A Molecular Perspective on Colistin and Klebsiella pneumoniae: Mode of Action, Resistance Genetics, and Phenotypic Susceptibility.
A Molecular Perspective on Colistin and Klebsiella pneumoniae: Mode of Action, Resistance Genetics, and Phenotypic Susceptibility.
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DOI：
10.3390/diagnostics11071165
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发表时间：
2021-06-25
期刊：
影响因子：
--
通讯作者：
Perdigão J
中科院分区：
文献类型：
--
作者：
Elias R;Duarte A;Perdigão J
肺炎克雷伯菌是一种杆状、被包裹的革兰氏阴性细菌，与多种医院感染有关。耐多药(MDR)肺炎克雷伯菌菌株一直在增加，治疗选择越来越有限。粘菌素是一种长期使用的聚阳离子七肽，由于其对革兰氏阴性菌，包括耐多药肺炎克雷伯菌的活性而重新引起人们的注意。然而，这种抗生素具有复杂的作用模式，仍在研究中，并有许多副作用。粘菌素抗性的获得主要与通过多基因调控网络的基因产物合成阳离子基团改变脂质A净电荷有关。除了这些染色体基因的突变外，粘菌素抗性也可以通过获得质粒编码的基因来实现。然而，粘菌素抗性分子标记的多样性以及一些不利的粘菌素特性损害了粘菌素抗性监测方法的可靠性。本文就粘菌素的作用和分子耐药机制以及肺炎克雷伯菌药敏试验的局限性作一综述。
Klebsiella pneumoniae is a rod-shaped, encapsulated, Gram-negative bacteria associated with multiple nosocomial infections. Multidrug-resistant (MDR) K. pneumoniae strains have been increasing and the therapeutic options are increasingly limited. Colistin is a long-used, polycationic, heptapeptide that has regained attention due to its activity against Gram-negative bacteria, including the MDR K. pneumoniae strains. However, this antibiotic has a complex mode of action that is still under research along with numerous side-effects. The acquisition of colistin resistance is mainly associated with alteration of lipid A net charge through the addition of cationic groups synthesized by the gene products of a multi-genic regulatory network. Besides mutations in these chromosomal genes, colistin resistance can also be achieved through the acquisition of plasmid-encoded genes. Nevertheless, the diversity of molecular markers for colistin resistance along with some adverse colistin properties compromises the reliability of colistin-resistance monitorization methods. The present review is focused on the colistin action and molecular resistance mechanisms, along with specific limitations on drug susceptibility testing for K. pneumoniae.
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影响因子：
6.7
作者：
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作者：
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DOI：
10.1093/jac/dky054
发表时间：
2018-06-01
期刊：
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影响因子：
--
作者：
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Wang JT
影响因子：
3.3
作者：
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