisfortheclinicalpreventionandtreatmentofdrug-resistantstrainsofCZAandprovideguidanceforthedevelopmentofnewdrugs.Keywords:KPC-producingKlebsiellapneumoniae;ceftazidime;avibactam;drugresistance;mechanismmec...
