抗菌多药耐药的分子机制

Molecular mechanisms of antibacterial multidrug resistance.

作者信息

Alekshun Michael N, Levy Stuart B

机构信息

Schering-Plough Research Institute, Kenilworth, NJ 07033, USA.

出版信息

Cell. 2007 Mar 23;128(6):1037-50. doi: 10.1016/j.cell.2007.03.004.

DOI:10.1016/j.cell.2007.03.004

PMID:17382878

Abstract

Treatment of infections is compromised worldwide by the emergence of bacteria that are resistant to multiple antibiotics. Although classically attributed to chromosomal mutations, resistance is most commonly associated with extrachromosomal elements acquired from other bacteria in the environment. These include different types of mobile DNA segments, such as plasmids, transposons, and integrons. However, intrinsic mechanisms not commonly specified by mobile elements-such as efflux pumps that expel multiple kinds of antibiotics-are now recognized as major contributors to multidrug resistance in bacteria. Once established, multidrug-resistant organisms persist and spread worldwide, causing clinical failures in the treatment of infections and public health crises.

摘要

多重耐药细菌的出现使全球范围内的感染治疗受到影响。虽然传统上认为耐药性是由染色体突变引起的，但耐药性最常与从环境中其他细菌获得的染色体外元件有关。这些元件包括不同类型的可移动DNA片段，如质粒、转座子和整合子。然而，现在人们认识到，由移动元件通常未明确指定的内在机制，如能排出多种抗生素的外排泵，是细菌多重耐药的主要原因。一旦形成，多重耐药生物就会在全球持续存在并传播，导致感染治疗的临床失败和公共卫生危机。