Carbapenem-resistant Acinetobacter baumannii in Taiwan

碳青黴烯類抗藥性鮑氏不動桿菌在台灣之現況

劉明麗(Ming-Li Liou) ； 林明鋒(Ming-Feng Lin) ； 張凱誌(Kai-Chih Chang) ； 郭漢岳(Han-Yueh Kuo)

《Journal of Biomedical & Laboratory Sciences》 22卷3期 (2010/09) Pp. 81-87

https://doi.org/10.30046/JBLS.201009.0001

摘要

鮑氏不動桿菌(Acinetobacter baumannii)由於易對抗生素產生抗藥性，故常導致院內感染的暴發，最近已成爲院內感染主要病原之一。碳青黴烯類抗生素(carbapenem)已被廣泛用於治療多重抗藥性鮑氏不動桿菌造成之感染。然而，在台灣和其他許多國家都發現對碳青黴烯類抗生素具抗藥性鮑氏不動桿菌之分離率正逐年上升。這些對碳青黴烯類抗生素具抗藥性之鮑氏不動桿菌之散播已被證實主要經醫院內部或跨院間之菌株傳播而來；且經證實其抗藥性的產生主要是獲得一段苯唑西林水解β內酰胺酶(oxacillin-hydrolyzing-β-lactamase)(OXA)基因。此外在台灣各地區所分離出之亞胺培南(imipenem)抗藥性鮑氏不動桿菌經證明其帶有不同的抗藥基因。由此可推測鮑氏不動桿菌對亞胺培南之抗藥機制並非由單一基因所調控。隨著高通量基因組分析技術的進步，或許未來更多有關於鮑氏不動桿菌功能基因組的研究能幫助我們找出所有與其抗藥性相關的基因。

關鍵字

碳青黴烯類抗生素 ； 鮑氏不動桿菌 ； 苯唑西林水解β內酰胺酶

並列摘要

Acinetobacter baumannii has emerged recently as a major cause of health care-associated infections due to the extent of its antimicrobial resistance and its propensity to cause nosocomial infectious outbreaks. Carbapenems have been used to treat multidrug-resistant A. baumannii infections. However, the incidences of carbapenem-resistant A. baumannii are rising in Taiwan and many other countries. Clonal spread of cabapenem-resistant A. baumannii via intra-hospitals or inter-hospitals has been reported; their resistance phenotype is mainly due to the acquisition of oxacillin-hydrolyzing-β-lactamase (OXA) genes. The rapid emergence and increase of imipenem resistance in A. baumannii in different areas of Taiwan is contributed to by a variety of mechanisms. The finding of different resistant gene determinants could not explain the phenotypic variation in drug susceptibility. More researches would be required to solve the gaps from resistant genes to phenotypic dynamics by functional genomic studies via the products of genome using high throughput analytic technologies.

並列關鍵字

carbapenem ； Acinetobacter baumannii ； bla(subscript OXA) genes