Aminoglikozidlere Direnç Mekanizmaları
Özet
Aminoglikozid (AG) antibiyotikler klinikte özellikle sistemik gelişen hastane infeksiyonlarının tedavisinde önemli bir tedavi seçeneğidir. AG’lere bakteriyel direnç mekanizmaları: bakteri hücresi içine ilaç girişini azaltan ve hücre içinde AG birikimini engelleyen, bakteriyel membran değişiklikleri veya aktif dışa atım pompa (efflux) sistemi-aracılı ya da her ikisi de; mutasyon veya 16S rRNA bağlanma bölgesinin metilasyonu ile AG’in bağlanmasında azalma; AG’lerin enzimatik deaktivasyonudur. Bu mekanizmaların her birinin farklı AG sınıfları üzerine değişken etkileri vardır ve herhangi bir dirençli izolatta sıklıkla çoklu mekanizmalar yer almaktadır.
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