| 黄李丹,杨美娟,孙爱华,严杰.肺炎链球菌耐药分子机制的研究进展.[J].中南医学科学杂志.,2021,(3):275-280. |
| 肺炎链球菌耐药分子机制的研究进展 |
| Research progress in molecular mechanisms of drug resistance of Streptococcus pneumoniae |
| 投稿时间：2021-02-15 修订日期：2021-03-29 |
| DOI：10.15972/j.cnki.43-1509/r.2021.03.006 |
| 中文关键词: 肺炎链球菌 抗生素 耐药性 |
| 英文关键词:Streptococcus pneumoniae antibiotics drug resistance |
| 基金项目: |
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| 中文摘要: |
| 肺炎链球菌感染可引起细菌性肺炎、中耳炎和脑膜炎等疾病,临床上常采用β-内酰胺类抗生素、大环内酯类和喹诺酮类抗生素进行治疗。近年来,肺炎链球菌感染性疾病发病率不断升高,究其原因主要是耐药或多重耐药菌株日趋流行。肺炎链球菌不产β-内酰胺酶,该菌对β-内酰胺类抗生素耐药主要是青霉素结合蛋白(PBPs)突变,其次是与PBPs突变无关的调控感受态ComD/ComE二元信号传导系统(TCSS)以及调控细胞壁合成或完整性的CiaH/CiaR-TCSS和StkP-PhpP信号偶联相关基因突变。肺炎链球菌对大环内酯类抗生素的耐药机制主要是ErmB甲基化酶对药物作用的核糖体靶点甲基化修饰和MefA/E药物外排泵功能增强。肺炎链球菌对喹诺酮类抗生素的耐药机制是DNA回旋酶和/或拓扑异构酶Ⅳ中喹诺酮类耐药决定区域(QRDR)变异和药物外排作用增强。肺炎链球菌19F和19A血清型在中国优势流行且对多种抗生素耐药。 |
| 英文摘要: |
| Infection of Streptococcus pneumoniae(S.pneumoniae) can cause bacterial pneumonia, tympanitis and meningitis that are commonly treated with β-lactam, macrolide and quinolone antibiotics. Recently, the incidences of S.pneumoniae-infected diseases are persistently increased mainly due to the prevalence of drug or multiple drug resistance pneumococcal strains. S.pneumoniae does not produce any β-lactamases and its resistance against β-lactam antibiotics is mainly caused by mutation of penicillin-binding proteins (PBPs) and then the gene mutation in PBP mutation-independent competence-regulated ComD/ComE two-component signaling system (TCSS), cell wall synthesis/integrity-regulated CiaH/CiaR-TCSS and StkP-PhpP signal couple. The resistance mechanisms of S.pneumoniae against macrolide antibiotics are mainly due to the methylation modification in drug target sites in ribosomes by ErmB methylase and enhancement of MefA/E drug excretion pump functions. The major resistance mechanisms of S.pneumoniae against quinolone antibiotics are caused by the mutations in quinolone resistance-determining region(QRDR) of DNA gyrase and/or gyrase and enhancement of drug excretion effects. S.pneumoniae 19F and 19A serotypes are predominant in China and resistant to multiple antibiotics. |
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