Department of Laboratory Medicine, Affiliated Hospital of Nantong University, Nantong, China.
Institute of Public Health, Nantong University, Nantong, China.
Ann Palliat Med. 2021 Jun;10(6):6926-6935. doi: 10.21037/apm-20-2247. Epub 2021 May 20.
The prevalence of antibiotic resistance is a growing worldwide problem in the control of pathogens, particularly negative bacteria that are resistant to antibiotics, Pseudomonas aeruginosa (PA) is one of these bacteria. The development of new effective antibiotics is time-consuming and costly, and the new antibiotics may become resistant again. Therefore, non-antibiotic clinical treatment for antibiotic-resistant PA infection is necessary and needs to be strengthened. The antibiotic resistance (AR) mechanism of PA is complex. Biofilm formation is one of the reasons why its resistance is difficult to overcome. The formation of biofilms is mainly regulated by quorum sensing (QS). QS is a mechanism by which PA increases its virulence by producing small diffusible molecules, which regulates a series of genes associated with virulence and nutrient acquisition. QS inhibitors are potions that obstruct QS systems in bacteria and destruction of virulence. This review summarizes AR mechanism of PA, Basic knowledge of QS of PA and some non-antibiotic methods for inhibiting PA, including QS inhibitors, which have potential and far-reaching significance for antibiotic-resistant PA's clinical treatment. The review helps to provide new ideas and new schemes for clinical anti-PA infection research and treatment, and has positive significance for delaying the occurrence of bacterial drug resistance and antibiotic use management.
抗生素耐药性的流行是全球范围内控制病原体的一个日益严重的问题，特别是对抗生素具有耐药性的阴性细菌，铜绿假单胞菌（PA）就是其中之一。开发新的有效抗生素既耗时又昂贵，而且新的抗生素可能再次产生耐药性。因此，需要对具有抗生素耐药性的 PA 感染进行非抗生素的临床治疗，并需要加强这方面的治疗。PA 的抗生素耐药（AR）机制复杂。生物膜形成是其耐药性难以克服的原因之一。生物膜的形成主要受群体感应（QS）调节。QS 是一种机制，通过产生小的可扩散分子，PA 可以增加其毒力，这些分子调节与毒力和营养获取相关的一系列基因。QS 抑制剂是阻止细菌中 QS 系统并破坏毒力的药物。本综述总结了 PA 的 AR 机制、PA 的 QS 基础知识和一些抑制 PA 的非抗生素方法，包括 QS 抑制剂，这些方法对治疗具有抗生素耐药性的 PA 具有潜在的、深远的意义。该综述有助于为临床抗 PA 感染研究和治疗提供新的思路和新方案，对延缓细菌耐药性的发生和抗生素的使用管理具有积极意义。
