淋球菌对阿奇霉素耐药性与耐药机制研究进展

阿奇霉素是15元环大环内酯类抗生素,其结构与红霉素相似,但在内酯环的9位上杂入了一个甲氨基。阿奇霉素的抗菌谱广,不仅对革兰阳性球菌、厌氧菌、支原体、衣原体有作用,对一些革兰阴性菌,包括流感嗜血菌、淋球菌等也有较好的作用,且对淋球菌的作用比红霉素强4倍。淋球菌为严重的人体寄生菌,常存在于急性尿道炎与阴道炎的脓性分泌物白细胞中,是引发淋病的病原体。如今,淋球菌正在对越来越多种类的抗生素产生耐药性,阿奇霉素便是其中一种。然而,淋球菌对阿奇霉素产生耐药性的机制尚不明确,有研究表明其机制可能与mtr系统有关。本文主要对一些国家出现的淋球菌对阿奇霉素的耐药性及其机制进行了概述。

The Research Progress on Azithromycin Resistance andMechanisms in Neisseria gonorrhoeae

Azithromycin was a 15-membered ring macrolide antibiotic. Its structure was similar to erythromycin, but there was a methylamino mixed into the lactone ring of 9. Azithromycin had a broad antibacterial spectrum, so it not only had effects on the Gram-positive cocci bacteria, anaerobic bacteria, mycoplasma and chlamydia, but also worked on some Gram-negative bacteria, including Haemophilus influenzae, Neisseria gonorrhoeae, etc. well. And its role on Neisseria gonorrhoea was 4 times stronger than erythromycin. Neisseria gonorrhoeae was a serious human parasite, which often existed in leukocytes of purulent secretions of acute urethritis and vaginitis, and was a pathogen that caused gonorrhea. Today, Neisseria gonorrhoeae was resistant to more and more types of antibiotics, such as azithromycin. However, mechanisms of azithromycin resistance in Neisseria gonorrhoeae were not very clear. Some studies had shown that the mechanisms might be related to the mtr system. The azithromycin resistance in Neisseria gonorrhoeae emerged in some countries and its mechanisms were mainly summarized.