摘要

鲍曼不动杆菌无疑是造成现代医疗系统中医院获得性院内感染的最成功的病原体之一。由于多重耐药鲍曼不动杆菌感染和暴发流行，很少有抗生素可有效治疗由该病原体引起的感染。为了解决这个问题，鲍曼不动杆菌的发病机理和抗生素耐药机制的知识很重要。在这篇综述中，我们总结了当前对导致鲍曼不动杆菌发病的毒力因子的研究，包括孔蛋白，荚膜多糖，脂多糖，磷脂酶，外膜囊泡，金属采集系统和蛋白分泌系统。还讨论了该生物体抗生素耐药机制，包括β-内酰胺酶的获得，多药外排泵的上调，氨基糖苷类的修饰，渗透性缺陷和靶位点的改变。最后，总结了由耐多药鲍氏不动杆菌引起的新型前瞻性治疗选择。

Acinetobacter baumannii is undoubtedly one of the most successful pathogens responsible for hospital-acquired nosocomial infections in the modern healthcare system. Due to the prevalence of infections and outbreaks caused by multi-drug resistant A. baumannii, few antibiotics are effective for treating infections caused by this pathogen. To overcome this problem, knowledge of the pathogenesis and antibiotic resistance mechanisms of A. baumannii is important. In this review, we summarize current studies on the virulence factors that contribute to A. baumannii pathogenesis, including porins, capsular polysaccharides, lipopolysaccharides, phospholipases, outer membrane vesicles, metal acquisition systems, and protein secretion systems. Mechanisms of antibiotic resistance of this organism, including acquirement of β-lactamases, up-regulation of multidrug efflux pumps, modification of aminoglycosides, permeability defects, and alteration of target sites, are also discussed. Lastly, novel prospective treatment options for infections caused by multi-drug resistant A. baumanniiare summarized.

https://www.frontiersin.org/articles/10.3389/fcimb.2017.00055/full