艰难梭菌耐药性及耐药机制研究进展

doi:10.16288/j.yczz.15-131

遗传 ›› 2015, Vol. 37 ›› Issue (5): 458-464.doi: 10.16288/j.yczz.15-131

艰难梭菌耐药性及耐药机制研究进展

高琼,黄海辉

复旦大学附属华山医院抗生素研究所,卫生部抗生素临床药理重点实验室,上海 200040

收稿日期:2015-03-26 出版日期:2015-05-20 发布日期:2015-05-20
通讯作者: 黄海辉, 主任医师, 博士生导师, 研究方向：感染性疾病的诊治,厌氧菌耐药性及耐药机制。Tel: 021-52888195; E-mail: huanghaihui@fudan.edu.cn
作者简介:高琼, 硕士研究生, 研究方向：艰难梭菌耐药机制。Tel: 021-52888193; E-mail: 14211220003@fudan.edu.cn
基金资助:
国家自然科学基金项目(编号：30973594, 81101292)

Update on antimicrobial resistance in Clostridium difficile

Qiong Gao, Haihui Huang

Institute of Antibiotics, Huashan Hospital, Fudan University, Key Laboratory of Clinical Pharmacology of Antibiotics, Ministry of Health, Shanghai 200040, China

Received:2015-03-26 Online:2015-05-20 Published:2015-05-20

摘要/Abstract

摘要： 艰难梭菌(Clostridium difficile)是医疗保健相关性腹泻最主要的病原菌。2002年起欧美地区艰难梭菌感染发病率和病死率均明显增高,耐药艰难梭菌的出现和传播更给临床治疗和预防带来了挑战。绝大多数临床分离菌对甲硝唑及万古霉素仍呈高度敏感,但已有异质性耐药或最低抑菌浓度上升的报道;对红霉素和莫西沙星等其他抗菌药物的耐药率在不同国家和地区则有较大差异。艰难梭菌对甲硝唑或万古霉素敏感性下降产生的耐药机制尚不明确,而对红霉素、氟喹诺酮类、四环素和利福霉素形成的耐药机制主要是因为作用靶点发生了改变。文章简述了近年来国际上艰难梭菌耐药性及耐药机制方面的研究进展。

关键词: 艰难梭菌, 耐药性, 耐药机制

Abstract: Clostridium difficile is the leading cause of healthcare-associated diarrhea. Since 2002, the morbidity and mortality rates of C. difficile infection have increased dramatically in Europe and North America. The emergence of C. difficile strains that are resistant to multiple antimicrobial agents can complicate prevention programs and potential treatment. Although most clinical isolates are still susceptible to metronidazole and vancomycin, heteroresistance to metronidazole and increasing vancomycin MICs (minimum inhibitory concentrations) have been reported. The prevalence of resistance to other antimicrobial agents, including erythromycin and moxifloxacin, is highly variable in different countries and regions. The exact mechanism of reduced susceptibility to metronidazole or vancomycin is still not clear. The principal mechanism of erythromycin, fluoroquinolones and rifamycins resistance in C. difficile is determined by target alterations. This review will focus primarily on the antimicrobial susceptibility patterns and resistance mechanisms of C. difficile in order to provide an up-to-date review on the topic.

Key words: clostridium difficile, antimicrobial resistance, resistance mechanism

高琼,黄海辉. 艰难梭菌耐药性及耐药机制研究进展[J]. 遗传, 2015, 37(5): 458-464.

Qiong Gao, Haihui Huang. Update on antimicrobial resistance in Clostridium difficile[J]. HEREDITAS(Beijing), 2015, 37(5): 458-464.

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