临床常见病原菌对替加环素耐药机制研究进展

Advances in Resistant Mechanisms of Clinical Isolated Bacteria to Tigecycline

目的探讨临床常见耐药菌对替加环素产生耐药的机制,对相关研究进展进行综述。方法综述了近年来国内外相关报道,根据细菌产生耐药的机制进行分类阐述,并对替加环素耐药菌的流行情况进行分析。结果细菌对替加环素产生耐药的机制主要与主动外排系统有关,另外还包括药物作用靶位的改变、耐药酶的产生2个方面。在主动外排机制中,RND家族外排泵起着关键作用。替加环素耐药菌在许多国家已经成为临床抗感染难题。结论替加环素耐药机制还需要进一步研究,从而指导临床合理使用替加环素。

OBJECTIVE To review the research progress on the resistant mechanisms of tigecycline-resistant bacterias in clinic. METHODS Base on the correlative reports in recent years, the resistant mechanisms of tigecycline-resistant bacterias were illustrated respectively. Also, the epidemiology of tigecycline-resistant bacterias were analyzed subsequently. RESULTS The resistant mechanisms of tigecycline-resistant bacterias mainly involved the efflux pump system and alteration of the drug targets, as well as the occurrence of resistant enzymes. The RND efflux pump plays a key role in the efflux pump system. Tigecycline-resistant bacterias has become a tough problem in clinical anti-infection therapy. CONCLUSION The definite mechanism of tigecycline resistant remains elusive. Further study are needed so as to guide rational use of tigecycline in clinic.