從分子生物機轉探究碳青黴烯抗藥性腸桿菌的治療以及感控作為

Exploring the Treatment and Control of Carbapenem-resistant Enterobacteriaceae Based on Molecular Biological Mechanisms

在世界各地，抗藥性革蘭氏菌感染的盛行率都在逐步升高，碳青黴烯抗藥性腸桿菌（Carbapenem-resistant Enterobacteriaceae, CRE）現在已經造成嚴重的院內感染問題。CRE的抗藥性機轉主要分為兩類：產生碳青黴烯酶以及不產生碳青黴烯酶。其中產生碳青黴烯酶的CRE，特別是KPC以及OXA-48的CRE近年來比例不斷升高，不管是治療或著是感控上都形成了嚴重的挑戰。目前除了一些老藥，新一代的藥物如ceftazidime/avibactam、imipenem/cilastatin/relebactam以及cefiderocol近期的臨床研究皆顯示有不錯的治療效果。另外，感控措施的介入對於減少CRE的傳播也是非常重要的一環。

The prevalence rate of multidrug-resistant pathogens is increasing worldwide. Carbapenem-resistant Enterobacteriaceae (CRE) has become the one of the most serious hospital-acquired infection issues globally. CRE strains can be classified as carbapenemase-producing and non-carbapenemase-producing. Carbapenemaseproducing CRE, especially KPC- and OXA-48-producing strains, are substantial challenges for clinical treatment and infection control. Newer classes of medication, such as ceftazidime/avibactam, imipenem/cilastatin/relebactam , and cefiderocol, display promising treatment efficacy in recent studies. Infection control is another important way to prevent the spread of CRE.