摘要

生物膜是微生物群落，其彼此粘附并粘附到表面并分泌包裹在基质中的细胞外聚合物（EPS）。生物膜是一个主要的医疗保健问题，因为它们可以在导致感染的医疗设备上形成。此外，越来越多的证据表明它们在慢性伤口中形成的能力，导致伤口愈合和炎症延迟。由于多种原因，例如EPS的形成导致抗菌剂的亚抑制浓度到达细菌细胞，细菌细胞的生长速度缓慢使得一些抗生素无效，并且存在持久性细胞，生物膜显示出对许多细胞的耐受性增加抗菌药和抗生素。此外，已开始出现研究显示抗微生物剂抗生素与抗生素之间存在联系。交叉抗性可归因于许多因素，例如，多药物外排泵的表达增加，所述多药物外排泵流出多种底物，并且在多微生物生物膜内的不同物种之间编码多个抗性基因的遗传物质的水平基因转移。抗菌素耐药性是由包括交叉耐药在内的多种因素引起的日益严重的威胁，并且是全球健康问题。本综述重点介绍目前在抗菌药物和抗生素之间发现的抗菌和抗生素耐药性和交叉耐药性的研究，这些药物通常用于伤口护理，以评估这种获得性抗生素耐药性的重要性。此外，该评论讨论了抗菌耐受性的重要性以及生物膜在增强抗生素抗性中的作用。

A biofilm is a community of microorganisms that adhere to each other and to surfaces and secrete extracellular polymeric substances (EPS) encasing themselves in a matrix. Biofilms are a major healthcare concern, as they can form on medical devices leading to infection. Additionally, there is growing evidence to show their ability to form in chronic wounds, which leads to delayed wound healing and inflammation. Due to a number of reasons, such as formation of the EPS resulting in sub-inhibitory concentrations of antimicrobials reaching the bacterial cells, slow growth rate of bacterial cells rendering some antibiotics ineffective, and the presence of persister cells, biofilms show increased tolerance to many antimicrobials and antibiotics. Additionally, studies have started to emerge showing a link between resistance to antimicrobials and antibiotics. Cross-resistance can be attributed to a number of factors, for example, increased expression of multidrug efflux pumps that efflux a wide range of substrates and horizontal gene transfer of genetic material encoding multiple resistance genes between different species within the polymicrobial biofilm. Antimicrobial resistance is an increasing threat caused by multiple factors including cross-resistance, and it is a global health concern. This review focuses on current research on antimicrobial and antibiotic resistance and cross-resistance found between antimicrobials and antibiotics commonly used in woundcare to evaluate the significance of this acquired antibiotic resistance. Furthermore, the review discusses the significance of antimicrobial tolerance and the role biofilms play in enhancing antibiotic resistance.

https://www.ncbi.nlm.nih.gov/pubmed/30326137