Korczak Lukasz, Majewski Piotr, Iwaniuk Dominika, Sacha Pawel, Matulewicz Mariola, Wieczorek Piotr, Majewska Paulina, Wieczorek Anna, Radziwon Piotr, Tryniszewska Elzbieta
Department of Microbiological Diagnostics and Infectious Immunology, Medical University of Bialystok, Bialystok, Poland.
Regional Centre for Transfusion Medicine, Bialystok, Poland.
Front Cell Infect Microbiol. 2024 Apr 9;14:1289396. doi: 10.3389/fcimb.2024.1289396. eCollection 2024.
The global emergence of antimicrobial resistance to multiple antibiotics has recently become a significant concern. Gram-negative bacteria, known for their ability to acquire mobile genetic elements such as plasmids, represent one of the most hazardous microorganisms. This phenomenon poses a serious threat to public health. Notably, the significance of tigecycline, a member of the antibiotic group glycylcyclines and derivative of tetracyclines has increased. Tigecycline is one of the last-resort antimicrobial drugs used to treat complicated infections caused by multidrug-resistant (MDR) bacteria, extensively drug-resistant (XDR) bacteria or even pan-drug-resistant (PDR) bacteria. The primary mechanisms of tigecycline resistance include efflux pumps' overexpression, genes and outer membrane porins. Efflux pumps are crucial in conferring multi-drug resistance by expelling antibiotics (such as tigecycline by direct expelling) and decreasing their concentration to sub-toxic levels. This review discusses the problem of tigecycline resistance, and provides important information for understanding the existing molecular mechanisms of tigecycline resistance in . The emergence and spread of pathogens resistant to last-resort therapeutic options stands as a major global healthcare concern, especially when microorganisms are already resistant to carbapenems and/or colistin.
全球范围内多重抗生素耐药性的出现最近已成为一个重大问题。革兰氏阴性菌以能够获取诸如质粒等可移动遗传元件而闻名，是最具危害性的微生物之一。这一现象对公众健康构成了严重威胁。值得注意的是，抗生素甘氨酰环素类成员、四环素衍生物替加环素的重要性有所增加。替加环素是用于治疗由多重耐药（MDR）菌、广泛耐药（XDR）菌甚至泛耐药（PDR）菌引起的复杂感染的最后手段抗菌药物之一。替加环素耐药的主要机制包括外排泵的过度表达、基因和外膜孔蛋白。外排泵通过排出抗生素（如直接排出替加环素）并将其浓度降低至亚毒性水平，在赋予多重耐药性方面起着关键作用。本综述讨论了替加环素耐药问题，并为理解替加环素耐药的现有分子机制提供了重要信息。对最后手段治疗选择耐药的病原体的出现和传播是全球主要的医疗保健问题，尤其是当微生物已经对碳青霉烯类和/或黏菌素耐药时。
