Zhanel G G, Nicolle L E
Department of Internal Medicine, Faculty of Medicine, University of Manitoba, Winnipeg, Canada.
J Antimicrob Chemother. 1992 Jun;29(6):617-27. doi: 10.1093/jac/29.6.617.
Subinhibitory antimicrobial concentrations have been reported to alter the adherence of bacteria to uroepithelial cells. Most investigators assessing the influence of subinhibitory antimicrobial concentrations on bacterial adherence in the urinary tract have employed in-vitro techniques using voided uroepithelial cells. These cells are incubated with bacteria previously exposed to antimicrobials and adherence is assessed by light microscopy. Most investigators have studied urinary Escherichia coli isolates. beta-Lactams, tetracyclines, aminoglycosides, nitrofurantoin, chloramphenicol, quinolones, trimethoprim and sulphonamides have been studied in concentrations ranging from 1/32-1/2x MIC. The following effects of subinhibitory antimicrobial concentrations on bacterial adherence have been reported: penicillins consistently reduce bacterial adherence at concentrations 1/4-1/2x MIC; nitrofurantoin and chloramphenicol demonstrate variable effects on bacterial adherence at 1/4x MIC; tetracyclines, but not doxycycline, decrease adherence at high concentrations (1/4-1/2x MIC) and increase it at low concentrations (1/8-1/32x MIC); both trimethoprim and sulphonamides consistently decrease bacterial adherence at concentrations ranging from 1/32-1/2x MIC and 1/4-1/2x MIC, respectively, but it is unclear whether the combination of trimethoprim and a sulphonamide decreases bacterial adherence to a greater extent than either agent alone; aminoglycosides decrease adherence at 1/2x MIC; and quinolones decrease adherence at 1/4x MIC, with variable effects at 1/8x MIC and 1/16x MIC. Subinhibitory antimicrobial concentrations may exert their antiadhesive effects through suppression of formation and/or expression on the surface adhesin, the formation of functionally aberrant adhesins, or a direct effect on the bacterial surface. Presently, the clinical significance of the alterations in bacterial adherence to uroepithelial cells is not fully understood.
据报道，亚抑菌浓度的抗菌药物可改变细菌对尿路上皮细胞的黏附。大多数评估亚抑菌浓度的抗菌药物对尿路中细菌黏附影响的研究人员采用体外技术，使用排空的尿路上皮细胞。将这些细胞与先前接触过抗菌药物的细菌一起孵育，并通过光学显微镜评估黏附情况。大多数研究人员研究的是尿路大肠杆菌分离株。已对β-内酰胺类、四环素类、氨基糖苷类、呋喃妥因、氯霉素、喹诺酮类、甲氧苄啶和磺胺类药物进行了研究，浓度范围为1/32-1/2倍最低抑菌浓度（MIC）。已报道亚抑菌浓度的抗菌药物对细菌黏附的以下影响：青霉素在1/4-1/2倍MIC浓度时持续降低细菌黏附；呋喃妥因和氯霉素在1/4倍MIC时对细菌黏附表现出可变影响；四环素类（但多西环素除外）在高浓度（1/4-1/2倍MIC）时降低黏附，在低浓度（1/8-1/32倍MIC）时增加黏附；甲氧苄啶和磺胺类药物分别在1/32-1/2倍MIC和1/4-1/2倍MIC浓度时持续降低细菌黏附，但尚不清楚甲氧苄啶和磺胺类药物的组合是否比单独使用任何一种药物更能降低细菌黏附；氨基糖苷类在1/2倍MIC时降低黏附；喹诺酮类在1/4倍MIC时降低黏附，在1/8倍MIC和1/16倍MIC时影响可变。亚抑菌浓度的抗菌药物可能通过抑制表面黏附素的形成和/或表达、形成功能异常的黏附素或对细菌表面产生直接作用来发挥其抗黏附作用。目前，细菌对尿路上皮细胞黏附改变的临床意义尚未完全明了。
