某些革兰阴性菌是临床感染的重要病原菌,面对越来越严重的耐药菌威胁,多黏菌素已经成为临床抗多药耐药革兰阴性菌病原菌的最后一道防线。革兰阴性菌中脂质A的修饰可以造成细菌表面电负性的变化,进而造成对于多黏菌素的耐药,该文综述了铜绿假单胞菌、鲍曼不动杆菌、肺炎克雷伯菌、沙门氏菌和弗朗西斯菌等重要革兰阴性菌中,脂质A修饰的研究进展,以期为临床多黏菌素耐药机制及其相关药物的开发提供参考。 Some Gram-negative bacteria are important pathogens of clinical infection, in the face of more and more serious resistance to drug-resistant bacteria, polymyxin has become the clinical anti-multi-drug resistant Gram-negative bacteria the last line of defense. The modification of lipid A in Gram-negative bacteria can cause the change of electronegativity on the surface of bacteria, which in turn leads to the resistance to polymyxin. This paper reviews the progress of Pseudomonas aeruginosa, Acinetobacter baumannii, Salmonella and Francisella and other important Gram-negative bacteria, lipid A modification of the research, in order to provide a reference for the development of clinical polymyxin resistance mechanisms and related drugs.