吉林医药学院学报2026，Vol.47Issue(2)：129-133,5.
金黄色葡萄球菌对万古霉素耐药机制的研究进展
Research Progress on Mechanism of Vancomycin Resistance of Staphylococcus Aureus
摘要
Abstract
As an important gram-positive pathogen,Staphylococcus aureus has co-evolved its resistance to vancomycin through multiple mechanisms,which seriously threatens clinical anti-infective therapy.In this review,we systematically summarize the key pathways of drug resistance:cell wall thickening(increased peptidoglycan cross-linking due to activation of GraSR/WalKR signaling pathway),anti-biotic efflux(controversial role of NorA/MepA pump mediated drug efflux),ribosomal protection(erm gene-mediated rRNA methylation and ribosomal protein modification),biofilm formation(spatial barrier and metabolic inhibition of EPS matrix),and quorum sensing regu-lation(agr system multi-dimensional coordinated drug resistance network).Regulatory genes such as mgrA and vanA construct a three-dimensional defense system through epigenetic and metabolic reprogramming,while the resting state of retained bacteria further aggra-vates the difficulty of treatment.The clinical combination of vancomycin and β-lactam drugs can enhance the antibacterial effect,but the risk of nephrotoxicity and intestinal microbiota imbalance needs to be weighed.In the future,it is necessary to integrate multi-omics tech-nology to explore new drug resistance targets,develop TCS inhibitors and enzyme inhibitor adjuvants,and optimize the PK/PD model of combination therapy to meet the global challenges of drug-resistant bacterial infection.关键词
金黄色葡萄球菌/万古霉素/耐药机制/临床应对策略Key words
Staphylococcus aureus/vancomycin/drug resistance mechanism/clinical coping strategies分类
医药卫生引用本文复制引用
时文艳,杨子雯,张雨婷,王悦玲,刘水..金黄色葡萄球菌对万古霉素耐药机制的研究进展[J].吉林医药学院学报,2026,47(2):129-133,5.基金项目
吉林省教育厅项目(JJKH20210502KJ) （JJKH20210502KJ）
吉林省卫健委项目(2018Q048) （2018Q048）
吉林省大学生创新创业项目(202037) （202037）
