质粒介导黏菌素耐药机制研究进展

黏菌素是一种多肽类抗生素,对革兰阴性菌具有较强的抗菌活性。由于其副作用大,一直以来黏菌素在临床中很少被使用。近年来,随着多重耐药菌,特别是耐碳青霉烯类肠杆菌的产生,黏菌素耐药基因mcr的研究逐渐受到重视。过去通常认为,黏菌素耐药性由染色体介导,无法在细菌间水平传播。mcr-1基因的发现证明黏菌素耐药性还可能通过质粒介导水平传播。本文将介绍多种黏菌素耐药基因mcr及其流行特征、MCR作用机制和分类特点,为黏菌素的合理使用提供理论支持,以及采取针对性的预防措施。     

耐药细菌分析——“只有民族的才是世界的”

正细菌的耐药问题已经成为一种全球性的严重威胁[1],耐甲氧西林金黄色葡萄球菌(MRSA)、多重耐药鲍曼不动杆菌和耐药性艰难梭菌等多种耐药细菌感染疾病负担巨大,中国的情况尤其严重。近期中国研究团队在动物和人源细菌中均发现了一种新型的位于细菌质粒上的粘菌素耐药基因mcr-1[2],使细菌耐药问题受到进一步关注。本刊2015年第1期刊登了杨永刚、陈瑜等的研究文章"耐甲氧西林金黄色葡萄球菌分型及流行现状"[3],     

非流动环境下基于mcr-1耐药基因传播机制的种群传播模型

耐药性的研究一直是近些年来的研究热点,2015年11月,中国的科研团队在《柳叶刀.感染性疾病》上刊载了一份研究报告,该团队从中国人和猪体内发现了一种能对终极抗生素多粘菌素产生强耐药性的新基因mcr-1.该基因在屠宰动物、零售肉类、健康人体肠道细菌、临床菌株同时存在,给出了一个完整的动物源性食物链传播途径.本文基于mcr-1的这一传播特性,建立数学模型,给出非流动环境下该耐药基因在食源性动物层面和人群层面传播的系统动力学模型,分析其稳定性,并对模型中的重要参数进行数值模拟分析,借此对mcr-1的传播状态进行理论研究.通过对重要参数的数值模拟,对mcr-1耐药基因的传播情况进行分析,并给出控制该耐药基因传染的关键所在.     

CRISPR/Cas系统作为抗菌药的现状及展望

抗生素长期滥用导致了人体内菌群失调及细菌耐药性的产生,因此需要寻找新型、靶向抗菌方法来治疗耐药细菌的感染。近年来,CRISPR/Cas系统的深入研究为设计特异性靶向耐药基因,定向清除耐药细菌的药物提供了新的思路。在此介绍了CRISPR/Cas系统作为新型抗菌方法,通过靶向切割抗性质粒或细菌基因组以实现对耐药基因或病原菌的特异性清除,并对CRISPR抗菌药的不同类型核酸酶的选择,以及CRISPR递送系统的运载工具进行了评价。     

CRISPR-Cas系统调控细菌生理功能的机制研究进展

CRISPR-Cas系统是存在于部分细菌和绝大部分古细菌中的一种获得性免疫防御系统,使细菌在外源性基因入侵时具有免疫防御能力。此外,CRISPR-Cas系统对细菌自身生物膜的形成、耐药性、毒力等生理功能都有调控作用,这对于研究人员进行相关研究有着重要意义。本文以细菌CRISPR-Cas系统及其发挥免疫防御作用的相关研究为基础展开论述,重点阐述该系统对细菌生理功能的调控作用,并对其应用前景进行了展望,以期为进一步研究细菌耐药性和致病性提供新思路。     

质粒介导的黏菌素耐药基因mcr-1研究进展

mcr-1基因是迄今为止国际上首次发现的质粒介导的黏菌素耐药基因,可介导肠杆菌科细菌对多粘菌素类药物产生耐药并可通过质粒进行水平转移。最新研究表明该基因已通过IncI2、IncX4和IncHI2等流行性质粒以及可移动元件,在全球35个不同国家和地区的人、动物和环境源多种肠杆菌中广泛传播。这些研究对于深入了解mcr-1基因介导的黏菌素耐药和传播机制、全球流行分布特征奠定了基础,丰富了耐药性形成理论。文章主要介绍了不同来源肠杆菌科细菌中mcr-1的分布流行情况、耐药和传播机制、基因环境等方面的研究进展,探讨了其临床风险性以及后续应对措施,以期为相关科研人员和临床工作者提供参考,共同应对抗生素耐药日益严峻的局面。     

多黏菌素的流行状况与耐药机制的研究

近年来,由于革兰阴性菌(Gram-negative bacteria)多药耐药性的增加,严重地威胁着人类的健康。由于可选择的抗菌药物越来越少,感染病医师和临床微生物学家需重新评估多黏菌素的临床应用。多黏菌素是治疗临床碳青霉烯类耐药革兰阴性菌的最后一道抗生素。现结合国内外最新研究报道,对多黏菌素耐药流行状况、耐药机制、耐药基因类型、预防干预措施等方面作一概述。     

分子模拟在多黏菌素药理机制研究中的应用

多黏菌素是一种膜靶向的脂肽类抗生素，是临床上治疗革兰氏阴性多重耐药菌感染的最后一道防线。通过与脂多糖相互作用，多黏菌素破坏细菌外膜结构并导致细菌死亡。然而，受限于生物化学和结构生物学手段对细胞膜-药物相互作用的表征能力，目前对多黏菌素药理机制的认识还不充分，从而限制了新一代多黏菌素药物的设计和开发。为此，本文总结了近年来利用分子动力学方法对细胞膜系统与多黏菌素相互作用的研究进展，为深入理解多黏菌素药理机制与细胞膜系统的内在联系，加快新型抗生素药物研发提供新思路。     

质粒介导重排子的发现、结构和功能

细菌耐药性已成为全球关注的重大公共卫生问题。接合转移是耐药质粒快速传播的重要方式,其中Ⅳ型菌毛在此过程中发挥着重要的作用。Ⅳ型菌毛具有黏附作用,能够使细菌黏附在宿主细胞和其他介质表面,帮助细菌形成生物被膜、细菌聚集体和微菌落,是细菌在液体中接合转移的重要因素。PilV蛋白是R64质粒Ⅳ型菌毛尖端黏附素,可以识别细菌细胞膜上的脂多糖(lipopolysaccharide, LPS)。重排子(shufflon)结构是多重DNA倒位系统,可使PilV蛋白多样化,进而影响细菌液体接合转移过程中的受体菌识别和接合转移频率。重排子结构最先发现存在于IncI1质粒R64,后陆续在IncI2、IncK、IncZ质粒以及伤寒沙门氏菌致病岛中被发现,其主要由A、B、C、D这4个片段及特异性重组位点sfx组成,受其下游重组酶基因rci的调控,不同质粒的重排子结构存在一定的差异。近期备受关注的可转移多黏菌素耐药基因mcr-1主要位于IncI2型质粒上,重排子可能是其快速传播的原因之一。本文综述了质粒介导重排子的发现、结构、功能和流行,期望基于对重排子更全面深入地了解,能够为耐药质粒的传播机制和控制策略研究提供...     

CRISPR-Cas9与抗肿瘤免疫治疗的研究进展

CRISPR是最早发现于原核生物中的一种适应性免疫机制,具有序列特异性核酸切割活性,新近迅速发展成为一种新的基因编辑工具CRISPR-Cas9系统,并被广泛应用于包括抗肿瘤免疫在内的医学研究。其中,基于CRISPR-Cas9技术的CAR T细胞和肿瘤特异性TCR T细胞在抗肿瘤治疗研究中显示出良好的应用前景。本文综述了有关CRISPR-Cas9在基因编辑中的作用机制、递送策略及其用于抗肿瘤免疫治疗的研究进展。     

Association of the colistin resistance gene mcr-1 with faecal pollution in water environments in Hanoi,Vietnam

Colistin is one of the antibiotics of last resort for human health. However, the dissemination of the plasmid-mediated colistin resistance gene mcr-1 is of great concern globally. In the One Health framework, the environment is an important component for managing antimicrobial resistance. However, little information is available concerning the prevalence of mcr-1 in water environments. We aimed to reveal the prevalence of mcr-1 in different water environments in Hanoi, Vietnam. Quantitative PCR was applied to detect mcr-1 in four urban drainages receiving untreated domestic wastewater, three rivers, five lakes and two groundwater samples. Urban drainages contained higher concentrations of mcr-1, suggesting that urban residents carry the gene. The class 1 integron-integrase gene was identified as a good surrogate of antibiotic resistance genes including mcr-1. A significant correlation was found between the levels of mcr-1 and the human-specific cross-assembly phage, which is an indicator of human faecal pollution. These results indicated that the primary source of mcr-1 in urban water environments is human faeces, which is consistent with the fact that most domestic wastewater is untreated in Hanoi. The control of untreated wastewater is critical for alleviating the spread of mcr-1 in water environments in Vietnam.     

Tryptamine derivatives disarm colistin resistance in polymyxin-resistant gram-negative bacteria

The last three decades have seen a dwindling number of novel antibiotic classes approved for clinical use and a concurrent increase in levels of antibiotic resistance, necessitating alternative methods to combat the rise of multi-drug resistant bacteria. A promising strategy employs antibiotic adjuvants, non-toxic molecules that disarm antibiotic resistance. When co-dosed with antibiotics, these compounds restore antibiotic efficacy in drug-resistant strains. Herein we identify derivatives of tryptamine, a ubiquitous biochemical scaffold containing an indole ring system, capable of disarming colistin resistance in the Gram-negative bacterial pathogens Acinetobacter baumannii, Klebsiella pneumoniae, and Escherichia coli while having no inherent bacterial toxicity. Resistance was overcome in strains carrying endogenous chromosomally-encoded colistin resistance machinery, as well as resistance conferred by the mobile colistin resistance-1 (mcr-1) plasmid-borne gene. These compounds restore a colistin minimum inhibitory concentration (MIC) below the Clinical & Laboratory Sciences Institute (CLSI) breakpoint in all resistant strains.     

Dominant chloramphenicol-resistant bacteria and resistance genes in coastal marine waters of Jiaozhou Bay,China

Studies of abundance, diversity and distribution of antibiotic-resistant bacteria and their resistance determinants are necessary for effective prevention and control of antibiotic resistance and its dissemination, critically important for public health and environment management. In order to gain an understanding of the persistence of resistance in the absence of a specific antibiotic selective pressure, microbiological surveys were carried out to investigate chloramphenicol-resistant bacteria and the chloramphenicol acetyltransferase resistance genes in Jiaozhou Bay after chloramphenicol was banned since 1999 in China. About 0.15–6.70% cultivable bacteria were chloramphenicol resistant, and the highest abundances occurred mainly in the areas near river mouths or sewage processing plants. For the dominant resistant isolates, 14 genera and 25 species were identified, mostly being indigenous estuarine or marine bacteria. Antibiotic-resistant potential human or marine animal pathogens, such as Escherichia coli, Klebsiella pneumoniae, Proteus mirabilis and Shewanella algae, were also identified. For the molecular resistance determinants, the cat I and cat III genes could be detected in some of the resistant strains, and they might have the same origins as those from clinical strains as determined via gene sequence analysis. Further investigation about the biological, environmental and anthropogenic mechanisms and their interactions that may contribute to the persistence of antibiotic-resistance in coastal marine waters in the absence of specific antibiotic selective pressure is necessary for tackling this complicated environmental issue.     

大熊猫源细菌耐药性研究进展

耐药菌和耐药基因已成为一种新型环境污染物,引发世界公共卫生问题。细菌耐药性尤其是多重耐药菌在人医临床、畜禽养殖以及环境传播等多个方面得到越来越多的关注,而关于大熊猫等野生动物的耐药性研究相对较少。大熊猫(Ailuropoda melanoleuca)是世界公认的珍稀野生动物,其种群数量易受到各种疾病的威胁,尤其是肠道细菌性疾病。随着抗菌药物在疾病预防和控制中的普遍使用,由此带来的耐药性危害日益明显。本文总结了关于大熊猫源细菌耐药的国内外研究报道,对其耐药表型、耐药基因型、耐药机制及水平传播机制等方面内容进行了综述,旨在为大熊猫源细菌耐药性的研究和防控提供依据,为临床科学用药提供理论参考,从而助力大熊猫迁地保护。     

A rapid MALDI-TOF mass spectrometry-based method for colistin susceptibility testing in Escherichia coli

Colistin is recognized as a last-resort treatment option against multi-drug resistant bacteria including carbapenem-resistant Enterobacteriaceae (CRE). However, the plasmid-mediated colistin-resistance gene mcr-1 has been reported globally resulting in an increase of colistin-resistant bacteria. A quick and accurate method for determining the pathogen resistance of colistin is therefore crucial in the clinic. Matrix-assisted laser desorption/ionization time-of-flight mass spectrometry (MALDI-TOF MS) is a potential tool forto be applied for antimicrobial susceptibility testing. We compared the growth of Escherichia coli strains in the presence or absence of colistin. Automated analyses of the spectra were performed with a prototype software tool written with package R. Three mcr-1-positive and six mcr-1-negative E. coli were used for establishing the model to obtain the optimal incubation time, the breakpoint concentration of colistin and cut-off of the relative growth (RG) value. The distinction between susceptible and resistant strains was already noticeable after 2 h of incubation. The best separation between the susceptible and resistant strains was achieved at a concentration of 4 µg ml^-1 and a relative growth cut-off value of 0.6. Application of the model for the analysis of 128 E. coli isolates, a sensitivity of 97.4% and a specificity of 88.2% were achieved compared with colistin MIC results. The rapid MALDI-TOF MS-based method approach is simple to set-up, uses a short incubation time, and had excellent outcomes with respect to sensitivity and specificity for colistin sensitivity testing in Escherichia coli.     

A ProQ/FinO family protein involved in plasmid copy number control favours fitness of bacteria carrying mcr-1-bearing IncI2 plasmids

The plasmid-encoded colistin resistance gene mcr-1 challenges the use of polymyxins and poses a threat to public health. Although IncI2-type plasmids are the most common vector for spreading the mcr-1 gene, the mechanisms by which these plasmids adapt to host bacteria and maintain resistance genes remain unclear. Herein, we investigated the regulatory mechanism for controlling the fitness cost of an IncI2 plasmid carrying mcr-1. A putative ProQ/FinO family protein encoded by the IncI2 plasmid, designated as PcnR (plasmid copy number repressor), balances the mcr-1 expression and bacteria fitness by repressing the plasmid copy number. It binds to the first stem-loop structure of the repR mRNA to repress RepA expression, which differs from any other previously reported plasmid replication control mechanism. Plasmid invasion experiments revealed that pcnR is essential for the persistence of the mcr-1-bearing IncI2 plasmid in the bacterial populations. Additionally, single-copy mcr-1 gene still exerted a fitness cost to host bacteria, and negatively affected the persistence of the IncI2 plasmid in competitive co-cultures. These findings demonstrate that maintaining mcr-1 plasmid at a single copy is essential for its persistence, and explain the significantly reduced prevalence of mcr-1 following the ban of colistin as a growth promoter in China.     

Characterization of CRISPR-Cas systems in the Ralstonia solanacearum species complex

Clustered regularly interspaced short palindromic repeats (CRISPRs) are composed of an array of short DNA repeat sequences separated by unique spacer sequences that are flanked by associated (Cas) genes. CRISPR-Cas systems are found in the genomes of several microbes and can act as an adaptive immune mechanism against invading foreign nucleic acids, such as phage genomes. Here, we studied the CRISPR-Cas systems in plant-pathogenic bacteria of the Ralstonia solanacearum species complex (RSSC). A CRISPR-Cas system was found in 31% of RSSC genomes present in public databases. Specifically, CRISPR-Cas types I-E and II-C were found, with I-E being the most common. The presence of the same CRISPR-Cas types in distinct Ralstonia phylotypes and species suggests the acquisition of the system by a common ancestor before Ralstonia species segregation. In addition, a Cas1 phylogeny (I-E type) showed a perfect geographical segregation of phylotypes, supporting an ancient acquisition. Ralstoniasolanacearum strains CFBP2957 and K60^T were challenged with a virulent phage, and the CRISPR arrays of bacteriophage-insensitive mutants (BIMs) were analysed. No new spacer acquisition was detected in the analysed BIMs. The functionality of the CRISPR-Cas interference step was also tested in R. solanacearum CFBP2957 using a spacer-protospacer adjacent motif (PAM) delivery system, and no resistance was observed against phage phiAP1. Our results show that the CRISPR-Cas system in R. solanacearum CFBP2957 is not its primary antiviral strategy.     

Non-viral and viral delivery systems for CRISPR-Cas9 technology in the biomedical field

The clustered regularly interspaced short palindromic repeats(CRISPR)-associated protein 9(CRISPR-Cas9) system provides a novel genome editing technology that can precisely target a genomic site to disrupt or repair a specific gene. Some CRISPR-Cas9 systems from different bacteria or artificial variants have been discovered or constructed by biologists, and Cas9 nucleases and single guide RNAs(sgRNA) are the major components of the CRISPR-Cas9 system. These Cas9 systems have been extensively applied for identifying therapeutic targets, identifying gene functions, generating animal models, and developing gene therapies.Moreover, CRISPR-Cas9 systems have been used to partially or completely alleviate disease symptoms by mutating or correcting related genes. However, the efficient transfer of CRISPR-Cas9 system into cells and target organs remains a challenge that affects the robust and precise genome editing activity. The current review focuses on delivery systems for Cas9 mRNA, Cas9 protein, or vectors encoding the Cas9 gene and corresponding sgRNA. Non-viral delivery of Cas9 appears to help Cas9 maintain its on-target effect and reduce off-target effects, and viral vectors for sgRNA and donor template can improve the efficacy of genome editing and homology-directed repair. Safe, efficient, and producible delivery systems will promote the application of CRISPR-Cas9 technology in human gene therapy.