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mcr 基因赋予肠杆菌科细菌对黏菌素的耐药性;五年概述。

mcr Genes Conferring Colistin Resistance in Enterobacterales; a Five Year Overview.

机构信息

Department of Biomedical Sciences, School of Health Sciences, International University of Greece, Thessaloniki, Greece.

Medical School, Faculty of Health Sciences, Aristotle University of Thessaloniki, Thessaloniki, Greece.

出版信息

Acta Med Acad. 2021 Dec;50(3):365-371. doi: 10.5644/ama2006-124.355.

Abstract

The present review aims to study and detect the global emergence of mcr genes in E. coli, K. pneumoniae and Salmonella spp., isolates from human specimens over the last six years. Nowadays the rise of multidrug-resistant superbugs has made essential the return of drugs that were previously abandoned. A clear example is colistin, which acts against multidrug - resistant gram - negative pathogens, including Enterobacterales. Colistin resistance is an unfortunate fact, with the emergence of mcr genes conferring resistance to colistin in Enterobacterales posing the most recent threat. Literature about mcr genes and their spread in E. coli, K. pneumoniae and Salmonella spp. is cited, focusing on the emergence of mcr genes in human specimens since 2015. The data were taken from the PubMed and Scopus databases. It seems that the mcr-1 gene continues to be the protagonist among the three species. E. coli is the dominant species harbouring mcr genes. Moreover, plasmid - mediated colistin resistance is also conferred upon other species that carry different genes resistant to antibiotics. There are only scarse reports on human Salmonella spp isolates harbouring mcr genes. Finally, the emergence of the mcr-9 gene in all of them is quite remarkable. CONCLUSION: Plasmid - mediated colistin resistance in Enterobacterales is a global issue and has been worsening over the years. The continuous mutations of mcr gene subtypes underline the need for better surveillance, constant investigation and wise use of colistin, especially in countries with high levels of antibiotic resistance.

摘要

本综述旨在研究和检测过去六年中人类标本中分离的大肠杆菌、肺炎克雷伯菌和沙门氏菌属中 mcr 基因的全球出现情况。如今,多药耐药超级细菌的兴起使得重新使用以前被弃用的药物变得至关重要。一个明显的例子是黏菌素,它可以对抗包括肠杆菌科在内的多种耐药革兰氏阴性病原体。黏菌素耐药是一个不幸的事实,肠杆菌科中 mcr 基因的出现对黏菌素耐药构成了最近的威胁。本文引用了有关 mcr 基因及其在大肠杆菌、肺炎克雷伯菌和沙门氏菌属中传播的文献,重点关注自 2015 年以来人类标本中 mcr 基因的出现情况。数据来自 PubMed 和 Scopus 数据库。似乎 mcr-1 基因在这三种细菌中仍然是主角。大肠杆菌是携带 mcr 基因的主要物种。此外,质粒介导的黏菌素耐药性也赋予了其他携带不同抗生素耐药基因的物种。关于携带 mcr 基因的人类沙门氏菌属分离株的报告很少。最后,mcr-9 基因在所有这些细菌中的出现也非常显著。结论:肠杆菌科中质粒介导的黏菌素耐药性是一个全球性问题,而且近年来一直在恶化。mcr 基因亚型的不断突变强调了需要更好的监测、持续的调查和明智地使用黏菌素,特别是在抗生素耐药水平较高的国家。

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