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。     

鲍曼不动杆菌耐药程度与其主动外排泵蛋白的相关性研究

目的:探讨鲍曼不动杆菌耐药程度与其主动外排泵蛋白的相关性。方法:首先用纸片扩散法检测64株临床鲍曼不动杆菌对8种抗菌药物的敏感性;将其分为A组(0～2种抗生素耐药)、B组(对3～5种抗生素耐药)和C组(对6～8种抗生素耐药);检测64株临床鲍曼不动杆菌对罗丹明6G的外排情况,筛选出罗丹明6G外排明显增加的菌株;并用逆转录-聚合酶链反应(RT-PCR)方法检测主动外排泵基因AdeABC的表达水平。结果:64株鲍曼不动杆菌中有4株对0～2种抗生素耐药(A组),对3～5种抗生素耐药的有33株(B组),对6～8种抗生素耐药的有27株(C组);多重耐药组鲍曼不动杆菌罗丹6G外排明显增高,外排程度A组相似文献   

近三年鲍曼不动杆菌耐药性变迁及外排泵基因研究

目的研究鲍曼不动杆菌的耐药性变迁及外排泵基因携带情况,为控制医院感染提供依据。方法运用纸片扩散法检测我院2015-2017年临床分离的鲍曼不动杆菌对18种抗菌药物的耐药性,并对耐药性变化趋势进行分析。PCR技术检测多重耐药菌adeB、adeJ、adeE、abeM四种外排泵基因的携带情况。结果三年时间共分离出鲍曼不动杆菌385株,检出数量逐年升高,以呼吸科和重症医学科为主,分别占32.7%和28.3%。药敏结果显示鲍曼不动杆菌对多黏菌素B (0.0%)、替加环素(0.0%～1.6%)耐药率最低,其次为头孢哌酮舒巴坦(22.9%～32.0%)。三年来鲍曼不动杆菌对左氧氟沙星、亚胺培南、美罗培南耐药率有显著升高,超过20%,对庆大霉素、阿米卡星耐药率下降超过10%。172株多重耐药菌(44.7%)中,PCR扩增结果显示adeB和adeJ阳性率分别为76.7%和51.2%,并有5株(2.91%)检出adeE基因。结论近三年鲍曼不动杆菌耐药性呈上升趋势,外排泵是导致其耐药的机制之一。     

主动外排机制在鲍曼不动杆菌耐药性中的作用

目的探讨细菌主动外排机制在临床分离的鲍曼不动杆菌耐药性中的作用。方法琼脂稀释法检测临床分离的鲍曼不动杆菌对常用抗生素的耐药性,测定经外排泵抑制剂碳酰氰基-对-氯苯腙（CCCP）处理前后鲍曼不动杆菌对抗生素最小抑菌浓度（MIC）的变化,以聚合酶链反应（PCR）、逆转录-聚合酶链反应（RT-PCR）检测多重耐药主动外排基因以出及其表达水平。结果临床分离的鲍曼不动杆菌对常用抗生素耐药率高且具有多重耐药性,并存在药物的主动外排。所有临床分离的菌株均能检测到adeB基因,但多重耐药株表达水平明显高于敏感株（P〈0．01）。结论临床分离的鲍曼不动杆菌的耐药性尤其是多重耐药性与外排泵介导的耐药机制密切相关。     

临床分离鲍曼不动杆菌的外排泵基因检测及同源性分析

目的探讨临床分离鲍曼不动杆菌主动外排基因的分布和菌株克隆相关性,为指导临床合理用药和制定恰当的感染控制措施提供理论依据。方法对临床分离的80株鲍曼不动杆菌采用琼脂稀释法检测对抗菌药物的敏感性,聚合酶链反应(PCR)检测adeB、adeG、adeJ外排泵基因的携带情况,脉冲场凝胶电泳法分析多重耐药鲍曼不动杆菌的同源性。结果 80株临床分离鲍曼不动杆菌中,57株为多重耐药株(MDRAB),且对多粘菌素B、头孢哌酮/舒巴坦和美罗培南较为敏感,对其他临床常用抗生素普遍耐药。adeB、adeG、adeJ外排泵基因分布广泛,在敏感菌株中存在率也很高;PFGE分型结果显示57株MDRAB菌株共分为四大群(A、B、C、D),并以流行克隆A为主。结论临床分离鲍曼不动杆菌耐药形式严峻,其临床分离株普遍存在外排泵编码基因adeB、adeG、adeJ,携带外排泵阳性MDRAB菌株的克隆播散是温州地区鲍曼不动杆菌发生耐药的机制之一。     

外排AdeABC和AdeIJK系统与鲍曼不动杆菌耐药性的相关研究进展

鲍曼不动杆菌是医院感染及免疫缺陷者感染的重要致病菌之一。近年来,临床分离率逐年上升,耐药性日益严重,其耐药性与多种机制有关,其中主动外排AdeABC和AdeIJK系统的结构、功能及表达调节在多重耐药过程中起重要作用,也是研究的热点之一。     

大肠杆菌的AcrAB-TolC多药外排泵及其调控研究进展

多药外排泵造成了细菌的多种药物的耐药现象, 这对感染性疾病的防治提出了挑战。对于多药外排泵的研究不仅使人们认识细菌耐药性机制, 而且为细菌耐药性的防治提供思路。大肠杆菌AcrAB-TolC外排泵系统的结构和调控机制研究取得了一些新进展, 这为病原菌的相关研究提供了参考, 本文对其进行了综述。     

革兰氏阴性菌多药外排泵MacAB-TolC的功能与结构

病原菌日益增长的多药耐药性已成为人类健康和生命的主要威胁之一。多药外排泵介导的药物主动外排是细菌产生耐药性的主要原因之一，给感染性疾病的防治带来了极大挑战。深入研究多药外排泵，了解其作用机制，揭示药物结合位点，可以为临床抗感染治疗提供新思路。在革兰氏阴性菌中，一些多药外排泵形成跨越细菌胞外被膜的三联复合物。MacAB-TolC是普遍存在于革兰氏阴性菌中的ABC家族三联外排泵，在近些年逐渐被关注。本文综述了关于MacAB-TolC外排泵的功能与结构研究以及相应抑制剂研发方面的进展。MacAB-TolC外排泵的底物种类多样，包含抗生素、毒力因子以及代谢产物。本文据此将MacAB-TolC外排泵的功能归纳为3类：耐药功能、病理功能和生理功能，并对相应功能分别进行了阐述。在结构研究方面，本文总结了MacAB-TolC外排泵单个组分的晶体结构和组装完全的MacAB-TolC三联外排泵的冷冻电镜单颗粒结构，并对结构数据所揭示的MacAB-TolC外排泵发挥功能的机制进行了论述。最后，本文介绍了MacAB-TolC外排泵抑制剂的最新研究进展，指出解析MacAB-TolC的原位结构，以及MacB结合底...     

大肠杆菌的AcrAB-To1C多药外排泵及其调控研究进展

多药外排泵造成了细菌的多种药物的耐药现象,这对感染性疾病的防治提出了挑战.对于多药外排泵的研究不仅使人们认识细菌耐药性机制,而且为细菌耐药性的防治提供思路.大肠杆菌AcrAB-To1C外排泵系统的结构和调控机制研究取得了一些新进展,这为病原菌的相关研究提供了参考,本文对其进行了综述.     

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。     

The protein synthesis inhibitors mycalamides A and E have limited susceptibility toward the drug efflux network

The mycalamides belong to a family of protein synthesis inhibitors noted for antifungal, antitumour, antiviral, immunosuppressive, and nematocidal activities. Here we report a systematic analysis of the role of drug efflux pumps in mycalamide resistance and the first isolation of mycalamide E. In human cell lines, neither P-glycoprotein overexpression nor the use of efflux pump inhibitors significantly modulated mycalamide A toxicity in the systems tested. In Saccharomyces cerevisiae, it appears that mycalamide A is subject to efflux by the principle mediator of xenobiotic efflux, Pdr5p along with the major facilitator superfamily pump Tpo1p. Mycalamide E showed a similar efflux profile. These results suggest that future drugs based on the mycalamides are likely to be valuable in situations where efflux pump-based resistance leads to failure of other chemotherapeutic approaches, although efflux may be a mediator of resistance in antifungal applications.     

Development of a high-throughput cloning strategy for characterization of Acinetobacter baumannii drug transporter proteins

Heterologous expression of membrane proteins in Escherichia coli often requires optimization to overcome problems with toxicity of the recombinant protein to the host cell. A number of Gateway-based destination vectors were constructed to investigate expression of membrane proteins using a high-throughput approach. These vectors were tested using putative drug transporter proteins from the multidrug and toxic compound extrusion (MATE) family and the resistance-nodulation-cell division superfamily encoded by the human pathogen Acinetobacter baumannii. Active transport of antibiotics and antiseptics mediated by efflux proteins contributes to the high level of multidrug resistance observed in A. baumannii. Substrates for 4 of the 5 putative efflux proteins investigated were identified using the expression vectors designed in this study. Additionally, a Gateway-based suicide vector was designed for construction of specific A. baumannii insertion disruption mutants. This knockout cloning strategy was tested and shown to be successful in inactivating AbeM4, a putative MATE family protein. Therefore, we have shown that the Gateway-based vectors constructed in this study are versatile tools that can be used for manipulation and characterization of membrane proteins.     

Identification and molecular characterisation of CmeB, a Campylobacter jejuni multidrug efflux pump

A multidrug efflux pump gene (cmeB) was identified from the published Campylobacter jejuni genome sequence. Secondary structural analysis showed that the gene encoded a protein belonging to the resistance nodulation cell division (RND) family of efflux transporters. The gene was inactivated by insertional mutagenesis. Compared with the wild-type strain (NCTC 11168), the resultant knockout strain (NCTC 11168-cmeB::kan(r)) displayed increased susceptibility to a range of antibiotics including beta-lactams, fluoroquinolones, macrolides, chloramphenicol, tetracycline, ethidium bromide, the dye acridine orange and the detergent sodium dodecyl sulfate. Accumulation of ciprofloxacin was increased in the knockout mutant, but carbonyl cyanide m-chlorophenyl hydrazone, a proton motive force inhibitor, had less effect upon ciprofloxacin accumulation in the knockout mutant compared with NCTC 11168. These data show that the identified gene encodes an RND-type multi-substrate efflux transporter, which contributes to intrinsic resistance to a range of structurally unrelated compounds in C. jejuni. This efflux pump has been named CmeB (for Campylobacter multidrug efflux).     

Directed evolution of a bacterial efflux pump: adaptation of the E. coli TolC exit duct to the Pseudomonas MexAB translocase

Bacterial multidrug efflux pumps operate by periplasmic recruitment and opening of TolC family outer membrane exit ducts by cognate inner membrane translocases. Directed evolution of active hybrid pumps was achieved by challenging a library of mutated, shuffled TolC variants to adapt to the non-cognate Pseudomonas MexAB translocase, and confer resistance to the efflux substrate novobiocin. Amino acid substitutions in MexAB-adapted TolC variants that endowed high resistance were recreated independently, and revealed that MexAB-adaptation was conferred only by substitutions located in the lower alpha-helical barrel of TolC, specifically the periplasmic equatorial domain and entrance coiled coils. These changes converge to the native MexAB partner OprM, and indicate an interface key to the function and diversity of efflux pumps.     

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。     

Bacterial efflux systems and efflux pumps inhibitors

It is now well established that bacterial resistance to antibiotics has become a serious problem of public health that concerns almost all antibacterial agents and that manifests in all fields of their application. Among the three main mechanisms involved in bacterial resistance (target modification, antibiotic inactivation or default of its accumulation within the cell), efflux pumps, responsible for the extrusion of the antibiotic outside the cell, have recently received a particular attention. Actually, these systems, classified into five families, can confer resistance to a specific class of antibiotics or to a large number of drugs, thus conferring a multi-drug resistance (MDR) phenotype to bacteria. To face this issue, it is urgent to find new molecules active against resistant bacteria. Among the strategies employed, the search for inhibitors of resistance mechanisms seems to be attractive because such molecules could restore antibiotic activity. In the case of efflux systems, efflux pump inhibitors (EPIs) are expected to block the pumps and such EPIs, if active against MDR pumps, would be of great interest. This review will focus on the families of bacterial efflux systems conferring drug resistance, and on the EPIs that have been identified to restore antibiotic activity.     

The properties and contribution of the Corynebacterium glutamicum MscS variant to fine-tuning of osmotic adaptation

Based on sequence similarity, the mscCG gene product of Corynebacterium glutamicum belongs to the family of MscS-type mechanosensitive channels. In order to investigate the physiological significance of MscCG in response to osmotic shifts in detail, we studied its properties using both patch-clamp techniques and betaine efflux kinetics. After heterologous expression in an Escherichiacoli strain devoid of mechanosensitive channels, in patch-clamp analysis of giant E. coli spheroplasts MscCG showed the typical pressure dependent gating behavior of a stretch-activated channel with a current/voltage dependence indicating a strongly rectifying behavior. Apart from that, MscCG is characterized by significant functional differences with respect to conductance, ion selectivity and desensitation behavior as compared to MscS from E. coli. Deletion and complementation studies in C. glutamicum showed a significant contribution of MscCG to betaine efflux in response to hypoosmotic conditions. A detailed analysis of concomitant betaine uptake (by the betaine transporter BetP) and efflux (by MscCG) under hyperosmotic conditions indicates that MscCG may act in osmoregulation in C. glutamicum by fine-tuning the steady state concentration of compatible solutes in the cytoplasm which are accumulated in response to hyperosmotic stress.     

Chloramphenicol and expression of multidrug efflux pump in Enterobacter aerogenes

Chloramphenicol has been reported to act as an inducer of the multidrug resistance in Escherichia coli. A resistant variant able to grow on plates containing 64 microg/ml chloramphenicol was obtained from the Enterobacter aerogenes ATCC 13048-type strain. Chloramphenicol resistance was due to an active efflux of this antibiotic and it was associated with resistance to fluoroquinolones and tetracycline, but not to aminoglycoside or beta-lactam antibiotics. MDR in the chloramphenicol-resistant variant is linked to the overexpression of the major AcrAB-TolC efflux system. This overexpression seems unrelated to the global Mar and the local AcrR regulatory pathways.