МОЛЕКУЛЯРНЫЕ ОСНОВЫ УСТОЙЧИВОСТИ ПАТОГЕННЫХ ДЛЯ ЧЕЛОВЕКА МИКОПЛАЗМ К ФТОРХИНОЛОНАМ

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Патогенные для человека микоплазмы из-за отсутствия клеточной стенки устойчивы к ряду антибиотиков. Для лечения микоплазмозов чаще всего используют макролиды, однако распространение устойчивых к ним форм требует применения альтернативных схем лечения, в частности, назначения фторхинолонов и тетрациклинов. Из существующих противомикробных соединений только фторхинолоны обладают бактерицидным эффектом в отношении микоплазм, поэтому их применение предпочтительно при лечении пациентов в состоянии иммуносупрессии. Ограничением применения фторхинолонов может стать устойчивость возбудителя к соединениям данной группы. Наиболее частой причиной развития устойчивости к фторхинолонам как у микоплазм, так и у других бактерий являются мутации, ведущие к аминокислотным заменам в составе мишеней фторхинолонов: гиразы и топоизомеразы IV. Отмечено, что для микоплазм, относящихся к различным видам, характерны разные паттерны замен в субъединицах гиразы и топоизомеразы IV. Причиной могут быть различия в структуре этих белков, отражающиеся в видовых особенностях природной восприимчивости к фторхинолонам у микоплазм. Ряд исследований указывает на существование дополнительных механизмов резистентности, к которым, в первую очередь, относятся системы множественной резистентности. Подобные системы, относящиеся к группе ABC-транспортеров, были найдены и у микоплазм. Они описаны у Mycoplasma hominis и M. pneumoniae, причем у M. hominis наблюдалась их способность к выведению из клеток фторхинолонов, а у M. pneumoniae отмечена способность систем множественной резистенции экспортировать макролиды. Гены, кодирующие компоненты систем множественной резистентности, были найдены и в геномах других видов, в том числе M. genitalium и микоплазм, вызывающих заболевания животных. Также у непатогенных для человека микоплазм вида Acholeplasma laidlawii была обнаружена ассоциированная с устойчивостью к фторхинолонам способность к экспорту белков и генетического материала. Понимание роли мутаций, активности транспортеров и их кумулятивного эффекта в развитии устойчивости к фторхинолонам особенно важно в контексте определения устойчивости к фторхинолонам у плохо поддающихся культивированию патогенов M. genitalium и M. pneumoniae. Молекулярно-биологические методы определения устойчивости к противомикробным соединениям в настоящее время входят в клиническую практику, однако недостаток сведений о молекулярных основах устойчивости микоплазм делает результат недостаточно информативным для патогенов данной группы. В обзоре рассмотрены особенности развития устойчивости к фторхинолонам у патогенных для человека микоплазм разных видов и их проявления на молекулярном уровне.

Об авторах

А. Н. Ваганова

ФБУН НИИ эпидемиологии и микробиологии имени Пастера

Автор, ответственный за переписку.
Email: van.inprogress@gmail.com

Ваганова Анастасия Николаевна - младший научный сотрудник лаборатории молекулярно-биологических технологий отдела новых технологий.

197101, Санкт-Петербург, ул. Мира, 14. Тел.: 8 (812) 232-01-08 (служебн.)

Россия

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