optrA基因介导肠球菌对利奈唑胺耐药的研究进展
Research progress on the optrA gene mediating linezolid resistance in enterococci
杨佩霓 1李庆蓉 1杨旭 1王清 1和平安 1吕梅 1张双丽2
作者信息
- 1. 昆明医科大学第二附属医院,昆明 650032
- 2. 中国人民解放军联勤保障部队第926医院,开远 661600
- 折叠
摘要
肠球菌是导致尿路感染、心内膜炎及医院相关感染的常见病原体之一,利奈唑胺被认为是治疗由多重耐药革兰阳性菌引起严重感染的最后一种药物,然而自利奈唑胺被引入临床应用以来,不断有研究报道利奈唑胺耐药肠球菌(linezolidin-resistant Enterococcus,LRE)的出现,已成为临床治疗和公共卫生面临的重大挑战.获得可转移性恶唑烷酮耐药基因optrA是导致LRE的重要耐药机制,其在肠球菌中的扩散和流行,削弱了利奈唑胺治疗临床耐药菌株的疗效,应在临床应用中引起极大重视.本文综述了携带optrA基因的LRE菌株流行情况、参与optrA基因传播的可移动性遗传元件、optrA基因变体等,为临床控制LRE的流行、合理选择抗菌药物等方面提供理论科学依据.
Abstract
Enterococcus is one of the common pathogens causing urinary tract infections,endocarditis,and hospital-associated infections.Linezolid is considered to be the last line of treatment for serious infections caused by multidrug-resistant Gram-positive bacteria.However,since the introduction of linezolid into clinical application,the emergence of linezolidin-resistant Enterococcus(LRE)has been reported continuously,which has become a major challenge to clinical treatment and public health.The acquisition of the transferrable oxazolidinone resistance gene optrA is an important resistance mechanism leading to LRE.The spread and prevalence of optrA in enterococci weakened the efficacy of linezolid in the treatment of clinically resistant strains,and great attention should be paid to its clinical application.This article reviewed the prevalence of LRE strains carrying the optrA gene,the mobile genetic elements involved in the transmission of the optrA gene,and the variants of the optrA gene,so as to provide a theoretical and scientific basis for clinical control of the prevalence of LRE and rational selection of antibiotics.
关键词
肠球菌/利奈唑胺耐药/利奈唑胺耐药肠球菌/optrA基因Key words
Enterococcus/Linezolid resistance/Linezolidin-resistant Enterococcus/optrA gene引用本文复制引用
出版年
2024
NETL
NSTL
万方数据