Geisinger Edward, Isberg Ralph R
Howard Hughes Medical Institute, and.
Department of Molecular Biology and Microbiology, Tufts University School of Medicine, Boston, Massachusetts.
J Infect Dis. 2017 Feb 15;215(suppl_1):S9-S17. doi: 10.1093/infdis/jiw402.
Diseases caused by antibiotic-resistant bacteria in hospitals are the outcome of complex relationships between several dynamic factors, including bacterial pathogenicity, the fitness costs of resistance in the human host, and selective forces resulting from interventions such as antibiotic therapy. The emergence and fate of mutations that drive antibiotic resistance are governed by these interactions. In this review, we will examine how different forms of antibiotic resistance modulate bacterial fitness and virulence potential, thus influencing the ability of pathogens to evolve in the context of nosocomial infections. We will focus on 3 important multidrug-resistant pathogens that are notoriously problematic in hospitals: Pseudomonas aeruginosa, Acinetobacter baumannii, and Staphylococcus aureus. An understanding of how antibiotic resistance mutations shape the pathobiology of multidrug-resistant infections has the potential to drive novel strategies that can control the development and spread of drug resistance.
医院中由耐抗生素细菌引起的疾病是多种动态因素之间复杂关系的结果，这些因素包括细菌致病性、在人类宿主中耐药性的适应性代价，以及抗生素治疗等干预措施产生的选择压力。驱动抗生素耐药性的突变的出现和命运受这些相互作用的支配。在本综述中，我们将研究不同形式的抗生素耐药性如何调节细菌适应性和毒力潜力，从而影响病原体在医院感染环境中进化的能力。我们将重点关注医院中臭名昭著的3种重要多重耐药病原体：铜绿假单胞菌、鲍曼不动杆菌和金黄色葡萄球菌。了解抗生素耐药性突变如何塑造多重耐药感染的病理生物学，有可能推动控制耐药性发展和传播的新策略。
