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2005, Número 2

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Bioquimia 2005; 30 (2)


Emergencia de la resistencia a carbapenemes en Pseudomonas aeruginosa productora de metalo-β-lactamasas

Andrade V

Idioma: Español
Referencias bibliográficas: 51
Paginas: 53-58
Archivo PDF: 75.12 Kb.


RESUMEN

Los carbapenemes son agentes antimicrobianos usualmente activos contra agentes bacterianos multirresistentes; sin embargo, la resistencia a estos compuestos ha sido descrita en diversas regiones del mundo, considerado a este evento un problema global emergente. Pseudomonas aeruginosa es uno de los agentes etiológicos que con frecuencia es causante de infecciones nosocomiales, capaces de expresar mecanismos que generan la resistencia a diversos antimicrobianos, incluyendo carbapenemes. El principal mecanismo de resistencia a los carbapenemes en bacilos gram-negativos es la producción de β-lactamasas de la clase B, denominadas también metalo-β-lactamasas (M-bLs), por requerir de iones zinc para su actividad enzimática. Se ha reportado que la distribución de las M-βLs y el perfil de sustratos que hidroliza es diferente en cada región del mundo, considerando que la divergencia evolutiva de estas enzimas es el reflejo de la administración en la práctica clínica de los diferentes esquemas antimicrobianos y/o debido a la diseminación de clonas endémicas multirresistentes. Hasta el momento se han descrito cuatro familias de M-βLs: IMP, VIM, SPM y GIM, las cuales han originado diversas variantes con características catalíticas distintas, lo que complica la selección terapéutica. En esta revisión se describen las M-βLs causantes de la resistencia a carbapenemes y la expresión de otras familias de β-lactamasas de espectro extendido que podrían contribuir a la resistencia de estos antimicrobianos.


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