Academy of Chinese Medical Sciences, Henan University of Chinese Medicine, Zhengzhou, China.
Eur Rev Med Pharmacol Sci. 2020 Sep;24(18):9274-9281. doi: 10.26355/eurrev_202009_23009.
The oxazolidinone drug linezolid is mainly used for severe infections caused by multidrug-resistant Gram-positive bacteria. However, emerging linezolid resistance is aggravating difficulties in the treatment of certain infectious diseases. The objective of this review was to provide a reference for researchers and clinicians to be able to better face together the serious challenge of antimicrobial resistance.
A systematic literature search was performed using PubMed, Web of Science, Google Scholar, and the China National Knowledge Infrastructure (CNKI) database. The articles were scrutinized to extract information on oxazolidinone drug linezolid resistance, and the prevalence of the resistance gene optrA. We reviewed the latest advances in epidemic properties, resistance mechanism, and transfer mechanism of linezolid resistance genes in different isolates isolated from various samples worldwide.
Initially, it was thought that linezolid resistance was related to the change in drug target mediated by mutations in the 23S rRNA gene, rplC, rplD, and cfr. optrA was discovered in 2015, and is a gene encoding oxazolidinone resistance, which exists in both plasmids and chromosomes, but mostly plasmids. The emergence of the novel plasmid-borne ABC transporter gene optrA expanded the understanding of the mechanism of linezolid resistance.
At present, the prevalence of linezolid resistance has become increasingly serious. The resistance gene optrA has been reported in Enterococcus, Staphylococcus squirrel and Streptococcus, which indicates that this gene has a strong ability to spread across bacteria, so the prevalence and spread of optrA gene should be monitored carefully.
恶唑烷酮类药物利奈唑胺主要用于治疗多重耐药革兰阳性菌引起的严重感染。然而，利奈唑胺耐药性的出现加剧了某些传染病治疗的困难。本综述的目的是为研究人员和临床医生提供参考，以便能够更好地共同应对抗菌药物耐药性的严峻挑战。
通过 PubMed、Web of Science、Google Scholar 和中国知网（CNKI）数据库进行系统文献检索。仔细筛选这些文章，以提取有关恶唑烷酮类药物利奈唑胺耐药性和耐药基因 optrA 流行率的信息。我们综述了来自全球不同样本中分离的不同分离株的利奈唑胺耐药基因的流行特征、耐药机制和转移机制的最新进展。
最初认为利奈唑胺耐药与药物靶标 23S rRNA 基因、rplC、rplD 和 cfr 介导的突变有关。2015 年发现 optrA 是一种编码恶唑烷酮类药物耐药的基因，它存在于质粒和染色体中，但主要存在于质粒中。新型质粒携带的 ABC 转运蛋白基因 optrA 的出现扩展了对利奈唑胺耐药机制的认识。
目前，利奈唑胺耐药的流行情况日益严重。已在屎肠球菌、松鼠葡萄球菌和链球菌中报告了耐药基因 optrA，这表明该基因具有在细菌间传播的强大能力，因此应密切监测 optrA 基因的流行和传播。
