摘要

多粘菌素是已确立的抗生素，由于耐多药的革兰氏阴性细菌感染的发病率增加，最近已重新获得了显着的兴趣。粘菌素和多粘菌素B在许多临床医学中观察到多药耐药性的地区被认为是最后的抗生素。与此同时，由于多粘菌素耐药菌的报道增多，目前正在重新考虑在兽药中大量使用多粘菌素。多粘菌素对易感性测试具有挑战性，目前可用的技术在此处介绍。介绍了为诊断实验室提供相关信息的基因型和表型方法。这篇综述还介绍了近期有关多粘菌素耐药性机制的研究，包括染色体编码的抗性性状以及最近鉴定的质粒编码的多粘菌素耐药决定簇MCR-1。介绍了总结当前该领域知识的流行病学特征。

Polymyxins are well-established antibiotics that have recently regained significant interest as a consequence of the increasing incidence of infections due to multidrug-resistant Gram-negative bacteria. Colistin and polymyxin B are being seriously reconsidered as last-resort antibiotics in many areas where multidrug resistance is observed in clinical medicine. In parallel, the heavy use of polymyxins in veterinary medicine is currently being reconsidered due to increased reports of polymyxin-resistant bacteria. Susceptibility testing is challenging with polymyxins, and currently available techniques are presented here. Genotypic and phenotypic methods that provide relevant information for diagnostic laboratories are presented. This review also presents recent works in relation to recently identified mechanisms of polymyxin resistance, including chromosomally encoded resistance traits as well as the recently identified plasmid-encoded polymyxin resistance determinant MCR-1. Epidemiological features summarizing the current knowledge in that field are presented.

http://cmr.asm.org/content/30/2/557.short