Adegoke Anthony A, Stenström Thor A, Okoh Anthony I
Institute for Water and Wastewater Technology, Durban University of Technology, Durban, South Africa.
Applied and Environmental Microbiology Research Group, University of Fort Hare, Alice, South Africa.
Front Microbiol. 2017 Nov 30;8:2276. doi: 10.3389/fmicb.2017.02276. eCollection 2017.
is a commensal and an emerging pathogen earlier noted in broad-spectrum life threatening infections among the vulnerable, but more recently as a pathogen in immunocompetent individuals. The bacteria are consistently being implicated in necrotizing otitis, cutaneous infections including soft tissue infection and keratitis, endocarditis, meningitis, acute respiratory tract infection (RTI), bacteraemia (with/without hematological malignancies), tropical pyomyositis, cystic fibrosis, septic arthritis, among others. is also an environmental bacteria occurring in water, rhizospheres, as part of the animals' microflora, in foods, and several other microbiota. This review highlights clinical reports on both as an opportunistic and as true pathogen. Also, biofilm formation as well as quorum sensing, extracellular enzymes, flagella, pili/fimbriae, small colony variant, other virulence or virulence-associated factors, the antibiotic resistance factors, and their implications are considered. Low outer membrane permeability, natural MDR efflux systems, and/or resistance genes, resistance mechanisms like the production of two inducible chromosomally encoded β-lactamases, and lack of carefully compiled patient history are factors that pose great challenges to the control arsenals. The fluoroquinolone, some tetracycline derivatives and trimethoprim-sulphamethaxole (TMP-SMX) were reported as effective antibiotics with good therapeutic outcome. However, TMP-SMX resistance and allergies to sulfa together with high toxicity of fluoroquinolone are notable setbacks. 's production and sustenance of biofilm by quorum sensing enhance their virulence, resistance to antibiotics and gene transfer, making quorum quenching an imperative step in control. Incorporating several other proven approaches like bioengineered bacteriophage therapy, Epigallocatechin-3-gallate (EGCG), essential oil, nanoemulsions, and use of cationic compounds are promising alternatives which can be incorporated in control arsenal.
它是一种共生菌，也是一种新出现的病原体，早期在弱势群体中引发的广谱危及生命的感染中被发现，但最近在免疫功能正常的个体中也被视为病原体。这种细菌一直与坏死性中耳炎、包括软组织感染和角膜炎在内的皮肤感染、心内膜炎、脑膜炎、急性呼吸道感染（RTI）、菌血症（伴/不伴血液系统恶性肿瘤）、热带脓性肌炎、囊性纤维化、化脓性关节炎等有关。它也是一种环境细菌，存在于水、根际、作为动物微生物群的一部分、食物以及其他几种微生物群落中。本综述重点介绍了关于它作为机会性病原体和真正病原体的临床报告。此外，还考虑了生物膜形成以及群体感应、胞外酶、鞭毛、菌毛/纤毛、小菌落变体、其他毒力或毒力相关因素、抗生素耐药因素及其影响。外膜通透性低、天然多药耐药外排系统和/或耐药基因、如产生两种可诱导的染色体编码β-内酰胺酶的耐药机制以及缺乏详细的患者病史等因素，给控制手段带来了巨大挑战。氟喹诺酮类、一些四环素衍生物和甲氧苄啶-磺胺甲恶唑（TMP-SMX）被报道为具有良好治疗效果的有效抗生素。然而，TMP-SMX耐药性、对磺胺类药物的过敏反应以及氟喹诺酮类药物的高毒性是明显的障碍。它通过群体感应产生和维持生物膜增强了其毒力、对抗生素的耐药性和基因转移，使得群体猝灭成为控制它的必要步骤。纳入其他几种已证实的方法，如生物工程噬菌体疗法、表没食子儿茶素-3-没食子酸酯（EGCG）、精油、纳米乳剂以及使用阳离子化合物，是有前景的替代方法，可以纳入控制手段中。
