非鲍曼的不动杆菌耐药机制研究进展

Advances in the molecular mechanisms of antibiotics resistance in non-baumannii Acinetobacter

鲍曼不动杆菌是世界公认的医院感染主要致病菌之一;而非鲍曼的不动杆菌(Non-baumannii Acinetobacter,NbA)也逐步成为医院和社区感染的病原菌之一。NbA的临床分离率、耐药率仍明显低于鲍曼不动杆菌,但已屡有多耐药的NbA导致严重医院感染的报道。因此,其临床重要性可能并未得到应有的重视。NbA是否会像其同属的鲍曼不动杆菌一样成为临床重要病原菌?目前已发现NbA存在一些明显的有别于鲍曼不动杆菌的耐药机制和特点。本文主要从产生水解酶、外排泵机制等方面综述NbA的耐药分子机制,并探讨相关研究中存在的问题。

Acinetobacter baumannii was recognized worldwide as one of the main pathogens of nosocomial infection; Species of Acinetobacter other than Acinetobacter baumannii are generally called non-baumannii Acinetobacter （NbA）, which were involved in nosocomial and community acquired infections. Overall the isolation rate and antirnicrobial resistance rates of NbA are much lower than that of Acinetobacter baumannii, but the differences are now becoming less apparent, for the growing reports of severe nosocomial infection caused by NbA. The clinical significance of NbA may be greatly underestimated. It is worth to note that whether NbA will emerge as another successful clinically important pathogens like its homogeneous member--Acinetobacter baumannii？ Research data have disclosed that there were some differences in antimicrobial resistance mechanisms between Acinetobacter baumannii and the other Acinetobacter species. In this review, we formulated the leading mechanisms concerning hydrolytic enzymes production, targets modification and active efflux in NbA, and the main problems in the researches of antimicrobial resistance mechanisms.