万古霉素敏感性下降金黄色葡萄球菌(VISA/hVISA)的研究进展

万古霉素敏感性下降的金黄色葡萄球菌(VISA/hV ISA)日益增多,已经成为公共健康的重要威胁。来自临床或实验室的VISA/hV ISA菌株表现出一些共同特征,如细胞壁增厚,自溶活性降低,毒力减弱,醋酸盐代谢异常。金葡菌从VSSA到VISA/hV ISA的转化是一个逐步演变的过程,VISA中一些调控基因的变异,特别是如wal KR、graRS、vra SR、rpo B、rpo C、rpo D、agr、msrR、fdh2、sle1等基因连续的变异与金葡菌对万古霉素的耐药性相关。VISA/hV ISA中相应基因的变异也是VISA/hV ISA对宿主毒力减弱,持续定殖及对宿主适应性改变的遗传基础。为了预防和控制VISA/hI VSA感染,应全面了解其生物学特性,开发简便有效的检验方法,探索制定灵活的治疗策略,达到有效防治的目的。

Advances in Vancomycin Sensitivity Declining Staphylococcus aureus

The day by day increasing vancomycin sensitivity declining Staphylococcus aureus (VISA) and heterogeneous VISA (hVISA) have become an important threat to public health. VISA/hVISA strains from the clinic or laboratory exhibited common characteristics, such as cell wall thickening, autolysis reducing, attenuating, and abnormal acetate catabolism. The metaplasia of VISA from VSSA is a gradual evolution process, continuous and diverse mutations in some regulatory genes in VISA, in particular such as walKR, graRS, vraSR, rpoB, rpoC, rpoD, agr, msrR, fdh2, and sle1 etc, have been correlated with hVISA and VISA. Corresponding gene mutations in VISA/hVISA are also supposed to be correlated with the attenuation, persistent colonization and adaptability changes of the host genetic basis. In order to prevent and control the infection of VISA/hVISA infection, it is necessary to comprehensively understand its biological characteristics, and develop simple and effective inspection methods, explore and institute flexible therapeutic tactics, to meet the goal of effective therapy.