Hancock R E, Woodruff W A
Department of Microbiology, University of British Columbia, Vancouver, Canada.
Rev Infect Dis. 1988 Jul-Aug;10(4):770-5. doi: 10.1093/clinids/10.4.770.
Pseudomonas aeruginosa demonstrates high intrinsic resistance to most beta-lactam antibiotics. Two factors that are interrelated appear to be important in this intrinsic resistance: an inducible, chromosomally encoded type Id beta-lactamase and low outer-membrane permeability. beta-Lactamase-noninducible mutants are supersusceptible to many beta-lactam agents, whereas constitutively derepressed mutants are considerably more resistant even to so-called beta-lactamase-stable beta-lactams. For the latter mutants, by analysis of kinetics, it can be demonstrated that synergy between slow permeation across the outer membrane and slow hydrolysis of the beta-lactamase-stable beta-lactams can explain resistance. Wild-type P. aeruginosa allows outer membrane permeation of beta-lactam agents at rates 1%-8% of those measured for Escherichia coli. The majority of trans-outer-membrane channels formed by P. aeruginosa porin protein F are too small to allow passage of beta-lactam antibiotics. Nevertheless, this porin is apparently a conduit for beta-lactams, since protein F-deficient mutants have small changes in susceptibility to certain beta-lactam agents. This low outer-membrane permeability acting in synergy with beta-lactamase is probably responsible for intrinsic beta-lactam resistance in P. aeruginosa.
铜绿假单胞菌对大多数β-内酰胺类抗生素表现出高度的固有耐药性。两个相互关联的因素似乎在这种固有耐药性中起重要作用:一种可诱导的、染色体编码的Ⅰd型β-内酰胺酶和低外膜通透性。β-内酰胺酶非诱导型突变体对许多β-内酰胺类药物超敏感,而组成型去阻遏突变体甚至对所谓的β-内酰胺酶稳定的β-内酰胺类药物也有更强的耐药性。对于后一种突变体,通过动力学分析可以证明,外膜缓慢渗透与β-内酰胺酶稳定的β-内酰胺类药物缓慢水解之间的协同作用可以解释耐药性。野生型铜绿假单胞菌允许β-内酰胺类药物通过外膜的速率仅为大肠杆菌所测速率的1% - 8%。铜绿假单胞菌孔蛋白F形成的大多数跨外膜通道太小,无法允许β-内酰胺类抗生素通过。然而,这种孔蛋白显然是β-内酰胺类药物的通道,因为缺乏蛋白F的突变体对某些β-内酰胺类药物的敏感性有微小变化。这种低外膜通透性与β-内酰胺酶协同作用可能是铜绿假单胞菌固有β-内酰胺耐药性的原因。