Emergence of AmpC β-Lactamase– and Metallo-β-Lactamase–producing Klebsiella pneumoniae in Sebha, Libya

K. Ahmad, Almahdi Ahmed Mohamed Alamen, Shamsi Abdullah Mohamd Saad, Abdelkader Alsanousi G. Elzen
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引用次数: 2

Abstract

The emergence of antimicrobial resistance, especially to the β-lactam group, which is the most commonly used antibiotic to treat various infectious diseases, is particularly important because it limits the therapeutic options, thereby increasing the morbidity and mortality rates [1, 2]. In Enterobacteriaceae, antibiotic resistance is linked to different mechanisms, for example the production of a certain type of enzymes named as extended-spectrum β-lactamases (ESBLs). ESBLs are plasmid-mediated and efficiently hydrolyze penicillins, third-generation cephalosporins, and aztreonam, which are commonly used to treat infections [3, 4]. In addition, antibiotic resistance due to AmpC β-lactamases, 16S rRNA methylases, aminoglycoside-modifying enzymes, and carbapenemases has also been reported [5]. ESBL-producing bacteria remain susceptible to carbapenems, and the activity of these enzymes is inhibited by clavulanic acid [6, 7]. In K. pneumoniae, AmpC beta-lactamases are located on plasmids, while in other Enterobacteriaceae spp., these enzymes are either plasmid or chromosomally encoded [8, 9]. AmpC β-lactamases confer resistance to cephamycins (e.g., cefoxitin and cefotetan) and β-lactamase inhibitor combinations [6]. Moreover, K. pneumoniae has also been found to harbor carbapenemase enzyme (KPC), which confers resistance to carbapenems such as imipenem and meropenem [10]. The emergence of carbapenem-resistant Enterobacteriaceae spp. in general and K. pneumoniae, in particular, has become a major public health problem due to lack of effective antibiotics [11], increasing the morbidity ABSTRACT
产AmpC β-内酰胺酶和金属β-内酰胺酶肺炎克雷伯菌在利比亚塞卜哈的出现
抗菌素耐药性的出现,特别是对治疗各种传染病最常用的抗生素β-内酰胺类抗生素的耐药性尤为重要,因为它限制了治疗选择,从而增加了发病率和死亡率[1,2]。在肠杆菌科中,抗生素耐药性与不同的机制有关,例如,一种被称为扩展谱β-内酰胺酶(ESBLs)的酶的产生。ESBLs是质粒介导的,可有效水解青霉素、第三代头孢菌素和氨曲南,这些药物通常用于治疗感染[3,4]。此外,AmpC β-内酰胺酶、16S rRNA甲基化酶、氨基糖苷修饰酶和碳青霉烯酶引起的抗生素耐药也有报道[0]。产esbl的细菌仍然对碳青霉烯类敏感,这些酶的活性被克拉维酸抑制[6,7]。在肺炎克雷伯菌中,AmpC β -内酰胺酶位于质粒上,而在其他肠杆菌科中,这些酶要么是质粒编码的,要么是染色体编码的[8,9]。AmpC β-内酰胺酶赋予对头孢霉素(如头孢西丁和头孢替坦)和β-内酰胺酶抑制剂组合[6]的耐药性。此外,肺炎克雷伯菌也被发现含有碳青霉烯酶(KPC),它赋予碳青霉烯类药物如亚胺培南和美罗培南[10]的抗性。由于缺乏有效的抗生素,耐碳青霉烯类肠杆菌科,特别是肺炎克雷伯菌的出现,已经成为一个主要的公共卫生问题,增加了发病率
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