Rajput Pratiksing, Nahar Kazi S, Rahman Khondaker Miraz
Institute of Pharmaceutical Science, King's College London, 150 Stamford Street, London SE1 9NH, UK.
Department of Natural Sciences, Faculty of Science & Technology, Middlesex University, The Burroughs, Hendon, London NW4 4BT, UK.
Antibiotics (Basel). 2024 Dec 8;13(12):1197. doi: 10.3390/antibiotics13121197.
The prevalence of resistance in Gram-positive bacterial infections is rapidly rising, presenting a pressing global challenge for both healthcare systems and economies. The WHO categorizes these bacteria into critical, high, and medium priority groups based on the urgency for developing new antibiotics. While the first priority pathogen list was issued in 2017, the 2024 list remains largely unchanged. Despite six years having passed, the progress that has been made in developing novel treatment approaches remains insufficient, allowing antimicrobial resistance to persist and worsen on a global scale. Various strategies have been implemented to address this growing threat by targeting specific resistance mechanisms. This review evaluates antimicrobial resistance (AMR) in Gram-positive bacteria, highlighting its critical impact on global health due to the rise of multidrug-resistant pathogens. It focuses on the unique cell wall structure of Gram-positive bacteria, which influences their identification and susceptibility to antibiotics. The review explores the mechanisms of AMR, including enzymatic inactivation, modification of drug targets, limiting drug uptake, and increased drug efflux. It also examines the resistance strategies employed by high-priority Gram-positive pathogens such as , , and , as identified in the WHO's 2024 priority list.
革兰氏阳性菌感染的耐药性患病率正在迅速上升，这对医疗系统和经济都构成了紧迫的全球挑战。世界卫生组织根据开发新抗生素的紧迫性，将这些细菌分为关键、高和中优先级组。虽然第一份优先病原体清单于2017年发布，但2024年的清单基本保持不变。尽管已经过去了六年，但在开发新治疗方法方面取得的进展仍然不足，使得抗菌药物耐药性在全球范围内持续存在并恶化。通过针对特定的耐药机制，已经实施了各种策略来应对这一日益严重的威胁。本综述评估了革兰氏阳性菌中的抗菌药物耐药性（AMR），强调了由于多重耐药病原体的增加，其对全球健康的关键影响。它关注革兰氏阳性菌独特的细胞壁结构，这影响了它们的鉴定以及对抗生素的敏感性。该综述探讨了AMR的机制，包括酶促失活、药物靶点修饰、限制药物摄取和增加药物外排。它还研究了世界卫生组织2024年优先清单中确定的高优先级革兰氏阳性病原体（如 、 和 ）所采用的耐药策略。
