Abstract

Antibiotic resistance among bacterial pathogens is one of the most worrying problems in health systems today. To solve this problem, bacteriocins from lactic acid bacteria, especially nisin, have been proposed as an alternative for controlling multidrug-resistant bacteria. Bacteriocins are antimicrobial peptides that have activity mainly against Gram-positive strains. Nisin is one of the most studied bacteriocins and is already approved for use in food preservation. Nisin is still not approved for human clinical use, but many in vitro studies have shown its therapeutic effectiveness, especially for the control of antibiotic-resistant strains. Results from in vitro studies show the emergence of nisin-resistant bacteria after exposure to nisin. Considering that nisin has shown promising results for clinical use, studies to elucidate nisin-resistant mechanisms and the development of approaches to circumvent nisin-resistance are important. Thus, the objectives of this review are to identify the Gram-positive bacterial strains that have shown resistance to nisin, describe their resistance mechanisms and propose ways to overcome the development of nisin-resistance for its successful clinical application.

摘要

细菌病原体之间的抗生素耐药性是当今卫生系统中最令人担忧的问题之一。为了解决这个问题，已经提出了来自乳酸菌特别是乳链菌肽的细菌素作为控制耐多药细菌的替代方法。细菌素是主要对革兰氏阳性菌株具有活性的抗微生物肽。乳链菌肽是研究最多的细菌素之一，已被批准用于食品保鲜。乳链菌肽仍未被批准用于人类临床，但是许多体外研究表明其治疗效果，尤其是在控制抗生素耐药菌株方面。体外结果研究表明，暴露于乳链菌肽后出现了抗乳链菌肽的细菌。考虑到乳链菌肽在临床上显示出可喜的结果，阐明乳链菌肽抗性机制的研究以及规避乳链菌肽抗性方法的发展很重要。因此，本综述的目的是鉴定已显示出对乳链菌肽抗性的革兰氏阳性细菌菌株，描述其抗性机制，并提出克服其对乳链菌肽抗性发展的方法，以使其成功应用于临床。