鲍曼不动杆菌对多黏菌素产生耐药的多样性  

The diversity of Acinetobacter baumannii drug-resistance caused by polymyxin

作　　者：陈佳容[1] 邵雷[1] 张骏梁[1] 陈代杰[1] Chen Jia-rong Shao Lei Zhang Jun-liang Chen Dai-jie(State Key Lab of New Drug and Pharmaceutical Process, Shanghai Institute of Pharmaceutical Industry, China State Institute of Pharmaceutical Industry, Shanghai 201203)

机构地区：[1]中国医药工业研究总院,上海医药工业研究院,创新药物与制药工艺国家重点实验室,上海201203

出　　处：《中国抗生素杂志》2016年第12期881-887,共7页Chinese Journal of Antibiotics

基　　金：国家“重大新药创制”科技重大专项(No.2013ZX09301302,No.2014ZX09507009-025);上海市自然科学基金(No.16ZR1435400)

摘　　要：鲍曼不动杆菌是临床上导致感染的重要病原菌之一,其对临床抗感染药物的耐药性问题日益严重。目前,多黏菌素是临床抗革兰阴性菌的"最后一道防线",具有较多的毒副作用问题,而耐多黏菌素的鲍曼不动杆菌也已经在临床出现。本文列举了多黏菌素在临床抗感染治疗中遇到的主要问题,综述了鲍曼不动杆菌对多黏菌素产生"多样性"耐药机制的最新进展,包括作用靶细胞膜脂质A的修饰为主的特异性耐药机制与细菌菌膜耐药、适应性耐药和异质性耐药在内的非特异性耐药机制,以期为鲍曼不动杆菌对多黏菌素耐药机制的深入研究提供参考。Acinetobacter baumannii is one of the chief pathogens that leads to infection clinically, and the problem of its resistance to clinical anti-infection drugs is increasingly serious. Currently, as the ＂last line of defense＂ against clinical Gram-negative bacteria, polymyxin presents many poisonous side effects with the emergence of Acinetobacter baumannii resistant to it in clinical practice. This paper listed the main problems when polymyxin was used for clinical therapy of anti-infection. And the latest progress of multifarious mechanisms of Acinetobacter baumannii drug-resistance caused by polymyxin was reviewed, including the specific and non-specific resistant mechanisms. The specific resistant mechanism mainly refers to lipid A modification of the target cell membrane and the non-specific resistant mechanism includes bacterial biofilm resistance, the adaptive resistance, and the hetero- resistance. This review provided some references for the further study of the mechanisms ofAcinetobacter baumannii resistance caused by polymyxin.

关 键 词：鲍曼不动杆菌 多黏菌素 细菌耐药性 

分 类 号：R978.1[医药卫生—药品]