目的目前革兰阴性细菌对碳青霉烯类抗生素的耐药形势日趋严峻,耐药率日益增高,菌种类型也从非发酵菌扩大到肠杆菌科细菌。其耐药机制主要以产碳青霉烯酶为主,辅以细菌外膜蛋白通透性降低、主动外排泵功能亢进和药物作用靶点青霉素结合蛋白改变等多种耐药机制协同作用。耐药基因众多,新耐药基因层出不穷,耐药机制复杂,给临床和科研带来了极大挑战。本文主要就革兰阴性细菌耐碳青霉烯类抗生素的机制及耐药菌的流行情况做一简要综述。 OBJECTIVE: To date, the resistance of Gram-negative bacteria to carbapenem-based antibiotics has become more and more serious with the increasing rate of drug resistance. The types of bacteria have also been expanded from non-fermentative bacteria to enterobacteriaceae. The mechanism of its resistance mainly to carbapenema-based production, supplemented by bacterial permeability of the outer membrane protein decreased active efflux pump function and drug targets of change of penicillin binding protein and other drug resistance mechanisms synergistic. There are many drug resistance genes, new drug resistance genes emerge in an endless stream, the mechanism of drug resistance is complex, bringing great challenges to clinical and scientific research. This article mainly reviews the mechanism of Gram-negative bacteria resistant to carbapenem antibiotics and the prevalence of resistant bacteria.