外排泵介导肺炎克雷伯菌耐药的研究进展-微生物学报.PDFVIP

微生物学通报 Jun. 20, 2016, 43(6): 1351−1357 Microbiology China /wswxtbcn tongbao@ DOI: 10.13344/j.microbiol.china.150982 专论与综述 外排泵介导肺炎克雷伯菌耐药的研究进展 王于莉 姜昕汝 郑月娟* (上海中医药大学基础医学院病原教研室 上海 201203) 摘 要：肺炎克雷伯菌(Klebsiella pneumoniae)是重要的条件致病菌，近年来肺炎克雷伯菌感染在 医院内感染中所占的比率持续上升，耐药率也不断攀升，这给临床治疗带来极大的困难。肺炎克 雷伯菌发生耐药的重要机制之一就是其细胞膜上存在的外排泵系统，它们将渗入细菌体内的药物 不断泵出，导致菌体内的药物浓度过低，不足以发挥抗菌作用。本文主要针对外排泵介导肺炎克 雷伯菌的耐药现状，外排泵的分子结构和基因调节，外排泵抑制剂以及传统中药在耐药菌治疗方 面的应用等做系统性梳理，以期为临床治疗耐药肺炎克雷伯菌提供一些新思路。 关键词：肺炎克雷伯菌，外排泵，耐药机制，外排泵抑制剂 The progress on drug resistance of Klebsiella pneumoniae caused by efflux pump * WANG Yu-Li JIANG Xin-Ru ZHENG Yue-Juan (Department of Immunology Microbiology, School of Basic Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai 201203, China) Abstract: Klebsiella pneumoniae is an important opportunistic pathogen and the rate of its nosocomial infection rises continuously. It has brought difficulties to therapy. Efflux pumps’ overexpression has been recently recognized as one of the most important mechanisms of drug resistance displayed by K. pneumoniae . The most important developments were introduced in this review, including the latest progress on the drug resistant profile of K. pneumoniae caused by efflux pumps, and the molecular structure and genetic regulation of efflux pumps. The inhibitors of efflux