Meletis Georgios, Skoura Lemonia
Department of Microbiology, AHEPA University Hospital, S. Kiriakidi Str. 1, 54636, Thessaloniki, Greece.
Recent Pat Antiinfect Drug Discov. 2018;13(3):198-206. doi: 10.2174/1574891X14666181126142704.
The global spread of carbapenemase-encoding genes among Gram-negative nosocomial pathogens has led to the revival of polymyxins. Colistin and polymyxin B, despite their serious adverse effects, have become last resort treatment options for multi- or even extensively-drug-resistant bacterial infections due to Klebsiella pneumoniae, Acinetobacter baumannii and Pseudomonas aeruginosa. Their use, however, has been followed by an increase in polymyxin resistance rates and the spread of transferable resistance genes limiting further the treatment options and contributing to the emergence of pan-drug-resistance. In the present review, the to-date known polymyxin resistance mechanisms, as well as patents related to polymyxin resistance, are discussed.
碳青霉烯酶编码基因在革兰氏阴性医院病原体中的全球传播导致了多粘菌素的再度使用。尽管粘菌素和多粘菌素B具有严重的不良反应，但由于肺炎克雷伯菌、鲍曼不动杆菌和铜绿假单胞菌引起的多重甚至广泛耐药细菌感染，它们已成为最后的治疗选择。然而，它们的使用之后多粘菌素耐药率上升以及可转移耐药基因的传播，进一步限制了治疗选择并促使全耐药的出现。在本综述中，讨论了迄今为止已知的多粘菌素耐药机制以及与多粘菌素耐药相关的专利。
