Antimikrobiyal Direnç Mekanizmaları
Özet
21. yüzyılda antibiyotik direnci dünya çapında önemli bir halk sağlığı sorunu haline gelmiştir. Artık sadece hastane kaynaklı değil toplum kaynaklı enfeksiyonlarda da antibiyotik dirençli bakteriler ile sıklıkla karşılaşılmaktadır. Bakteriler antibiyotiklerin öldürücü etkilerinden kurtulmak için farklı değişimlere uğrayarak bu sürecin üstesinden gelmişlerdir. Klinik uygulamalarda kullanılan hemen hemen tüm antibiyotiklere karşı direnç geliştirmişlerdir. Bu nedenle direncin biyokimyasal ve genetik temelini anlamak oldukça önemlidir. Bu sayede direnç gelişimini ve yayılımını sınırlayacak prosedürlerin belirlenmesi ve yeni tedavi seçeneklerinin geliştirilmesi sağlanabilir. Bu bölümde, klinik uygulamada karşılaşılan antibiyotik direncinin ana mekanizmalarını ayrıntılı olarak açıklanacaktır.
Referanslar
Uddin TM, Chakraborty AJ, Khusro A, et al. Antibiotic resistance in microbes: History, mechanisms, therapeutic strategies and future prospects. J Infect Public Health. 2021;14(12):1750-1766. doi: 10.1016/j.jiph.2021.10.020.
Reygaert WC. An overview of the antimicrobial resistance mechanisms of bacteria. AIMS Microbiol. 2018;4(3):482-501. doi: 10.3934/microbiol.2018.3.482.
Christaki E, Marcou M, Tofarides A. Antimicrobial Resistance in Bacteria: Mechanisms, Evolution, and Persistence. J Mol Evol. 2020;88(1):26-40. doi: 10.1007/s00239-019-09914-3.
The Review on Antimicrobial Resistance. 2014. Antimicrobial Resistance:Tackling a Crisis for the Future Health and Wealth of Nations. http://amr-review.org.
Mendelson M, Matsoso MP. The World Health Organization Global Action Plan for antimicrobial resistance. S Afr Med J. 2015;105(5):325. doi: 10.7196/samj.9644.
Munita JM, Arias CA. Mechanisms of Antibiotic Resistance. Microbiol Spectr. 2016;4(2):10.1128. doi: 10.1128/microbiolspec.VMBF-0016-2015.
Varela MF, Stephen J, Lekshmi M, et al. Bacterial Resistance to Antimicrobial Agents. Antibiotics. 2021;10(5):593. doi: 10.3390/antibiotics10050593.
Giedraitienė A, Vitkauskienė A, Naginienė R, et al. Antibiotic resistance mechanisms of clinically important bacteria. Medicina (Kaunas). 2011;47(3):137-46.
Abushaheen MA, Muzaheed, Fatani AJ, Alosaimi M, et al. Antimicrobial resistance, mechanisms and its clinical significance. Dis Mon. 2020;66(6):100971. doi: 10.1016/j.disamonth.2020.100971
Van Duijkeren E. Schink A. Roberts MC. et al. Mechanisms of Bacterial Resistance to Antimicrobial Agents. Microbiol Spectr, 2018; 6:10.1128. doi: 10.1128/microbiolspec.arba-0019-2017
García-Álvarez L, Holden MT, Lindsay H, et al. Meticillin-resistant Staphylococcus aureus with a novel mecA homologue in human and bovine populations in the UK and Denmark: a descriptive study. Lancet Infect Dis, 2011;11:595–603 http://dx.doi.org/10.1016/S1473-3099(11)70126-8.
Bush K, Jacoby GA. Updated functional classification of beta-lactamases. Antimicrob Agents Chemother. 2010;54(3):969-76. doi: 10.1128/AAC.01009-09.
Pitout JDD, Peirano G, Kock MM, et al. The Global Ascendency of OXA-48-Type Carbapenemases. Clin Microbiol Rev. 2019;33(1): e00102-19. doi: 10.1128/CMR.00102-19.
Roland Leclercq, Mechanisms of Resistance to Macrolides and Lincosamides: Nature of the Resistance Elements and Their Clinical Implications, Clinical Infectious Diseases,2002; 34(4):482–492. doi: 10.1086/324626.
Sujatha S, Praharaj I. Glycopeptide resistance in gram-positive cocci: a review. Interdiscip Perspect Infect Dis. 2012; 2012:781679. doi: 10.1155/2012/781679.
Li G, Walker MJ, De Oliveira DMP. Vancomycin Resistance in Enterococcus and Staphylococcus aureus. Microorganisms. 2022;11(1):24. doi: 10.3390/microorganisms11010024.
Shariati, A, Dadashi, M, Moghadam, MT. et al. Global prevalence and distribution of vancomycin resistant, vancomycin intermediate and heterogeneously vancomycin intermediate Staphylococcus aureus clinical isolates: a systematic review and meta-analysis. Sci Rep. 2020;10(1):12689. doi: 10.1038/s41598-020-69058-z.
Mohsen Heidary, Azar Dohkt Khosravi, Saeed Khoshnood, et al. Daptomycin, Journal of Antimicrobial Chemotherapy, 2018; 73(1): 1–11. https://doi.org/10.1093/jac/dkx349
Hooper DC, Jacoby GA. Mechanisms of drug resistance: quinolone resistance. Ann N Y Acad Sci. 2015;1354(1):12-31. doi: 10.1111/nyas.12830.
Correia S, Poeta P, Hébraud M, et al. Mechanisms of quinolone action and resistance: where do we stand? J Med Microbiol. 2017 May;66(5):551-559. doi: 10.1099/jmm.0.000475.
Mondal AH, Khare K, Saxena P, et al. A Review on Colistin Resistance: An Antibiotic of Last Resort. Microorganisms. 2024; 12(4):772. doi: 10.3390/microorganisms12040772.
Liu Y‐Y, Wang Y, Walsh TR, et al. Emergence of plasmid‐mediated colistin resistance mechanism MCR‐1 in animals and human beings in China: a microbiological and molecular biological study. Lancet Infect Dis 2016; 16: 161–68. doi: 10.1016/S1473-3099(15)00424-7.
Mattioni Marchetti V, Hrabak J, Bitar I. Fosfomycin resistance mechanisms in Enterobacterales: an increasing threat. Front Cell Infect Microbiol. 2023; 13:1178547. doi: 10.3389/fcimb.2023.1178547.
Falagas ME, Athanasaki F, Voulgaris GL, et al. Resistance to fosfomycin: Mechanisms, Frequency and Clinical Consequences. Int J Antimicrob Agents. 2019;53(1):22-28. doi: 10.1016/j.ijantimicag.2018.09.013
Andrea Brenciani, Gianluca Morroni, Stefan Schwarz, Eleonora Giovanetti, Oxazolidinones: mechanisms of resistance and mobile genetic elements involved, Journal of Antimicrobial Chemotherapy, 2022; 77(10):2596–2621. doi: 10.1093/jac/dkac263.
Maarouf, L., Omar, H., El-Nakeeb, M. et al. Prevalence and mechanisms of linezolid resistance among staphylococcal clinical isolates from Egypt. Eur J Clin Microbiol Infect Dis, 2021; 40:815–823. doi: 10.1007/s10096-020-04045-w.
Nguyen F, Starosta AL, Arenz S, et al. Tetracycline antibiotics and resistance mechanisms. Biol Chem. 2014 May;395(5):559-75. doi: 10.1515/hsz-2013-0292.
Ho PL, Ng KY, Lo WU, et al. Plasmid-Mediated OqxAB Is an Important Mechanism for Nitrofurantoin Resistance in Escherichia coli. Antimicrob Agents Chemother, 2015;60(1):537-43. doi: 10.1128/AAC.02156-15
Simon A Dingsdag, Neil Hunter, Metronidazole: an update on metabolism, structure–cytotoxicity and resistance mechanisms, Journal of Antimicrobial Chemotherapy, 2018;73(2):265–279. doi: 10.1093/jac/dkx351.
Alauzet C, Lozniewski A, Marchandin H. Metronidazole resistance and nim genes in anaerobes: A review. Anaerobe. 2019;55:40-53. doi: 10.1016/j.anaerobe.2018.10.004.
