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Molecular Mechanisms and Clinical Impact of Acquired and Intrinsic Fosfomycin Resistance

机译:获得性和内在性磷霉素耐药的分子机制及其临床影响

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Bacterial infections caused by antibiotic-resistant isolates have become a major health problem in recent years, since they are very difficult to treat, leading to an increase in morbidity and mortality. Fosfomycin is a broad-spectrum bactericidal antibiotic that inhibits cell wall biosynthesis in both Gram-negative and Gram-positive bacteria. This antibiotic has a unique mechanism of action and inhibits the initial step in peptidoglycan biosynthesis by blocking the enzyme, MurA. Fosfomycin has been used successfully for the treatment of urinary tract infections for a long time, but the increased emergence of antibiotic resistance has made fosfomycin a suitable candidate for the treatment of infections caused by multidrug-resistant pathogens, especially in combination with other therapeutic partners. The acquisition of fosfomycin resistance could threaten the reintroduction of this antibiotic for the treatment of bacterial infection. Here, we analyse the mechanism of action and molecular mechanisms for the development of fosfomycin resistance, including the modification of the antibiotic target, reduced antibiotic uptake and antibiotic inactivation. In addition, we describe the role of each pathway in clinical isolates.
机译:近年来,由抗生素抗性分离株引起的细菌感染已成为主要的健康问题,因为它们很难治疗,从而导致发病率和死亡率增加。磷霉素是一种广谱杀菌抗生素,可抑制革兰氏阴性菌和革兰氏阳性菌中的细胞壁生物合成。这种抗生素具有独特的作用机制,并通过阻断酶MurA抑制肽聚糖生物合成的起始步骤。磷霉素已被成功用于治疗尿路感染很长时间,但是抗生素耐药性的增加使磷霉素成为治疗由多药耐药性病原体引起的感染的合适人选,特别是与其他治疗伙伴联合使用时。磷霉素耐药性的获得可能会威胁到这种抗生素的重新引入以治疗细菌感染。在这里,我们分析了磷霉素耐药性发展的作用机理和分子机制,包括修饰抗生素靶标,减少抗生素摄取和抗生素灭活。此外,我们描述了每种途径在临床分离株中的作用。

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