氨基糖苷类抗生素的抗HIV潜力

以新霉素为代表的氨基糖苷类抗生素通过与HIV RNA的RRE结构域结合,对HIV的RRE—Rev相互作用产生抑制作用．从而具有阻遏HIV复制的活性。人们通过对各种氨基糖苷类抗生素单体及其多种衍生物与RRE结合的实验研究,对它们之间的相互作用有了越来越多的了解。     

细菌对氨基糖苷类抗生素的耐药机制

氨基糖苷类抗生素起源于1944年链霉素的发现,其主要抑制细菌蛋白质的合成,以及破坏细菌胞浆膜的完整性。具有抗菌谱广、杀菌完全、与β-内酰胺等抗生素有很好的协同作用,是最常用的抗感染药物。它依赖电子转运,通过细菌内膜而到达胞质溶胶中后,与核糖体30S亚基结合,但这种结合并不阻止起始复合物的形成,而是通过破坏控制翻译准确性的校读过程来干扰新生链的延长。随着临床的广泛和不科学使用,细菌对氨基糖苷类抗生素的耐药性逐年增高,其耐药机制也十分复杂,主要包括细菌产生使抗生素失活的修饰酶、细菌对药物的摄取和积累减少,以及核糖体结合位点的减少等;另外还发现有新的机制参与细菌对氨基糖苷类抗生素的耐药过程。现将细菌对氨基糖苷类抗生素的耐药机制进行综述,并探讨联合用药控制耐药。     

氨基糖苷类抗生素钝化酶基因

氨基糖苷类抗生素的耐药性主要由细菌产生钝化酶所致,本文对其编码基因的起源,分布及调控,扩散机制作一介绍。     

氨基糖苷类修饰酶引起的细菌耐药性机制的研究进展

氨基糖苷类抗生素是高效、广谱的杀菌药物。随着在临床的广泛应用,抗生素的抗药性日趋严重,这在很大程度上降低了其临床应用的潜力。其中,最主要的原因就是细菌产生了一系列修饰酶修饰抗生素的特定基团,使其失去药效。细菌产生的修饰酶种类众多,主要包括磷酸化、乙酰化和腺苷化修饰酶。研究发现,一种酶可以修饰多种抗生素,同时,一种抗生素也可以被多种修饰酶修饰。由于修饰酶底物的广谱性,使得细菌的耐药性难以克服。因此,本文就氨基糖苷类修饰酶和抗生素相互作用的热力学和动力学性质进行了详细的论述,试图找出不同修饰酶失活抗生素药物的共同作用机制。这将为设计新的抗生素药物及修饰酶抑制剂、克服细菌的耐药性,提供理论指导和技术支持。     

等温滴定量热法研究核糖开关aac与氨基糖苷类抗生素的相互作用

核糖开关(riboswitch)是位于m RNA非编码区域的RNA元件,可与小分子配体结合导致结构转变,进而调控下游基因的表达。核糖开关aac能够特异性结合氨基糖苷类抗生素,从而调控氨基糖苷类抗生素抗性基因的表达。目前,核糖开关aac与氨基糖苷类抗生素相互作用的位点和机制尚不清楚。作者利用等温滴定量热法对核糖开关aac与氨基糖苷类抗生素的结合亲和力及结合热力学性质进行了研究,并初步探讨了点突变对相互作用的影响。结果发现,西索米星、庆大霉素、G418、奈替霉素和巴龙霉素能够特异性结合核糖开关aac,而阿米卡星、卡那霉素A、链霉素、链丝菌素、新霉胺、新霉素及核糖霉素与核糖开关aac无特异性相互作用;核糖开关aac与氨基糖苷类抗生素的结合热力学性质表明二者通过氢键和范德华力发生相互作用。西索米星滴定核糖开关aac突变体的结果表明,U68和A18位点很可能与氨基糖苷类抗生素形成氢键,A13和A44位点对于相互作用也有影响。这些结果对进一步研究核糖开关aac与氨基糖苷类抗生素相互作用的位点和机制具有重要的参考价值。     

氨基糖苷-(3)-乙酰转移酶Ⅱ的表达纯化及初步活性

用PCR扩增的氨基糖苷-（3）-乙酰转移酶Ⅱ[aac（3）-Ⅱ]基因构建了能表达较高活性AAC（3）-Ⅱ的重组工程菌,并获取重组AAC（3）-Ⅱ。含pET28a质粒的工程菌转入aac（3）-Ⅱ基因前后对氨基糖苷类抗生素的最低抑菌浓度进行比较,重组菌超声裂解上清液及其纯化的AAC（3）-Ⅱ进行SDS-PAGE和Western印迹电泳鉴定。最低抑菌浓度表明转入aac（3）-Ⅱ基因的工程菌比未转入的工程菌对庆大霉素（gentamicin,GEN）的提高了256倍,对妥布霉素（tobramycin,TOB）及其奈替米星（netilmicin,NTL）提高了16倍,电泳鉴定表明纯化荻取的是重组AAC（3）-Ⅱ,其相对分子质量约为32kDa,纯度大于95％,纯化后的10μg AAC（3）-Ⅱ,分别在10s内使80μg GEN、30s内使80μg TOB和NTL乙酰化而失去抑菌作用。研究为氨基糖苷类抗生素伴侣的开发研究初步打下基础。     

氨基糖苷-(3)-乙酰转移酶II的表达纯化及初步活性

用PCR扩增的氨基糖苷-(3)-乙酰转移酶II[aac(3)-II]基因构建了能表达较高活性AAC(3)-II的重组工程菌,并获取重组AAC(3)-II。含pET28a质粒的工程菌转入aac(3)-II基因前后对氨基糖苷类抗生素的最低抑菌浓度进行比较,重组菌超声裂解上清液及其纯化的AAC(3)-II进行SDS-PAGE和Western印迹电泳鉴定。最低抑菌浓度表明转入aac(3)-II基因的工程菌比未转入的工程菌对庆大霉素(gentamicin,GEN)的提高了256倍,对妥布霉素(tobramycin,TOB)及其奈替米星(netilmicin,NTL)提高了16倍,电泳鉴定表明纯化获取的是重组AAC(3)-II,其相对分子质量约为32kDa,纯度大于95%,纯化后的10μgAAC(3)-II,分别在10s内使80μgGEN、30s内使80μgTOB和NTL乙酰化而失去抑菌作用。研究为氨基糖苷类抗生素伴侣的开发研究初步打下基础。     

细菌对氨基糖苷类抗生素产生抗性的机理及其控制策略

氨基糖苷类抗生素在治疗感染性疾病尤其是革兰氏阴性菌引起的严重感染方面起着重要作用 ,但是耐药菌株的出现较大地限制了此类抗生素的发展 ,因此 ,如何控制耐药性已经成为一项迫切需要解决的任务。细菌对氨基糖苷类抗生素产生抗性的机制很多 ,目前普遍接受的主要有三种 :1. 通过减少对氨基糖苷类抗生素的摄取或减少药物在体内的累积而产生抗性。 2. 通过改变核糖体结合位点而产生抗性。 3. 通过表达氨基糖苷类抗生素修饰酶而产生抗性。目前细菌耐药性的控制主要集中在对原有氨基糖苷类抗生素进行改造或合成新的抗生素 ,开发氨基糖苷类抗生素修饰酶抑制剂。     

铜绿假单胞菌新基因PA0058插入失活对氨基糖苷类抗生素耐药性的影响

【目的】铜绿假单胞菌是一种重要的条件致病菌,临床上常引起难治性和顽固性感染,随着各种抗生素的广泛使用,该菌对多种抗生素呈现耐药性,研究其耐药性机理有着重要意义。【方法】以一株临床分离株Pseudomonas aeruginosa PA68作为出发菌株,应用人工Mu转座技术构建突变文库并从中筛选得到一株对链霉素抗性明显增强的菌株M122,并对突变株M122进行测序分析及表型检测。通过Southern杂交实验证实转座子是否为单拷贝插入,对突变株M122的基因表达谱与野生型PA68菌株进行对比分析。【结果】确定了Mu转座子在M122基因组上为单拷贝插入,插入位点为基因PA0058的第214 bp处。对M122进行表型检测,发现其对多种氨基糖苷类抗生素的耐药性均得到增强,通过转入携带完整基因PA0058的表达质粒可以使突变株M122的耐药性有所降低,利用同源重组的方法,在模式菌株P.aeruginosa PAK中进行PA0058基因敲除,得到的敲除株具有链霉素耐药性升高的表型。基因PA0058的缺失引起多种基因表达水平改变,尤其是katB、ahpC、ahpF等抗氧化酶基因转录表达显著增高。【结论】首次发现铜绿假单胞菌PA0058基因的插入失活提高了细菌对氨基糖苷类抗生素的耐药性,且导致突变株M122中抗氧化酶基因转录表达水平的上调。     

利用糖芯片技术检测氨基糖苷类抗生素与RNAs和蛋白质之间的相互作用

氨基糖苷类抗生素是一类广谱型抗细菌感染药物,其不断增加的细菌耐药性很大程度上限制了它的临床应用,研究和开发新型氨基糖苷类抗生素具有重要意义。将氨基糖苷类抗生素固定到玻璃片基上,制成糖芯片,再分别与荧光标记的RNAs和蛋白质杂交,通过分析杂交后的荧光信号强度检测它们之间的相互作用。结果显示,氨基糖苷类抗生素芯片可以特异性地与r RNA的A位点模拟物、I型核酶和蛋白酶结合。因此糖芯片技术不仅可以检测氨基糖苷类抗生素与r RNAs的特异性结合,而且可以应用于寻找新型RNA结合配体的研究,为快速鉴定和筛选可紧密结合RNA靶标且毒性较低的新型氨基糖苷类抗生素奠定了一定的基础。     

Specific Antimicrobial Synergism of Synthetic Hydroxy Isothiocyanates with Aminoglycoside Antibiotics

Hydroxy isothiocyanates, especially 2-(4-hydroxy-phenyl)ethyl isothiocyanate (hITC), were examined for antimicrobial synergism with several antibiotics against Escherichia coli and Staphylococcus aureus, using a multiwell plate system. hITC had antibacterial synergism, specifically with aminoglycoside antibiotics. The synergism was observed in synthetic medium (M9 minimal medium) or soybean casein digest broth, but not in nutrient broth. Synergism was seen in the presence of certain sugars such as glucose, fructose, and maltose in the medium.     

三例氨基糖甙类抗生素致聋患者的线粒体DNA测序分析

应用PCR扩增产物直接对3名氨基糖甙类抗生素致聋患者的线粒体DNA进行序 列分析, 结果表明,他们的线粒体DNA均存在第1555位核苷酸A-G的突变。因此认为该突 变是人体对氨基糖甙类抗生素致聋遗传易感性的分子基础,与氨基糖甙类抗生素共同作用造成耳聋。 Abstract:The mitochondria DNAs(mtDNAs)of three patients with AAID were analysed using the method of direct sequencing of their PCR products.The results showed that all their mtDNAs had an A-G mutation at nucleotides 1555.It is considered that this mutation is the molecular basis causing human susceptibility to Aminoglycoside Antibiotics toxicity which in cooperation with Aminoglycoside Antibiotics results in deafness.     

Bloodstream Infections in the Intensive Care Unit: A Single-Center Retrospective Bacteriological Analysis Between 2007 and 2019

Hospital-acquired bloodstream infections are a severe worldwide problem associated with significant morbidity and mortality. This retrospective, single-center study aimed to analyze bloodstream infections in patients hospitalized in the intensive care unit of the Military Institute of Medicine, Poland. Data from the years 2007–2019 were analyzed. When the infection was suspected, blood samples were drawn and analyzed microbiologically. When bacterial growth was observed, an antimicrobial susceptibility/resistance analysis was performed. Among 12,619 analyzed samples, 1,509 were positive, and 1,557 pathogens were isolated. In 278/1,509 of the positive cases, a central line catheter infection was confirmed. Gram-negative bacteria were the most frequently (770/1,557) isolated, including Acinetobacter baumannii (312/770), Klebsiella pneumoniae (165/770; 67/165 were the isolates that expressed extended spectrum beta-lactamases (ESBL), 5/165 isolates produced the New Delhi metallo-β-lactamases (NDM), 4/165 isolates expressed Klebsiella pneumoniae carbapenemase (KPC), and 1/165 isolate produced OXA48 carbapenemase), Pseudomonas aeruginosa (111/770; 2/111 isolates produced metallo-β-lactamase (MBL), and Escherichia coli (69/770; 11/69 – ESBL). Most Gram-positive pathogens were staphylococci (545/733), mainly coagulase-negative (368/545). Among 545 isolates of the staphylococci, 58 represented methicillin-resistant Staphylococcus aureus (MRSA). Fungi were isolated from 3.5% of samples. All isolated MRSA and methicillin-resistant coagulase-negative Staphylococcus (MRCNS) strains were susceptible to vancomycin, methicillin-sensitive Staphylococcus aureus (MSSA) isolates – to isoxazolyl penicillins, and vancomycin-resistant Enterococcus (VRE) – to linezolid and tigecycline. However, colistin was the only therapeutic option in some infections caused by A. baumannii and KPC-producing K. pneumoniae. P. aeruginosa was still susceptible to cefepime and ceftazidime. Echinocandins were effective therapeutics in the treatment of fungal infections.     

Aminoglycoside antibiotics bound to aminoglycoside-detoxifying enzymes and RNA adopt similar conformations

Conformations of ribostamycin and isepamicin, aminoglycoside antibiotics, bound to an aminoglycoside antibiotic, 3′-phosphotransferase, were determined by transferred nuclear Overhauser effect spectroscopy and molecular modeling. Two major conformers of enzyme-bound ribostamycin, a neomycin-group aminoglyeoside were observed. The 3′- and 5″-OH groups (reactive hydroxyl groups) in the conformers are placed in approximate locations. One of the conformers is similar to the structure of paromomycin bound to a 27-nucleotide piece of ribosomal RNA that represents the A-site of the small ribosomal subunit, where rings A and C are in an orthogonal arrangement. Isepamicin, a kanamycin-group aminoglycoside antibiotic, also showed two major enzyme-bound conformations. Both conformations were similar to those observed for bound isepamicin in the active site of an aminoglycoside(6′)-acetyl transferase-Ii. Conformations of other RNA-bound kanamycin-group aminoglycosides were also similar to the enzyme-bound conformations of isepamicin. These observations suggest that aminoglycosides may adopt similar conformations when bound to RNA and protein targets. This may have significant implications in the design of enzyme inhibitors and/or antibiotics.     

Structure of the 70S Ribosome from the Human Pathogen Acinetobacter baumannii in Complex with Clinically Relevant Antibiotics

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Aminoglycoside sensitivity of ribosomes from the archaebacterium Methanococcus vannielii: Structure-activity relationship

Abstract The effect of about 20 aminoglycoside antibiotics comprising compounds with specific 70S or with 70S plus 80S activity on polypeptide synthesis and translational misreading by ribosomes from the archaebacterium Methanococcus vannielii was investigated. A clear structure-activity relationship was found: sensitivity was observed only to the class of 4,5-disubstituted deoxystreptamine compounds, with neomycin and paromomycin as the most active ones. The streptomycin class aminoglycosides were completely inactive whereas the gentamicin group compounds solely affected misreading and only at high concentrations. Viomycin, a specific inhibitor of the translocation reaction at the eubacterial ribosome which competes with binding of 2-deoxystreptamine aminoglycosides was inactive as well.     

The comparison of susceptibility patterns of Gram-negative invasive and non-invasive pathogens in Estonian hospitals

A total of 560 invasive and 1062 non-invasive isolates were collected. The antimicrobial susceptibility of invasive versus non-invasive Pseudomonas aeruginosa, Acinetobacter baumannii, and Klebsiella pneumoniae isolates were evaluated using the E-tests. The equal domination of Gram-negative among both invasive and non-invasive pathogens was estimated in our study if contaminants were excluded. The emergence trend of Gram-positive microbes especially of coagulase negative staphylococci may be proved only after application of exclusive algorithms. Due to similar susceptibility, the data of non-invasive Gram-negative pathogens can be useful to predict resistance of invasive ones. Also, the surveillance of invasive pathogens provides useful information about the general susceptibility of pathogens.     

Advances in macrocyclic peptide-based antibiotics

Macrocyclic peptide-based natural products have provided powerful new antibiotic drugs, drug candidates, and scaffolds for medicinal chemists as a source of inspiration to design novel antibiotics. While most of those natural products are active mainly against Gram-positive pathogens, novel macrocyclic peptide-based compounds have recently been described, which exhibit potent and specific activity against some of the most problematic Gram-negative ESKAPE pathogens. This mini-review gives an up-date on recent developments.