Servicio de Microbiología and CIBER en Epidemiología y Salud Pública, Hospital Universitario Ramón y Cajal and Instituto Ramón y Cajal de Investigación Sanitaria, Carretera Colmenar Km 9.1. 28034 Madrid, Spain.
Curr Opin Pharmacol. 2011 Oct;11(5):477-85. doi: 10.1016/j.coph.2011.07.007. Epub 2011 Aug 11.
Co-resistance involves transfer of several genes into the same bacteria and/or the acquisition of mutations in different genetic loci affecting different antimicrobials whereas pleiotropic resistance implies the same genetic event affecting several antimicrobials. There is an increasing prevalence of isolates with co-resistance which are over-represented within the so-called high-risk clones. Compensatory events avoid fitness cost of co-resistance, even in the absence of antimicrobials. Nevertheless, they might be selected by different antimicrobials and a single agent might select co-resistant isolates. This process, named as co-selection, is not avoided with cycling or mixing strategies of antimicrobial use. Co-resistance and co-selection processes increase the opportunity for persistence of the bacteria and resistance genes and should be considered when designing strategies for decreasing antimicrobial resistance.
共耐药性涉及将多个基因转移到同一细菌中，和/或在影响不同抗菌药物的不同遗传基因座获得突变，而多效耐药性则意味着同一遗传事件影响几种抗菌药物。具有共耐药性的分离株越来越普遍，在所谓的高风险克隆中过度表达。补偿事件避免了共耐药性的适应性代价，即使没有抗菌药物也是如此。然而，它们可能会被不同的抗菌药物选择，并且单一药物可能会选择共耐药分离株。这个过程，被称为共选择，不能通过循环或混合使用抗菌药物的策略来避免。共耐药性和共选择过程增加了细菌和耐药基因持续存在的机会，在设计减少抗菌药物耐药性的策略时应予以考虑。
