Makrolidlere ve Linkozamidlere Direnç Mekanizmaları
Özet
Makrolidler ve linkozamidler bakteriyel etki ve direnç mekanizmaları yönünden benzerlik gösteren antimikrobiyal ajanlardır. Uzun süredir klinik kullanımda olan bu ajanların direnç mekanizmalarını incelemeye yönelik birçok çalışma yapılmıştır. Bu direnç mekanizmaları; hedef bölgedeki değişiklikler, ilaç inaktivasyonu ve eflüks pompaları başlıkları altında bu yazıda ele alınmıştır. Ribozomal metilasyonda etkili erm ve cfr genleri ile 23S rRNA da ortaya çıkan mutasyonların MLSB dirençli fenotipleri ortaya çıkarmada oldukça etkili mekanizmalar olduğunu kanıtlayan çalışmalar mevcut olsa da ilaç inaktivasyonu ve eflüks pompalarına ait veriler, mekanizmaların tam olarak açıklanmasında yetersiz kalmaktadır. Yapılan çalışmalar direnç mekanizmalarına yeni başlıkların da ekleneceğini göstermektedir.
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