大肠埃希菌异质性耐药的研究进展

Research Progress in Heteroresistance of Escherichia coli

大肠埃希菌(Escherichia coli)是人类和动物中常见细菌病原体,E.coli已对多种抗菌药物产生耐药,且由于抗菌药物选择压力越来越大,致使菌株的适应性和致病性更强,耐药的传播更快、定植率更高,给全球流行病学和临床治疗带来极大的挑战。近年来,E.coli的异质性耐药(heteroresistance,HR)相关研究相继被报道,异质性耐药是指细菌中的同源亚群对某种抗菌药物表现出不同的敏感性,是敏感菌进化为耐药菌的中间阶段,不同于完全耐药,异质性耐药在临床上不易及时检出,常导致临床抗菌药物治疗失败。因此,为有效防控E.coli感染及耐药的演变,深入剖析E.coli异质性耐药的流行特征及可能的机制尤为重要,本文就E.coli的异质性耐药研究进行了梳理,并对异质性耐药从表型特征、检测方法和可能的机制等方面进行了概述。旨在加强对E.coli异质性耐药的认识和研究,以期为全面了解E.coli耐药过程及发生机制、优化抗菌药物使用策略、减缓完全耐药菌种的出现提供参考。

Escherichia coli is a commonly pathogen in humans and animals,which has developed resistance to a variety of antibiotics.Due to the increasing selection pressure of antibiotics,the E.coli strains are more adaptable and pathogenic,the spread of antimicrobial resistance is faster,and the colonization rate is higher,that poses great challenges to epidemiology and clinical treatment.In recent years,researches related to heteroresistance(HR)of E.coli have been reported.HR refers to the fact that the homologous subpopulations in bacteria show different susceptibility to a certain antibiotic,which is the intermediate stage of sensitive bacteria evolving into drug-resistant bacteria.Different from full resistance,it is difficult for HR to be detected clinically in time,which often leads to the failure of clinical therapy.Therefore,in order to effectively prevent and control E.coli infection and the evolution of antimicrobial resistance,it is particularly important to deeply analyze the epidemiological characteristics and possible mechanisms of E.coli’s HR.This paper sorts the studies on HR,and reviews the phenotypic characteristics,detection methods and possible mechanisms of HR.It is aimed to strengthen the understanding and research on the HR of E.coli,and to provide a comprehensive understanding of E.coli antimicrobial resistance process and mechanism,optimizing antibiotics use strategies,and slowing down the emergence of resistant strains.