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喹诺酮类抗菌药物从早期主要用于治疗尿道感染发展到后来治疗肠道感染和呼吸道感染,目前已在临床、畜牧业和水产业中广泛使用,细菌对其耐药性也逐渐呈蔓延趋势,耐药机制日趋复杂。喹诺酮类耐药机制主要分为染色体介导的耐药和质粒介导的耐药,后者对细菌耐药性的广泛传播起着重要作用。1998年首次报道了质粒介导的喹诺酮类耐药机制,即质粒上qnr基因介导的细菌对氟喹诺酮耐药机制,qnr基因可在不同细菌中迅速水平传播,引发的感染不易控制,使得院内感染大范围的流行。此外,qnr基因通常与β-内酰胺类耐药基因相关或存在于复杂整合子中与其它多重耐药基因共同整合,缩小了临床医生治疗相关细菌感染时选药或联合用药的空间,给我们带来了严峻的挑战。本文就qnr基因的发现历史、耐药机理及在国内的流行状况做了详细概述。
Quinolone antibiotics have been widely used in clinic, animal husbandry and aquaculture since the early application of the main antibiotics for the treatment of urinary tract infections to the subsequent treatment of intestinal infections and respiratory tract infections. The resistance of the bacteria to the bacteria also gradually spread, Increasing complexity of the drug mechanism. Quinolone resistance mechanisms are mainly divided into chromosome-mediated resistance and plasmid-mediated resistance, which plays an important role in the spread of bacterial resistance. The mechanism of plasmid-mediated quinolone resistance was first reported in 1998, that is, the mechanism of qnr gene-mediated resistance to fluoroquinolone in plasmids. The qnr gene can be rapidly transmitted in different bacteria and the infection is not easy to control. As a result, Infection is widespread. In addition, qnr genes are often associated with β-lactam resistance genes or exist in complex integrins and integrate with other multidrug resistance genes, reducing the space available for clinicians to choose drugs or combinations when treating bacterial infections Has posed a serious challenge. In this paper, the discovery of qnr gene history, resistance mechanism and epidemic situation in China made a detailed overview.