Kakoullis Loukas, Papachristodoulou Eleni, Chra Paraskevi, Panos George
Department of Respiratory Medicine, University General Hospital of Patras, 26504 Patras, Greece.
Department of Medicine, School of Health Sciences, University of Patras, 26504 Patras, Greece.
Antibiotics (Basel). 2021 Apr 10;10(4):415. doi: 10.3390/antibiotics10040415.
Multidrug-resistant bacteria have on overwhelming impact on human health, as they cause over 670,000 infections and 33,000 deaths annually in the European Union alone. Of these, the vast majority of infections and deaths are caused by only a handful of species-multi-drug resistant , , , spp., spp. and . These pathogens employ a multitude of antibiotic resistance mechanisms, such as the production of antibiotic deactivating enzymes, changes in antibiotic targets, or a reduction of intracellular antibiotic concentration, which render them insusceptible to multiple antibiotics. The purpose of this review is to summarize in a clinical manner the resistance mechanisms of each of these 6 pathogens, as well as the mechanisms of recently developed antibiotics designed to overcome them. Through a basic understanding of the mechanisms of antibiotic resistance, the clinician can better comprehend and predict resistance patterns even to antibiotics not reported on the antibiogram and can subsequently select the most appropriate antibiotic for the pathogen in question.
多重耐药菌对人类健康产生了巨大影响，仅在欧盟，它们每年就导致超过67万例感染和3.3万例死亡。其中，绝大多数感染和死亡仅由少数几种多重耐药菌引起，如耐甲氧西林金黄色葡萄球菌、肺炎克雷伯菌、鲍曼不动杆菌和铜绿假单胞菌。这些病原体采用多种抗生素耐药机制，如产生抗生素失活酶、改变抗生素靶点或降低细胞内抗生素浓度，这使得它们对多种抗生素不敏感。本综述的目的是以临床方式总结这6种病原体各自的耐药机制，以及为克服这些机制而研发的新型抗生素的作用机制。通过对抗生素耐药机制的基本了解，临床医生能够更好地理解和预测甚至针对抗菌谱未报告的抗生素的耐药模式，并随后为相关病原体选择最合适的抗生素。
