Carbapenem resistance in Acinetobacter baumannii:: mechanisms and epidemiology

被引：872
作者：
Poirel, L. [1 ]
Nordmann, P. [1 ]
机构：
[1] Univ Paris 11, S Paris Med Sch, Hop Bicetre, Serv Bacteriol Virol, F-94275 Le Kremlin Bicetre, France
来源：
CLINICAL MICROBIOLOGY AND INFECTION | 2006年 / 12卷 / 09期
关键词：
Acinetobacter baumannii; carbapenems; metallo-beta-lactamase; oxacillinase; resistance; review;
D O I：
10.1111/j.1469-0691.2006.01456.x
中图分类号：
R51 [传染病];
学科分类号：
100401 ;
摘要：
The increasing trend of carbapenem resistance in Acinetobacter baumannii worldwide is a concern since it limits drastically the range of therapeutic alternatives. Metallo-beta-lactamases (VIM, IMP, SIM) have been reported worldwide, especially in Asia and western Europe, and confer resistance to all beta-lactams except aztreonam. The most widespread beta-lactamases with carbapenemase activity in A. baumannii are carbapenem-hydrolysing class D beta-lactamases (CHDLs) that are mostly specific for this species. These enzymes belong to three unrelated groups of clavulanic acid-resistant beta-lactamases, represented by OXA-23, OXA-24 and OXA-58, that can be either plasmid- or chromosomally-encoded. A. baumannii also possesses an intrinsic carbapenem-hydrolysing oxacillinase, the expression of which may vary, that may play a role in carbapenem resistance. In addition to beta-lactamases, carbapenem resistance in A. baumannii may also result from porin or penicillin-binding protein modifications. Several porins, including the 33-kDa CarO protein, that constitute a pore channel for influx of carbapenems, might be involved in carbapenem resistance.
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页码：826 / 836
页数：11
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