多黏菌素异质性耐药机制研究进展  

Progress in the Study of Polymyxin Heteroresistance Molecular Mechanisms

作　　者：李琰冰 周梦兰[1,2,4] 徐英春 LI Yanbing;ZHOU Menglan;XU Yingchun(Department of Laboratory Medicine,Peking Union Medical College Hospital,Chinese Academy of Medical Sciences&Peking Union Medical College,Beijing 100730,China;State Key Laboratory of Complex Severe and Rare Diseases,Peking Union Medical College Hospital,Chinese Academy of Medical Sciences&Peking Union Medical College,Beijing 100730,China;Graduate School,Chinese Academy of Medical Sciences&Peking Union Medical College,Beijing 100730,China;Beijing Key Laboratory for Mechanisms Research and Precision Diagnosis of Invasive Fungal Diseases,Peking Union Medical College Hospital,Chinese Academy of Medical Sciences&Peking Union Medical College,Beijing 100730,China)

机构地区：[1]中国医学科学院北京协和医院检验科,北京100730 [2]中国医学科学院北京协和医院疑难重症及罕见病国家重点实验室,北京100730 [3]中国医学科学院北京协和医学院研究生院,北京100730 [4]中国医学科学院北京协和医院侵袭性真菌病机制研究与精准诊断北京市重点实验室,北京100730

出　　处：《协和医学杂志》2025年第1期177-183,共7页Medical Journal of Peking Union Medical College Hospital

基　　金：国家自然科学基金青年科学项目(82202541);中央高校基本科研业务费项目(3332022012)。

摘　　要：多黏菌素是一种环肽类抗菌药物,近年来随着多重耐药菌检出率不断攀升,多黏菌素类药物已成为治疗革兰阴性菌感染的最后手段。异质性耐药是指同一菌株中存在对抗菌药物敏感性不同的亚群,临床常规检测无法识别,感染异质性耐药菌株可导致临床治疗失败。在临床常见的革兰阴性菌中,PhoPQ和PmrAB双组分系统突变是导致多黏菌素异质性耐药的关键因素。本文围绕常见的革兰阴性菌,梳理其对多黏菌素异质性耐药机制研究进展,以期为快速准确检测异质性耐药菌株新技术的开发和临床治疗方案的制订提供更多参考依据。Polymyxins,a class of cyclic peptide antibiotics,have become the last line of defense against gram-negative bacterial infections as the number of multidrug-resistant bacteria continues to rise.Heteroresistance refers to the presence of subpopulations within the same strain with varying sensitivities to antibiotics,which cannot be detected by standard clinical tests and may result in treatment failure.In several common gram-negative bacteria,mutations in the PhoPQ and PmrAB two-component systems are key contributors to polymyxin heteroresistance.This review aims to summarize recent research on the mechanisms of polymyxin heteroresistance in gram-negative bacteria,so as to provide insights for developing rapid detection methods and improving clinical treatment strategies.

关 键 词：多黏菌素 异质性耐药 革兰阴性菌 分子机制 

分 类 号：R37[医药卫生—病原生物学] R563[医药卫生—基础医学]