黏杆菌素的抗菌机制及耐药性研究  

Colistin: Antibacterial mechanisms and bacterial resistance

作　　者：程古月[1] 李俊[2] 郝海红[1] 戴梦红[1] 王旭[1] 刘振利[2] 袁宗辉[1,2] 

机构地区：[1]华中农业大学农业部畜禽产品质量安全风险评估实验室(武汉),武汉430070 [2]华中农业大学国家兽药残留基准实验室(HZAU)/农业部食品兽药残留检测重点实验室,武汉430070

出　　处：《中国抗生素杂志》2016年第7期481-492,共12页Chinese Journal of Antibiotics

基　　金：国家自然科学基金(No.31502115);国家重点基础研究发展计划(973计划)项目(No.2013CB127201);国家畜禽产品质量安全风险评估项目(No.GJFP2016008)

摘　　要：随着革兰阴性致病菌对氟喹诺酮类、氨基糖苷类以及β-内酰胺类,包括碳青霉烯类、单酰胺菌素、头孢菌素类和广谱青霉素类耐药流行性增加,进一步促进了将黏菌素视为有效治疗药物的选择。黏杆菌素是一类老的阳离子型药物,可以干扰细菌的细胞膜造成细菌死亡。其主要用于治疗革兰阴性菌引起的感染,对多重耐药革兰阴性菌的抗菌活性亦非常显著。目前,黏杆菌素在人医和兽医中都有比较广泛的应用,但随着其使用量的增加,在一些国家和地区出现了黏杆菌素耐药的报道。本文将对目前所报道的黏杆菌素的抗菌机制和耐药机制进行综述,并对耐药流行性的有效数据进行评估。在全球范围内严格把控黏杆菌素的使用对于控制黏杆菌素耐药性的增长和传播是极有必要的。The rapid increase in the prevalence of Gram-negative pathogens that are resistant to fluoroquinolones and aminoglycosides as well as all β-lactams, including carbapenems, monobactam, cephalosporins and broad-spectrum penicillins, has prompted the reconsideration of colistin as a valid therapeutic option. Colistin is an old class of cationic drug, which act by disrupting the bacterial membranes through anionic displacement of stabilizing magnesium and calcium, resulting in leakage of cell contents and eventually in cellular death. It has strong antibacterial activity against Gram-negtive bacteria, especially multi-resistant pathogens. Nowadays, colistin was widely used not only for human clinical therapy but also for veterinary medicine. However, the prevalence of colistin resistance has been a major concern in many contries and areras as the usage increased. This review focus on the currently reported antibacterial mechanisms and resistance of colistin. Meanwhile we also evaluate the data of prevalence of colistin resistance. It＇s very important to emphasize the rational usage of antiboic to minimize the development and prevalence of colistin resistance.

关 键 词：黏杆菌素 抗菌机制 耐药机制 耐药流行性 

分 类 号：R978.1[医药卫生—药品]