外排泵介导肺炎克雷伯菌耐药的研究进展

肺炎克雷伯菌(Klebsiella pneumoniae)是重要的条件致病菌,近年来肺炎克雷伯菌感染在医院内感染中所占的比率持续上升,耐药率也不断攀升,这给临床治疗带来极大的困难。肺炎克雷伯菌发生耐药的重要机制之一就是其细胞膜上存在的外排泵系统,它们将渗入细菌体内的药物不断泵出,导致菌体内的药物浓度过低,不足以发挥抗菌作用。本文主要针对外排泵介导肺炎克雷伯菌的耐药现状,外排泵的分子结构和基因调节,外排泵抑制剂以及传统中药在耐药菌治疗方面的应用等做系统性梳理,以期为临床治疗耐药肺炎克雷伯菌提供一些新思路。     

药物外排泵与生物被膜在微生物耐药机制中的相关性研究进展

生物被膜是介导微生物耐药与多重耐药的一大热点机制,涉及微生物的生长代谢、耐药基因等基因表型改变、群体感应系统的调控及药物外排泵等多重因素。耐药基因、药物外排泵与生物被膜在微生物耐药机制中,具有复杂而密切的相互影响。分别从生物被膜对药物外排泵、耐药基因的影响,药物外排泵对生物被膜的影响,以及药物外排泵和微生物生物被膜共同的调节因素,对近年来的相关研究进展作一综述。     

碳青霉烯类耐药细菌的流行病学及耐药基因检测方法研究进展

抗生素在传染性疾病预防和治疗方面发挥着重要作用,但抗生素的滥用导致微生物在选择性压力作用下获得并维持耐药性。碳青霉烯类抗生素是一类用于治疗多重耐药菌感染的重要抗菌药物,曾被认为是治疗革兰氏阴性菌严重感染的最后一道防线。但随着碳青霉烯酶的出现,碳青霉烯类耐药革兰氏阴性菌的检出率在全球范围内迅速增长,严重威胁着全球的公共卫生安全。本综述重点介绍了碳青霉烯类耐药细菌的全球流行病学和临床相关耐药基因的检测方法,为合理使用抗生素、有效控制耐药性传播提供参考。     

鲍曼不动杆菌的耐药机制研究进展

鲍曼不动杆菌是临床常见感染菌,耐药性日益增强。其多重耐药性与可长期存活性将导致菌膜的形成,而这种可以抵抗抗菌素治疗的菌膜有着复杂的机构,在复杂结构中起到形成菌膜、维持菌膜稳定性的两个重要组成部分为胞外多糖(EPS)和菌膜相关性蛋白(the biofilm-associated protein,Bap),促使鲍曼不动杆菌躲避宿主免疫系统的攻击,因此针对鲍曼不动杆菌的治疗也愈发困难。     

单增李斯特菌耐药外排泵研究进展

单增李斯特菌是一种重要的人兽共患食源性胞内致病菌,广泛存在于自然环境中且易污染动物性食品,人及动物感染后可引起严重的李斯特菌病,死亡率高达30%。单增李斯特菌通常对多种药物敏感,然而,因不合理使用抗菌药或消毒剂形成的选择压力导致李斯特菌多重耐药情况的报道日渐增多。外排泵蛋白是细菌中一类重要的蛋白,可参与机体多种生物学过程,包括影响细菌对抗生素敏感性、促进有毒化合物泵出、影响细菌毒力等。本文综述了近年来关于单增李斯特菌耐药外排泵的功能及调控机制的研究进展,为深入理解李斯特菌耐药等环境适应机制及有效控制该病原污染传播和筛选抗感染药物新靶点提供理论基础。     

结核分枝杆菌外排泵研究进展

结核病是由结核分枝杆菌(Mycobacterium tuberculosis,Mtb)引起的一种传染病。随着多药耐药和广泛耐药结核分枝杆菌的出现,结核病的治疗变得更为艰难。近年来研究发现,结核分枝杆菌存在外排泵是其耐药的原因之一,现已发现结核分枝杆菌的主要易化子超家族(major facilitator superfamily,MFS)、三磷酸腺苷(adenosine-triphosphate,ATP)结合盒超家族(ATP-Binding Cassette,ABC)、耐受小节分裂区家族(resistance-nodulation-division,RND)和小耐多药性家族(small multidrug resistance,SMR)外排泵。但是人们对结核分枝杆菌外排泵介导的耐药现象认识不足,仍缺乏从新药发现角度研发外排泵抑制剂的研究。本文拟对结核分枝杆菌的ABC、MFS、RND和SMR外排泵的结构和功能,以及结核分枝杆菌外排泵抑制剂的研究进展进行综述。     

鲍曼不动杆菌中外排泵介导耐药机制的研究进展

外排泵的过表达是目前导致鲍曼不动杆菌多重耐药的最重要机制之一,详细了解这一复杂机制有助于尽快找到有效的防治策略。目前,鲍曼不动杆菌中已被报道的外排泵家族包括耐药结节细胞分化(resistance-nodulation-cell division,RND)家族、主要协同转运蛋白超家族(major facilitator superfamily,MFS)、多药及毒性化合物外排(multidrug and toxic compound extrusion,MATE)家族、小多重耐药(small multidrug resistance,SMR)家族。它们之中既有通过染色体介导的外排泵,也有通过质粒等遗传元件介导的外排泵。外排底物可呈现多样性,也可呈现专一性。本文就上述外排泵的种类、功能和调控机制进行综述。     

沙门氏菌抗生素抗性机理研究进展

沙门氏菌的多重耐药性问题已经成为世界范围内的公共卫生和经济问题.目前沙门氏菌抗生素抗性机理的研究主要集中以下方面:(1)基因突变与抗生素抗性;(2)外排泵与抗生素抗性:(3)耐药基因编码的钝化酶和灭活酶引起的抗生素抗性;(4)可移动的细菌遗传耐药基因元件及其转移与抗生素抗性.本文基于以上几个方面综述了与沙门氏菌抗生素抗性机理研究相关的研究动态和研究进展.     

金黄色葡萄球菌生物被膜形成与耐药机制的研究进展

金黄色葡萄球菌(Staphylococcus aureus)是一种常见的致病菌,但由于抗生素的滥用,多重耐药金黄色葡萄球菌(multiple drug-resistant S. aureus, DR S. aureus)大量出现,严重威胁人类健康。DR S. aureus通常具有生物被膜,它是细菌黏附于接触物表面,生长并分泌多糖、蛋白质和脂质等大分子物质,将其自身包裹其中而形成的具有复杂结构的聚集体,能够有效保护细菌免受外界不良因素影响。同时生物被膜还可保护DR S. aureus躲避宿主免疫系统的攻击并减弱药物的渗透和杀伤作用,是影响细菌耐药性的关键结构。因此深入认识DR S. aureus生物被膜的形成过程对治疗耐药菌相关感染疾病具有重要意义。本文综述了近年来关于DR S. aureus生物被膜的形成机制、耐药机理及抑制与清除策略的研究进展,并对未来的研究方向进行展望。     

AdeABC外排泵在鲍曼不动杆菌对亚胺培南耐药中的作用研究

目的 探讨AdeABC外排泵在鲍曼不动杆菌对亚胺培南耐药中的作用.方法 收集亚胺培南耐药鲍曼不动杆菌(imipenem resistant acinetobacter baumannii,IRAB)和亚胺培南敏感株(imipenem-sensitive Acinetobacter baumannii, ISAB)各30...     

革兰氏阴性菌AcrAB-TolC多药外排泵结构数据对抑制剂研发的启示

革兰氏阴性菌的多重耐药性已成为全球广泛聚焦的问题。近年研究发现,耐药结节细胞分化(resistance-nodulation-cell division,RND)家族外排泵的过表达,与革兰氏阴性菌的多重耐药性密切相关。在RND家族中,广泛存在于革兰氏阴性菌中的AcrAB-TolC外排泵被认为是导致多重耐药性的主要原因之一。为了开发有效的抑制剂,需要对AcrAB-TolC外排泵的结构有一个清晰的认识。以往对该外排泵结构的研究主要局限于体外采用X射线晶体学技术或冷冻电镜单颗粒分析技术来解析其单个组分或全泵的结构。细胞冷冻电子断层扫描技术为揭示AcrAB-TolC外排泵在天然细胞膜环境中的组装和运行机制提供了新的见解,本文综述了AcrAB-TolC不同层级的结构数据在研发外排泵抑制剂方面的贡献。     

Role of mycobacterial efflux transporters in drug resistance: an unresolved question

Two mechanisms are thought to be involved in the natural drug resistance of mycobacteria: the mycobacterial cell wall permeability barrier and active multidrug efflux pumps. Genes encoding drug efflux transporters have been isolated from several mycobacterial species. These proteins transport tetracycline, fluoroquinolones, aminoglycosides and other compounds. Recent reports have suggested that efflux pumps may also be involved in transporting isoniazid, one of the main drugs used to treat tuberculosis. This review highlights recent advances in our understanding of efflux-mediated drug resistance in mycobacteria, including the distribution of efflux systems in these organisms, their substrate profiles and their contribution to drug resistance. The balance between the drug transport into the cell and drug efflux is not yet clearly understood, and further studies are required in mycobacteria.     

Antiseptic susceptibility and distribution of antiseptic-resistance genes in methicillin-resistant Staphylococcus aureus

We examined the antiseptic susceptibilities and distribution of antiseptic-resistance genes qacA and smr in 98 isolates of methicillin-resistant Staphylococcus aureus obtained in 1992. Seventy-one strains were resistant to antiseptics. The qacA and smr genes were detected in 10 and 20 strains, respectively. The remaining 41 strains without qacA and smr were divided into two groups that exhibited low-level (n = 22) and high-level (n = 19) resistance to acriflavin. DNA cloning and sequencing suggested that norfloxacin-resistance gene norA was responsible for the high-level resistance to acriflavin. Our results indicated that four or more antiseptic-resistance genes exist in methicillin-resistant S. aureus and that antiseptic-resistant methicillin-resistant S. aureus strains without qacA and smr are widely spread in Japan.     

云南土壤宏基因组文库中替加环素耐药基因的筛选与分析

[背景]随着抗生素的广泛应用以及滥用,出现了多重耐药的\"超级细菌\",并且在临床上已出现对治疗\"超级细菌\"感染的最后一线抗生素——替加环素耐药的细菌.[目的]对土壤环境中存在的替加环素耐药基因进行筛选调查,探讨替加环素耐药机制,为临床抗生素治疗提供借鉴.[方法]利用功能宏基因组学技术对土壤宏基因组文库进行替加环素耐药阳性...     

Expression of efflux pump gene lde in ciprofloxacin‐resistant foodborne isolates of Listeria monocytogenes

The expression of efflux pump gene lde in ciprofloxacin resistant (Cip^R) and susceptible strains of Listeria monocytogenes collected from retail food samples was investigated. For two Cip^R strains, the MICs of ciprofloxacin decreased four‐ to eightfold in the presence of reserpine; however, no significant alterations were observed with naturally sensitive isolates. Overexpression of the lde gene induced by ciprofloxacin was observed in two resistant isolates. The present findings indicate that expression of lde and the MICs of ciprofloxacin are well correlated with the presence and absence of reserpine, suggesting that Lde might be involved in ciprofloxacin resistance of L. monocytogenes.     

Low expression of AcrB in the deoxycholate-sensitive strains of Salmonella enterica subspecies enterica serovar Pullorum

We investigated the mechanism responsible for bile susceptibility in three deoxycholate-sensitive (DCs) strains of Salmonella enterica subspecies enterica serovar Pullorum isolated in 1958 in Japan. Of the genes encoding the AcrAB-TolC efflux system, the expression of acrB mRNA was 10-fold lower in the DCs strains than in a deoxycholate-resistant (DCr) strain, whereas those of the acrA and tolC genes were two-fold lower. These results suggested that low expression of acrB was strongly correlated with bile susceptibility in the DCs strains. In addition, the increase in tolC expression levels was not detected in the DCr mutants derived from the DCs strains, suggesting that difference in the expression levels of tolC is not associated with bile susceptibility.     

西瓜食酸菌RND蛋白家族外排转运体cusB基因抗铜功能研究

【目的】研究RND外排泵中cus B基因突变对西瓜食酸菌抗铜性的影响。【方法】采用Tn5转座子随机插入基因组制备筛选得到突变体,通过双亲杂交的方法构建功能互补菌株,并从西瓜食酸菌抗铜性、胞外纤维素酶和胞外蛋白酶分泌、胞外多糖产生、生物膜形成、致病性及过敏性反应等方面阐明RND外排泵中MFP蛋白亚基对西瓜食酸菌的影响。【结果】突变体Δcus B在含有1.25 mmol/L或2.5 mmol/L Cu SO4的KMB平板上不能生长,cus B基因的突变导致西瓜食酸菌的胞外多糖分泌和生物膜形成与野生型有差异,但不影响胞外纤维素酶、胞外蛋白酶、致病性及过敏性反应。【结论】RND外排泵相关基因cus B的突变会影响西瓜食酸菌的某些生物学特性,并导致病菌对铜十分敏感。研究以RND外排泵转运重金属为导向初步解析了西瓜食酸菌的抗铜机制。     

结核杆菌的药物外排泵

外排泵基因过度表达促使细胞内的药物转移到细胞外,胞内药物浓度下降,致使药物临床疗效降低或无效。外排泵上有多个与识别底物结构无关的阴离子凹穴(底物结合位点),通过静电引力非特异性结合各种含阳离子的药物,在能量协助下将药物排到细胞外,进而导致细菌抗药性的产生。研究表明,结核杆菌基因组中存在外排泵基因,但仅分离到几个有功效的外排泵。本文就相关研究进展进行综述。     

Anti‐Campylobacter and resistance‐modifying activity of Alpinia katsumadai seed extracts

Aims

We tested extracts from Alpinia katsumadai seeds for anti‐Campylobacter activity and investigated the roles of the CmeABC and CmeDEF efflux pumps in Campylobacter resistance to these natural phenolics. Additionally, we investigated an A. katsumadai ethanolic extract (AlpE) and other plant extracts as putative efflux pump inhibitors on Campylobacter isolates and mutants in efflux pump genes.

Methods and Results

AlpE showed antimicrobial activity against sensitive and multidrug‐resistant Campylobacter isolates. CmeB inactivation resulted in the greatest reduction in resistance, while cmeF and cmeR mutations produced only moderate effects on minimal inhibitory concentrations (MICs). The chemical efflux pump inhibitors additionally reduced MICs in isolates and mutants, confirming that active efflux is an important mechanism in resistance to AlpE, with additional contributions of other efflux systems. A notable decrease in resistance to tested antimicrobials in the presence of subinhibitory concentrations of AlpE confirms its modifying activity in Campylobacter spp.

Conclusions

AlpE is important anti‐Campylobacter source of antimicrobial compounds with resistance‐modifying activity. At least two of the efflux systems are involved in the resistance to A. katsumadai antimicrobial seed extracts.

Significance and Impact of the Study

This is the first report of antimicrobial and resistance‐modifying activity of AlpE from A. katsumadai seeds, demonstrating its potential in the control of Campylobacter in the food chain.