金黄色葡萄球菌对达托霉素临床耐药性的研究进展

Clinical research progress of daptomycin resistance of Staphylococcus aureus

达托霉素(daptomycin,DAP)是一种环脂肽类抗生素,DAP作用机制与其他许多抗生素不同。DAP通过扰乱细胞膜对氨基酸的转运,从而阻碍细菌细胞壁肽聚糖的磷壁(酸)脂质(LTA)的生物合成。DAP主要作用于病菌细胞膜,DAP具有在体外抗绝大多数革兰阳性菌的作用。最近国际病例报告显示,有较多患者在服用此药治疗过程中产生了DAP耐药性(DAP-R)。金黄色葡萄球菌对DAP可能存在多种耐药机制,对DAP耐药性的临床产生过程也较为复杂,预防对DAP的耐药发生和合理治疗耐DAP金黄色葡萄球菌感染就显得尤为重要。

Daptomycin （DAP） is a cyclo-lipopeptide antibiotic, with different action mechanism from with other bacteria. It blocks biosynthesis of lipoteichoic acid from peptidoglycan of bacterial cell wall, by disturbing transportation of amino acids by ceil membrane. It mainly acts on membranes of pathogenic bacteria, and has antibacterial action to overwhelm most Gram-posi- tive bacteria in vitro. However, recently many cases show daptomycin resistance （DAP-R）. Staphylococcus aureus may have some resistance mechanism to daptomycin, but the process is more complicated, and it is particularly important to prevent oc- currence of daptomycin resistance and rationally treat infection of daptomycin resistant Staphylococcus aureus.