摘要

       日益增多的多重耐药微生物病原菌已成为全球公共卫生的重大威胁。抗生素的作用机制和对抗性耐药机制是密切相关的，但了解这些药物的生化和分子功能并不是一项简单的运动。环境和遗传环境都有助于表型抗性（自然细菌进化）的改变，并且使得很难控制抗生素抗性的出现和影响。在这种情况下，理解细菌是如何发展和/或获得抗生素耐药基因（ARG）的，对于发展对抗这些超级细菌的主张和寻找新的药物有着至关重要的作用。在这篇综述中，我们将介绍和讨论与抗生素耐药相关的一般信息和常见的遗传和分子机制，以及ARGs的表达和相互作用对耐药的重要性。同时，我们关注最近在寻找抗生素佐剂方面取得的成就，这些佐剂通过使细菌的作用机制（如β-内酰胺酶）失活来帮助对抗抗生素耐药性。最近的进展涉及抗耐药药物的使用，如：外排泵抑制剂；抗毒性药物；抗群体感应药物；以及抗II/III型分泌系统药物。这些抗生素佐剂（如本文所探讨的）协同对抗生素抵抗的问题，并且可以恢复或延长已知抗生素的治疗活性。

        The ever increasing number of multidrug-resistant microorganism pathogens has become a great and global public health threat. Antibiotic mechanisms of action and the opposing mechanisms of resistance are intimately associated, but comprehension of the biochemical and molecular functions of such drugs is not a simple exercise. Both the environment, and genetic settings contribute to alterations in phenotypic resistance (natural bacterial evolution), and make it difficult to control the emergence and impacts of antibiotic resistance. Under such circumstances, comprehension of how bacteria develop and/or acquire antibiotic resistance genes (ARG) has a critical role in developing propositions to fight against these superbugs, and to search for new drugs. In this review, we present and discuss both general information and examples of common genetic and molecular mechanisms related to antibiotic resistance, as well as how the expression and interactions of ARGs are important to drug resistance. At the same time, we focus on the recent achievements in the search for antibiotic adjuvants, which help combat antibiotic resistance through deactivation of bacterial mechanisms of action such as β-lactamases. Recent advances involving the use of anti-resistance drugs such as: efflux pump inhibitors; anti-virulence drugs; drugs against quorum sensing; and against type II/III secretion systems are revealed. Such antibiotic adjuvants (as explored herein) collaborate against the problems of antibiotic resistance, and may restore or prolong the therapeutic activity of known antibiotics.

        http://www.eurekaselect.com/159580/article