Multiple mechanisms of antimicrobial resistance in Pseudomonas aeruginosa:: Our worst nightmare?
Multiple mechanisms of antimicrobial resistance in Pseudomonas aeruginosa:: Our worst nightmare?
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DOI：
10.1086/338782
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发表时间：
2002-03-01
影响因子：
11.8
通讯作者：
Livermore, DM
中科院分区：
文献类型：
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作者：
Livermore, DM
铜绿假单胞菌携带多重耐药质粒的频率低于肺炎克雷伯菌，对头孢菌素的突变耐药性低于肠杆菌属，固有耐药性低于嗜麦芽窄食单胞菌。然而，使铜绿假单胞菌成为独特问题的是以下因素的组合：该物种对许多药物类别的固有耐药性;通过突变获得对所有相关治疗的耐药性的能力;其局部耐药率高且不断增加;以及其在严重感染中的频繁作用。一些铜绿假单胞菌分离株对所有可靠的抗生素都有耐药性，并且这个问题似乎可能随着携带编码碳青霉烯酶和阿米卡星乙酰转移酶的基因盒的整合素的出现而增长。
Pseudomonas aeruginosa carries multiresistance plasmids less often than does Klebsiella pneumoniae, develops mutational resistance to cephalosporins less readily than Enterobacter species, and has less inherent resistance than Stenotrophomonas maltophilia. What nevertheless makes P. aeruginosa uniquely problematic is a combination of the following: the species' inherent resistance to many drug classes; its ability to acquire resistance, via mutations, to all relevant treatments; its high and increasing rates of resistance locally; and its frequent role in serious infections. A few isolates of P. aeruginosa are resistant to all reliable antibiotics, and this problem seems likely to grow with the emergence of integrins that carry gene cassettes encoding both carbapenemases and amikacin acetyltransferases.