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本文从青霉素结合蛋白 (PBPs)、β-内酰胺酶、膜通透性障碍、主动外排和生物胶膜等方面对近年来铜绿假单胞菌对β-内酰胺类抗生素耐药机制的研究进展进行简要综述。铜绿假单胞菌中高分子量的PBP3及低分子量的PBP4、5、7等的改变可能与其耐药性的改变有关。所有的铜绿假单胞菌中都能表达出染色体介导ClassC类酶 ;ClassB类金属酶和质粒介导的ClassA类酶在铜绿假单胞菌中比较少见 ;而基本不受克拉维酸抑制的ClassD类酶在铜绿假单胞菌中比较常见。铜绿假单胞菌天然多重耐药的特点与其细胞膜结构密切相关性 ,外膜通透性屏障和主动外排MexA -MexB -OprM等系统的协同作用使得铜绿假单胞菌可以对多种类型的抗菌药物耐药。而在天然环境中 ,铜绿假单胞菌多以生物胶膜形式存在 ,群体内细菌间协同作用和多种耐药机制协同作用是其耐药特点。在临床治疗铜绿假单胞菌引发的感染和开发抗铜绿假单胞菌药物时应综合考虑多种耐药机制的作用。
In this paper, the mechanism of resistance of Pseudomonas aeruginosa to β-lactam antibiotics in recent years from the aspects of penicillin-binding protein (PBPs), β-lactamase, membrane permeability disorders, active efflux and bio- A brief overview of progress. The changes of high molecular weight PBP3 and low molecular weight PBP4,5,7 in Pseudomonas aeruginosa may be related to the change of their drug resistance. Chromosome-mediated Class C enzymes were expressed in all P. aeruginosa; Class B metalloenzymes and plasmid-mediated Class A enzymes were less common in Pseudomonas aeruginosa; and were not substantially inhibited by clavulanate ClassD enzymes are more common in Pseudomonas aeruginosa. The natural multi-drug resistance of Pseudomonas aeruginosa is closely related to its cell membrane structure. The synergistic effect of the adventitia membrane permeability barrier and the efflux of exogenous MexA-MexB-ProM system makes it possible for Pseudomonas aeruginosa to treat multiple types of Antibacterial drug resistance. However, in the natural environment, Pseudomonas aeruginosa mostly exists in the form of biofilms, and the synergistic effect among bacteria in the population and the synergistic effect of various drug resistance mechanisms are characteristic of its drug resistance. In the clinical treatment of Pseudomonas aeruginosa infection and the development of anti-Pseudomonas aeruginosa drug should consider the role of a variety of drug resistance mechanisms.