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耐甲氧西林金黄色葡萄球菌的流行率、分类及耐药机制研究进展

Progress in the Prevalence, Classification and Drug Resistance Mechanisms of Methicillin-Resistant .

作者信息

Hou Zhuru, Liu Ling, Wei Jianhong, Xu Benjin

机构信息

Department of Basic Medicine, Fenyang College of Shanxi Medical University, Fenyang, People's Republic of China.

Key Laboratory of Lvliang for Clinical Molecular Diagnostics, Fenyang, People's Republic of China.

出版信息

Infect Drug Resist. 2023 May 25;16:3271-3292. doi: 10.2147/IDR.S412308. eCollection 2023.

Abstract

is a common human pathogen with a variety of virulence factors, which can cause multiple infectious diseases. In recent decades, due to the constant evolution and the abuse of antibiotics, was becoming more resistant, the infection rate of MRSA remained high, and clinical treatment of MRSA became more difficult. The genetic diversity of MRSA was mainly represented by the continuous emergence of epidemic strains, resulting in the constant changes of epidemic clones. Different classes of MRSA resulted in different epidemics and resistance characteristics, which could affect the clinical symptoms and treatments. MRSA had also spread from traditional hospitals to community and livestock environments, and the new clones established a relationship between animals and humans, promoting further evolution of MRSA. Since the resistance mechanism of MRSA is very complex, it is important to clarify these resistance mechanisms at the molecular level for the treatment of infectious diseases. We firstly described the diversity of SCC elements, and discussed the types of SCC, its drug resistance mechanisms and expression regulations. Then, we described how the operon makes resistant to vancomycin and its expression regulation. Finally, a brief introduction was given to the drug resistance mechanisms of biofilms and efflux pump systems. Analyzing the resistance mechanism of MRSA can help study new anti-infective drugs and alleviate the evolution of MRSA. At the end of the review, we summarized the treatment strategies for MRSA infection, including antibiotics, anti-biofilm agents and efflux pump inhibitors. To sum up, here we reviewed the epidemic characteristics of , summarized its classifications, drug resistance mechanisms of MRSA (SCC element, operon, biofilm and active efflux pump system) and novel therapy strategies, so as to provide a theoretical basis for the treatment of MRSA infection.

摘要

是一种常见的人类病原体,具有多种毒力因子,可引起多种传染病。近几十年来,由于不断进化和抗生素的滥用,其耐药性越来越强,耐甲氧西林金黄色葡萄球菌(MRSA)的感染率居高不下,临床治疗MRSA变得更加困难。MRSA的遗传多样性主要表现为流行菌株的不断出现,导致流行克隆不断变化。不同类别的MRSA导致不同的流行情况和耐药特征,这可能影响临床症状和治疗。MRSA也已从传统医院传播到社区和牲畜环境,新的克隆在动物和人类之间建立了联系,促进了MRSA的进一步进化。由于MRSA的耐药机制非常复杂,在分子水平上阐明这些耐药机制对于传染病的治疗很重要。我们首先描述了葡萄球菌盒式染色体(SCC)元件的多样性,并讨论了SCC的类型、其耐药机制和表达调控。然后,我们描述了vanA操纵子如何使MRSA对万古霉素耐药及其表达调控。最后,简要介绍了生物膜和外排泵系统的耐药机制。分析MRSA的耐药机制有助于研究新的抗感染药物并减缓MRSA的进化。在综述结尾,我们总结了MRSA感染的治疗策略,包括抗生素、抗生物膜剂和外排泵抑制剂。总之,我们在此综述了MRSA的流行特征,总结了其分类、MRSA的耐药机制(SCC元件、vanA操纵子、生物膜和主动外排泵系统)以及新的治疗策略,以便为MRSA感染的治疗提供理论依据。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9fe1/10226514/7d84f748dcd9/IDR-16-3271-g0001.jpg

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