MECHANIZMY OPORNOŚCI NA ANTYBIOTYKI
WYKRYWANE U BAKTERII
Z RODZAJU CORYNEBACTERIUM
Alina M. Olender*
Katedra i Zakład Mikrobiologii Lekarskiej, Uniwersytet Medyczny w Lublinie
Wpłynęło w grudniu 2009 r.
1. Wstęp. 2. Problemy oznaczania oporności na antybiotyki i sposobie interpretacji. 3. Mechanizmy oporności na antybiotyki i chemioterapeutyki wykrywane u Corynebacterium spp. 3.1. Oporność na antybiotyki beta - laktamowe. 3.2. Oporność na makrolidy, linkozamidy i streptograminy B. 3.3. Oporność na fluorochinolony. 3.4. Oporność na tetracykliny. 3.5. Oporność na glikopeptydy. 3.6. Oporność na chloramfenikol. 3.7. Oporność na aminoglikozydy. 4. Wrażliwość na antybiotyki gatunków z rodzaju Corynebacterium najczęściej izolowanych z zakażeń. 5. Podsumowanie
Mechanisms of resistance to antibiotics in the species of the genus Corynebacterium
Abstract: In recent years, opportunistic species of the genus Corynebacterium, such as C. jeikeium, C. urealyticum, C. amycolatum, C. striatum and others, are becoming increasingly important to humans. The difficulties in the diagnosis of infections caused by these microorganisms are due to their presence on the skin and mucous membranes, which raises the possibility of contamination of the taken material, so that the real participation of these species in infections is underestimated. An additional problem in the application of effective antibiotic therapy is the lack of uniform rules for the assessment of antibiotic resistance. The possibility of determining the MIC by means of Etests, giving high correlation results with the dilution method and establishing the criteria for the interpretation of Corynebacterium sp., made it possible to standardize the methods for assessment of antibiotics resistance which are used in the treatment of infections produced by coryneform. The description of multidrug-resistant isolates of opportunistic strains of the genus Corynebacterium and genetic studies have highlighted the different mechanisms of resistance and confirmed the presence of responsible genes. Among detected mechanisms, the most significant is MLSB resistance to makrolides and linkozamides, streptogramins B (genes ermX, ermA, ermB, msrA, mej), quinolones (gene gyrA mutation), tetracyclines (tetA, tetB) and chloramphenicol (cmx). Moreover, the reports of glycopeptides resistance (van A) detection are extremely worrying. Based on the analysis of the sensitivity of resistant strains to antibiotics, it can be concluded that the most effective in the treatment of infections caused by Corynebacterium sp. are: vancomycin, teicoplanin, linezolid, daptomycin, quinupristm/dalfopristin, since they show the highest performance.
1. Introduction. 2. Problems in the determination of resistance to antibiotics and the way of their interpretation. 3. Mechanisms of resistance to antibiotics found in Corynebacterium. 3.1. Resistance to beta-lactam antibiotics. 3.2. Resistance to macrolides, linkozamides, streptogramins B. 3.3. Resistance to quinolones. 3.4. Resistance to tetracyclines. 3.5. Resistance to glicopeptides. 3.6. Resistance to chloramphenicol. 3.7. Resistance to aminoglicosides. 4. Sensitivity to antibiotics in the species of the genus Corynebacterium most frequently isolated from infections. 5. Summary
Słowa kluczowe: Corynebacterium, coryneform, mechanizmy oporności na antybiotyki, geny
Key words: Corynebacterium, coryneform, mechanisms of antibiotics resistanse, genes
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