细菌耐药性与控制策略-抗菌药物的抗菌机制与细菌耐药性

AlexanderFlemming(18811955)1928.Flemming1941.1944.1946.14%1947.38%1966.90%1959.1961.MRSA1987.VRE1997.VDE1997.VISA„drugresistance„„„„„„„„antibacterialagents„antibiotics„β-„NAG-NAM-β-„BB„30S30SA50S50S„DNADNAmRNADNADNA„„TMPPABAFAH2FAH4C1TMP„2050-7060-70MRSAG-80-90G-β-G-21G-„1231modifiedenzyme)yββ--ββ--lactamaselactamase„„β-„yy50Sy50S2PBPsPBP2’PBP2aDNARNAβ30SS1250S3„OMPG-porin„„1intrinsicresistance2acquiredresistance„„„-„„„„R„„„„RRTFG+G-„„IRIR„„ƒ„1„β-AmpC↑„β-mecAPBP2a„marA2↓↑123123