摘要:
抗生素的发现开启了人类药物改革中辉煌的篇章，然而，针对近年来多药物耐药的快速涌现及传播和抗生素的滥用等问题，如果没有有效的控制措施，我们将面临回归前抗生素时代的风险。由于缺乏有效的治疗措施，碳青霉烯类耐药的绿脓杆菌、万古霉素耐药的肠球菌、青霉素类耐药的金黄色葡萄球菌、广谱β-内酰胺酶耐药的鲍曼不动杆菌、大肠杆菌以及肺炎克雷伯菌是医院中最危险的病原菌，对这些耐药菌引起疾病的治疗不仅增加了住院的时间，也大大增加了住院的成本。相对抗生素，抗菌肽具有不易诱导耐药性、杀菌快、抗菌谱广以及临床疗效好等特点，可以针对多重耐药菌提供潜在有效的治疗方案。本文针对院内病原菌的多重耐药做一综述，同时强调了抗菌肽作为新型替抗药物对多重耐药菌治疗的重要性。
Abstract:
The discovery of antibiotics marked a golden age in the revolution of human medicine. However, decades later, bacterial infections remain a global healthcare threat, and a return to the pre-antibiotic era seems inevitable if stringent measures are not adopted to curb the rapid emergence and spread of multidrug resistance and the indiscriminate use of antibiotics. In hospital settings, multidrug resistant (MDR) pathogens, including carbapenem-resistant Pseudomonas aeruginosa, vancomycin-resistant enterococci (VRE), methicillin-resistant Staphylococcus aureus (MRSA), and extended-spectrum β-lactamases (ESBL) bearing Acinetobacter baumannii, Escherichia coli, and Klebsiella pneumoniae are amongst the most problematic due to the paucity of treatment options, increased hospital stay, and exorbitant medical costs. Antimicrobial peptides (AMPs) provide an excellent potential strategy for combating these threats. Compared to empirical antibiotics, they show low tendency to select for resistance, rapid killing action, broad-spectrum activity, and extraordinary clinical efficacy against several MDR strains. Therefore, this review highlights multidrug resistance among nosocomial bacterial pathogens and its implications and reiterates the importance of AMPs as next-generation antibiotics for combating MDR superbugs.
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