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#PaperDOI: 10.2217/fmb.12.61阴沟肠杆菌复合体:临床影响和新出现的抗生素耐药性Enterobacter cloacae complex: Clinical impact and emerging antibiotic resistance
July 2012Future Microbiology 7(7):887-902阴沟肠杆菌复合体的种类在自然界中广泛存在,但它们可以作为病原体。阴沟肠杆菌的生物化学和分子研究显示出基因组的异质性,包括 Enterobacter cloacae/ 阴沟肠杆菌 , Enterobacter asburiae/ 阿斯帛肠杆菌 , Enterobacter hormaechei/霍马埃希肠杆菌, Enterobacter kobei/ 哥贝肠杆菌, Enterobacter ludwigii/路德维希肠杆菌、 and Enterobacter nimipressuralis/ 米克雷肠杆菌 肠杆菌6种,其中阴沟肠杆菌和霍马埃希肠杆菌是人类临床标本中分离最频繁的两种。对属于这个分类单元的所有物种进行表型鉴定通常是困难的,而且并不总是可靠的;因此,分子生物学方法经常被使用。尽管阴沟肠杆菌复合菌株是过去十年中最常见的引起医院血流感染的肠杆菌属,但对其毒性相关特性知之甚少。相比之下,关于这些微生物的耐药特征已经发表了很多文章。事实上,它们能够通过对染色体基因的去抑制或在质粒上获得可转移的AmpC基因而产生过量的AmpC β-内酰胺酶。最近获得了许多其他的耐药决定因素,这些决定因素可以使几乎所有抗生素家族失效。对阴沟肠杆菌、霍氏肠杆菌和阿氏肠杆菌的药敏研究较多;这些研究报告了物种之间的微小差异,唯一显著的差异没有区分特征。
Abstract:
Species of the Enterobacter cloacae complex are widely encountered in nature, but they can act as pathogens. The biochemical and molecular studies on E. cloacae have shown genomic heterogeneity, comprising …
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Species of the Enterobacter cloacae complex are widely encountered in nature, but they can act as pathogens. The biochemical and molecular studies on E. cloacae have shown genomic heterogeneity, comprising six species: Enterobacter cloacae, Enterobacter asburiae, Enterobacter hormaechei, Enterobacter kobei, Enterobacter ludwigii and Enterobacter nimipressuralis, E. cloacae and E. hormaechei are the most frequently isolated in human clinical specimens. Phenotypic identification of all species belonging to this taxon is usually difficult and not always reliable; therefore, molecular methods are often used. Although the E. cloacae complex strains are among the most common Enterobacter spp. causing nosocomial bloodstream infections in the last decade, little is known about their virulence-associated properties. By contrast, much has been published on the antibiotic-resistance features of these microorganisms. In fact, they are capable of overproducing AmpC β-lactamases by derepression of a chromosomal gene or by the acquisition of a transferable ampC gene on plasmids conferring the antibiotic resistance. Many other resistance determinants that are able to render ineffective almost all antibiotic families have been recently acquired. Most studies on antimicrobial susceptibility are focused on E. cloacae, E. hormaechei and E. asburiae; these studies reported small variations between the species, and the only significant differences had no discriminating features.
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