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多黏菌素耐药基因mcr-1研究进展

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多黏菌素是治疗鲍氏不动杆菌、铜绿假单胞菌、肺炎克雷伯菌等革兰阴性菌感染的最后防线;2015年中国科学家首次报道了由质粒介导的多黏菌素耐药基因mcr-1;不同于已经发现的多黏菌素耐药机制,mcr-1基因整合于质粒,而非染色体上,可以随着质粒的接合转移在不同细菌中水平传播,多种细菌及动物宿主均能携带mcr-1基因.mcr-1基因还能与其他耐药基因共存于质粒上,产生多药耐药,引起临床患者的严重感染;目前,五大洲30多个国家相继报道检测到该基因,对全球抗菌药物耐药带来巨大挑战;本文从食物链传播模式、环境和人群的流行现状、携带mcr-1基因的肺炎克雷伯菌感染暴发研究等方面进行综述,为应对抗菌药物耐药提供参考.
Research progress on polymyxin resistance gene mcr-1
Polymyxin is the final choice for the treatment of gram-negative bacteria such as Acinetobacter bauman-nii ,Pseudomonas aeruginosa and Klebsiella pneumoniae .In 2015,Chinese scientists reported the plasmid-media-ted polymyxin resistance gene mcr-1 for the first time.Different from the polymyxin resistance mechanism that has been found,the mcr-1 gene is integrated into the plasmid rather than the chromosome and can be transmitted horizontally in different bacteria with the conjugation of the plasmid.A variety of bacterial and animal hosts can carry the mcr-1 gene.Mcr-1 gene can co-exist with other drug resistance genes in the plasmid,which will result in multidrug resistance and cause serious infection in clinical patients.At present,more than 30 countries on five con-tinents have reported mcr-1 gene,which is a great challenge to global antibiotic resistance.We reviewed the epide-miological patterns of food chain transmission,the prevalence of environment and population,and the outbreak of infection of Klebsiella pneumoniae carrying mcr-1 gene.We hope this review could provide references for antimi-crobial drug resistance.

Polymyxinmcr-1 geneResistanceInfectionOutbreak

徐虹、雷晓婷、赵丽华、史庆丰、刘聚源、王广芬、朱越燕、乔甫

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杭州市疾病预防控制中心环境所,浙江 杭州 310021

江苏省中医院感染管理办公室,江苏 南京 210029

鄂东医疗集团市中心医院公共卫生科,湖北 黄石 435000

复旦大学附属中山医院感染管理科,上海 200032

卫生部北京医院医院感染管理处,北京 100730

宁波市医疗中心李惠利医院感染管理科,浙江 宁波 315000

浙江省人民医院院感科,浙江 杭州 310014

四川大学华西医院医院感染管理科,四川 成都 610041

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多黏菌素 mcr-1基因 耐药 感染 暴发

2017

中华医院感染学杂志
中华预防医学会 中国人民解放军总医院

中华医院感染学杂志

CSCD北大核心
影响因子:1.885
ISSN:1005-4529
年,卷(期):2017.27(24)
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