耐碳青霉烯类大肠埃希菌对替加环素的耐药机制及治疗

The resistance mechanism of carbapenem-resistant Escherichia coli to tigecycline and therapies

大肠埃希菌是一种常见的共生菌和致病菌,作为肠道和尿路感染及败血症的主要致病菌,给全球的医疗卫生系统带来了巨大的负担。近年来,由于临床上抗菌药物的滥用,导致耐碳青霉烯类大肠埃希菌(CREO)产生,对临床治疗是一个严峻挑战。替加环素是治疗CREO的一线用药之一,但CREO可对替加环素产生耐药性。CREO对替加环素的耐药机制包括外排泵过表达、质粒介导的耐药基因、脂多糖核心生物合成途径基因突变等。本文综述了CREO对替加环素的耐药机制,探讨对耐替加环素CERO的治疗。

Escherichia coli is a common commensal and pathogenic bacterium in the human microflora.As a major causative agent of enteric,septicemia,and urinary tract infections,Escherichia coli poses a huge burden on healthcare systems worldwide.In recent years,the misuse of antimicrobial agents in clinical practice has led to the emergence of carbapenemresistant Escherichia coli(CREO),posing a serious challenge to clinical treatment.Tigecycline is considered to be one of the first-line therapies for the treatment of CREO.However,CREO can become resistant to tigecycline.The mechanisms of resistance in CREO to tigecycline include overexpression of efflux pumps,plasmid-mediated resistance genes,and gene mutations in the lipopolysaccharide core biosynthesis path way.This article reviews the resistance mechanism of CREO and explores the current alternative therapies for tigecycline-resistant CERO.