Acinetobacter baumannii Antibiotic Resistance Mechanisms.
Acinetobacter baumannii Antibiotic Resistance Mechanisms.
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DOI：
10.3390/pathogens10030373
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发表时间：
2021-03-19
期刊：
影响因子：
--
通讯作者：
Tragiannidis A
中科院分区：
文献类型：
--
作者：
Kyriakidis I;Vasileiou E;Pana ZD;Tragiannidis A
鲍曼不动杆菌是一种革兰氏阴性ESKAPE微生物，通过引起与高死亡率相关的严重和侵入性（主要是医院）感染对公共卫生构成威胁。在过去的几年里，这种病原体显示出多药耐药性（MDR），主要是由于广泛的抗生素滥用和管理不善。MDR分离株与长期住院、导管存在和机械通气的病史相关，而免疫功能低下和重症宿主易发生侵入性感染。下一代测序技术已经彻底改变了重症A。鲍曼不动杆菌感染，有助于及时诊断和个性化治疗方案，根据各自的耐药基因的鉴定。本文就目前国内外关于A.关于β-内酰胺类（青霉素类、头孢菌素类、碳青霉烯类、单环β-内酰胺类和β-内酰胺酶抑制剂）、氨基糖苷类、四环素类、氟喹诺酮类、大环内酯类、林可酰胺类、链阳性菌素类抗生素、多粘菌素类和其它（氨酚类、恶唑烷酮类、利福霉素类、磷霉素类、二氨基嘧啶类、磺胺类、糖肽类和脂肽类抗生素）的人体鲍曼不动杆菌耐药机制。抗生素耐药性的机制主要是指通过细菌膜的抗生素运输的调节、抗生素靶位点的改变和导致抗生素中和的酶修饰。毒力因素可能影响抗生素的敏感性和赋予耐药性也正在讨论。报道了A.已经研究了在COVID-19大流行期间鲍曼不动杆菌与SARS-CoV-2共感染的耐药谱和MDR基因。
Acinetobacter baumannii is a Gram-negative ESKAPE microorganism that poses a threat to public health by causing severe and invasive (mostly nosocomial) infections linked with high mortality rates. During the last years, this pathogen displayed multidrug resistance (MDR), mainly due to extensive antibiotic abuse and poor stewardship. MDR isolates are associated with medical history of long hospitalization stays, presence of catheters, and mechanical ventilation, while immunocompromised and severely ill hosts predispose to invasive infections. Next-generation sequencing techniques have revolutionized diagnosis of severe A. baumannii infections, contributing to timely diagnosis and personalized therapeutic regimens according to the identification of the respective resistance genes. The aim of this review is to describe in detail all current knowledge on the genetic background of A. baumannii resistance mechanisms in humans as regards beta-lactams (penicillins, cephalosporins, carbapenems, monobactams, and beta-lactamase inhibitors), aminoglycosides, tetracyclines, fluoroquinolones, macrolides, lincosamides, streptogramin antibiotics, polymyxins, and others (amphenicols, oxazolidinones, rifamycins, fosfomycin, diaminopyrimidines, sulfonamides, glycopeptide, and lipopeptide antibiotics). Mechanisms of antimicrobial resistance refer mainly to regulation of antibiotic transportation through bacterial membranes, alteration of the antibiotic target site, and enzymatic modifications resulting in antibiotic neutralization. Virulence factors that may affect antibiotic susceptibility profiles and confer drug resistance are also being discussed. Reports from cases of A. baumannii coinfection with SARS-CoV-2 during the COVID-19 pandemic in terms of resistance profiles and MDR genes have been investigated.
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影响因子：
8.1
作者：
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