Liu Wan-Ting, Chen En-Zhong, Yang Ling, Peng Chen, Wang Qun, Xu Zhenbo, Chen Ding-Qiang
Microbiome Medicine Center, Division of Laboratory Medicine, Zhujiang Hospital, Southern Medical University, Guangzhou, Guangdong, 510282, China.
Department of Laboratory Medicine, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, Guangdong, 510120, China.
Microb Pathog. 2021 Jul;156:104915. doi: 10.1016/j.micpath.2021.104915. Epub 2021 Apr 27.
Staphylococcus aureus is one of the leading hospital-associated and community-associated pathogens, which has caused a global public health concern. The emergence of methicillin-resistant S. aureus (MRSA) along with the widespread use of different classes of antibiotics has become a significant therapeutic challenge. Antibiotic resistance is a disturbing problem that poses a threat to humans. Treatment options for S. aureus resistant to β-lactam antibiotics include glycopeptide antibiotic, cyclic lipopeptide antibiotic, cephalosporins and oxazolidinone antibiotic. The most representative types of these antibiotics are vancomycin, daptomycin, ceftaroline and linezolid. The frequent use of the first-line drug vancomycin for MRSA treatment has increased the number of resistant strains, namely vancomycin intermediate resistant S. aureus (VISA) and vancomycin resistant S. aureus (VRSA). A systematic literature review of relevant published studies in PubMed before 2020 was conducted. In recent years, there have been some reports on the relevant resistant mechanisms of vancomycin, daptomycin, ceftaroline and linezolid. In this review, we have summarized the antibiotic molecular modes of action and different gene mutants at the whole-genome level, which will aid in further development on new drugs for effective MRSA treatment based on describing different resistance mechanisms of classic antibiotics.
金黄色葡萄球菌是主要的医院相关和社区相关病原体之一，已引起全球公共卫生关注。耐甲氧西林金黄色葡萄球菌（MRSA）的出现以及不同类抗生素的广泛使用已成为重大的治疗挑战。抗生素耐药性是一个令人不安的问题，对人类构成威胁。对β-内酰胺类抗生素耐药的金黄色葡萄球菌的治疗选择包括糖肽类抗生素、环脂肽类抗生素、头孢菌素和恶唑烷酮类抗生素。这些抗生素最具代表性的类型是万古霉素、达托霉素、头孢洛林和利奈唑胺。一线药物万古霉素用于治疗MRSA的频繁使用增加了耐药菌株的数量，即万古霉素中介耐药金黄色葡萄球菌（VISA）和万古霉素耐药金黄色葡萄球菌（VRSA）。我们对2020年之前在PubMed上发表的相关研究进行了系统的文献综述。近年来，已有一些关于万古霉素、达托霉素、头孢洛林和利奈唑胺相关耐药机制的报道。在本综述中，我们总结了抗生素在全基因组水平上的分子作用模式和不同的基因突变体，这将有助于在描述经典抗生素不同耐药机制的基础上进一步开发有效的MRSA治疗新药。
