Impact of Polymyxin Resistance on Virulence and Fitness among Clinically Important Gram-Negative Bacteria  

作　　者：Yuan Wang Qixia Luo Tingting Xiao Yunying Zhu Yonghong Xiao 

机构地区：[1]State Key Laboratory for Diagnosis and Treatment of Infectious Diseases,National Clinical Research Center for Infectious Diseases,Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases,The First Affiliated Hospital,College of Medicine,Zhejiang University,Hangzhou 310003,China

出　　处：《Engineering》2022年第6期178-185,共8页工程（英文）

基　　金：supported by the National Key Research and Development Program of China (2017YFC1600100 and2017YFC1200203);the National Natural Science Foundation of China (81702040);the National Science Foundation of Zhejiang Province,China (LY20H190002)

摘　　要：Humanity is facing an enormous and growing worldwide threat from the emergence of multi-drug-resistant(MDR)Gram-negative bacteria such as Escherichia coli,Klebsiella pneumoniae,and Acinetobacter baumannii.Polymyxin B and E(colistin)constitute the last-line therapies for treating MDR Gram-negative bacteria.Polymyxin is a cationic antibacterial peptide that can destroy the outer membrane of Gram-negative bacteria.With the increasing clinical application of polymyxin,however,there have been many reports of the occurrence of polymyxin-resistant Gram-negative bacteria.This resistance is mainly mediated by the modification or complete loss of lipopolysaccharide(LPS).LPS is also a virulence factor of Gram-negative bacteria,and alterations of LPS may correlate with virulence.Although it is generally believed that the biological costs associated with drug resistance may enable benign susceptible bacteria to overcome resistant bacteria when antibiotic pressure is reduced,some studies have shown that polymyxin-resistant bacteria are associated with higher virulence and greater fitness compared with their susceptible counterparts.To predict the development of polymyxin resis-tance and evaluate interventions for its mitigation,it is important to understand the relative biological cost of polymyxin resistance compared with susceptibility.The impact of polymyxin resistance mecha-nisms on the virulence and fitness of these three Gram-negative bacteria are summarized in this review.

关 键 词：POLYMYXIN RESISTANCE VIRULENCE FITNESS Gram-negative bacteria Acinetobacter baumannii Escherichia coli Klebsiella pneumoniae 

分 类 号：R446.5[医药卫生—诊断学]