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在外科感染中细菌的耐药性是普遍存在的,常见的细胞有:G~+菌中的金黄色葡萄球菌、凝固酶阴性葡萄球菌和肠球菌等,G菌中的大肠杆菌、肺炎克雷白杆菌、阴沟杆菌、脆弱类杆菌和绿脓杆菌等.不常见耐药性很高的菌有化脓性链球菌、棱状杆菌、粘质沙雷菌,对临床医生了解当地感染的菌种及其耐药情况和流行趋势具有重要意义.抗生素作用的基本机理:(1)抑制细菌胞壁的合成;(2)抑制细菌核酸的合成;(3)抑制细菌核糖体的蛋白合成;(4)干扰细菌叶酸代谢.尽管各种抗生素作用机理不同,但是细菌对各种抗生素可产生耐药性.例如,大肠杆菌对青霉素的耐药性,最早发生在1940年,这时该药还没有广泛应用于临床治疗.细菌耐药性的机制大致分三种:(1)细菌的药物作用靶位的改变;(2)阻断药物作用的靶位;(3)对药物灭活.β-内酰胺类抗生素的耐药机理是由于细菌产生β-内酰胺分解酶,这种酶可以分解青霉素类、头孢菌素类等β-内酰胺药物.这种酶可以编码于细菌的遗传物质上.绿脓杆菌对亚胺配基的耐药性,是通过改变细胞壁的渗透性来实现的.细菌对氨基糖甙类的耐
In surgical infections, bacterial resistance is ubiquitous. Common cells include Staphylococcus aureus, coagulase-negative staphylococci and enterococci in G ~ + bacteria, Escherichia coli in Klebsiella pneumoniae, Klebsiella pneumoniae Corynebacterium, Corynebacterium, Bacteroides fragilis and Pseudomonas aeruginosa, etc .. The most common high-resistant bacteria Streptococcus pyogenes, pyrethrum, Serratia marcescens, to understand the local clinicians infected bacteria and Its resistance and epidemiological trends are of great significance.The basic mechanism of antibiotic action: (1) inhibition of bacterial cell wall synthesis; (2) inhibition of bacterial nucleic acid synthesis; (3) inhibition of bacterial ribosome protein synthesis; (4) Interfere with bacterial folic acid metabolism.Although the mechanism of action of various antibiotics, but the bacteria can be resistant to a variety of antibiotics.For example, E. coli resistance to penicillin, first occurred in 1940, when the drug has not been widely used In clinical treatment, the mechanism of bacterial resistance can be roughly divided into three types: (1) the change of the target of bacterial drug action; (2) the target of blocking the action of the drug; (3) the inactivation of the drug Class antibiotic resistance mechanism is due to bacteria produce β-lactam Enzymes, this enzyme can break down penicillins, cephalosporins and other β-lactam drugs. This enzyme can be encoded in the genetic material of bacteria. Pseudomonas aeruginosa resistance to imine ligands by changing Cell wall permeability to achieve the resistance of bacteria to aminoglycosides