金黄色葡萄球菌异质性耐药机制及实验室检测技术

 异质性耐药是一种特殊的细菌耐药类型，常表现为同一克隆来源的不同细菌亚群对某种抗菌药物表现出不一致的耐药特征，大多数亚群对某种抗菌药物敏感，而少部分亚群对其耐药或高度耐药。异质性耐药分离株常会导致特定抗菌药物抗感染治疗失败。针对异质性耐药菌较为深入的研究主要集中于革兰阴性菌，革兰阳性球菌的相关报道较少。近年有研究报道万古霉素、利奈唑胺、苯唑西林等多种类型抗菌药物异质性耐药金黄色葡萄球菌分离株出现，但其实际临床意义尚待进一步评估。此文对金黄色葡萄球菌异质性耐药机制和检测技术最新进展进行综述，为细菌异质性耐药机制研究和新型检测技术研发提供新的思路。

Mechanisms and laboratory detection technologies of heteroresistance in Staphylococcus aureus

Heteroresistance is a special type of drug resistance of bacteria, which is often characterized by diffe-rent bacterial subpopulations from the same clone presenting inconsistent drug resistance to certain antimicrobial agents. Most subpopulations are sensitive to a certain type of antimicrobial agent, while a small number of the subpopulations are resistant or highly resistant to it. Heteroresistance isolates often lead to the failure of anti-infection treatment of specific antimicrobial agents. Studies on heteroresistant bacteria are mainly focused on Gram-negative bacteria, while reports on Gram-positive cocci are rare. In recent years, studies have reported the emergence of Staphylococcus aureus isolates with heteroresistance to vancomycin, linezolid, oxacillin and other types of antimicrobial drugs, but its practical clinical significance remains to be further evaluated. In this paper, the latest advances in the mechanisms and detection technologies of Staphylococcus aureus heteroresistance were reviewed to provide new ideas for the research of bacterial heteroresistance mechanism and the development of noval detection technologies.