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由于抗菌药物的广泛应用和不合理使用,细菌耐药进展越来越快,遏制细菌的进一步耐药迫在眉睫,研究发现异质性耐药是一种特殊的耐药形式,是细菌耐药进化的中间过程。目前许多临床工作者对异质性耐药的认识较局限,并且异质性耐药在临床常规药敏试验中多检测为假敏感,误导医生治疗用药,是导致临床感染治疗失败的重要原因。研究异质性耐药,对于细菌耐药的预防、控制和指导临床用药具有重要意义。革兰阴性菌是院内感染的主要病原菌,为了进一步加深对该类细菌异质性耐药的全面认识,现将国内外常见的革兰阴性杆菌异质性耐药的研究进展综述如下。
Due to the widespread use and irrational use of antimicrobial agents, bacterial resistance is progressing faster and faster, and it is imperative to contain further bacterial resistance. Studies have shown that heterogeneous drug resistance is a special form of drug resistance that is resistant to bacterial evolution process. At present, many clinicians have a limited understanding of heterogeneous drug resistance, and heterotypic drug resistance is often false-sensitive in clinical routine susceptibility testing. Misdiagnosis of doctors is the main reason for the failure of clinical infection treatment. Study of heterogeneous drug resistance, for bacterial resistance to prevention, control and guidance of clinical medication is of great significance. Gram-negative bacteria is the main pathogen of nosocomial infection. In order to further understand the heterogeneity of these bacteria, we summarized the research progress of the common drug-resistant Gram-negative bacilli at home and abroad.