在ESKAPE病原体中的诺基诺耐药性:进化途径,一个健康传播,和临床监测
Ayman Elbehiry1, Eman Marzouk1, Adil Abalkhail1
1Department of Public Health, College of Applied Medical Sciences, Qassim University, Buraydah, Saudi Arabia.
Frontiers in microbiology
|January 29, 2026
概括
由于分子变化和通过移动元件传播,诺基诺耐药性正在增加. 维护诺基诺有效性的策略包括优化剂量,组合疗法以及人工智能和菌体系统等新方法.
科学领域:
- 抗微生物耐药性 抗微生物耐药性
- 分子生物学分子生物学
- 流行病学 流行病学
背景情况:
- 诺基诺 (FQs) 对于治疗阴性和阳性感染至关重要.
- 快速发展的FQ耐药性限制了它们的临床实用性.
- 在ESKAPE组 (菌杆菌,黄金杆菌,Klebsiella pneumoniae,Acinetobacter baumannii,Pseudomonas aeruginosa和Enterobacter spp.) 进行了研究. 是抗药性研究的焦点.
研究的目的:
- 审查FQ耐药性的生物和流行病学证据.
- 在FQ耐药性方面采用One Health视角.
- 确定保护FQ有效性的策略.
主要方法:
- 对FQ抗性的分子机制的审查 (目标突变,等离子体介导的基因,排泄,外膜变化).
- 对导致耐药性传播的流行病学因素的分析 (共同选择,非患者储存).
- 检查影响耐药性发展的药理动力学/药理动力学原理.
主要成果:
- 耐药性源于位突变,并通过移动遗传元件 (例如携带耐药性基因的等离子体) 传播.
- 患者以外的存储库 (医院,兽医,食品生产,水) 维持选择压力和传播.
- 上升的MIC和低于最佳的药物暴露 (例如,低普洛克萨AUC/MIC) 促进了耐药性的发展.
结论:
- 基于机制的策略,如优化剂量和组合疗法是必不可少的.
- 包括人工智能,排泄抑制剂和菌体治疗在内的新方法显示出有前途.
- 整合快速诊断和强大的管理计划对于保持FQ有效性至关重要.
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