mtr外排系统的结构和功能的完整性。mtrRCDE 系统

    中任何基因的突变或缺失 ,或是其编码产物结构不完

    整 ,都会影响淋球菌对 HAs 的耐受性改变15。从生态

    学角度来看 ,淋球菌外排系统可为其在不利的生存环

    境中提供一个生存优势。有推测认为淋球菌在泌尿

    生殖道等高 HAs 的环境中首先发生 mtrR 基因突变 ,产生对 HAs 中度抵抗 ,进而发生 mtrR 基因启动区的

    插入重复序列碱基缺失使其产生更高抗性1 ,2。因此

    以淋球菌外排泵为靶目标进行干预研究 ,对于淋病的

    治疗和预防是非常必要的。

    参 考 文 献

    1 Rouquette - Loughlin CE , Balthazar JT, Hill Sa , et al . Modulation

    of the mtrCDE - encoded efflux pump gene complex of Neisseria

    meningitidis due to a Correia element insertion sequence. Mol Mi 2

    crobiol 2004 ;54 :731 - 741.

    2 Jerse AE , Sharma ND , Simms AN , et al . A gonococcal efflux pump

    system enhances bacterial survival in a female mouse model of geni 2

    tal tract infection. Infect Immun 2003 ;71 :5576 - 5582.

    3 Hagman KE , Pan W, Spratt BG. et al . Resistance of Neisseria

    gonorrhoeae to antimicrobial hydrophobic agents is modulated by the

    mtrRCDE efflux system. Microbiology 1995 ;141 :611 - 622.

    4 Lucas CE , Hagman KE , Levin JC , et al . Importance of

    lipooligosaccharide structure in determining gonococcal resistance to

    hydrophobic antimicrobial agents resulting from the mtr efflux sys 2

    tem. Mol Microbiol 1995 ;16 :1001 - 1009.

    5 Zarantonelli L , Borthagaray G, Lee EH , et al . Decreased suscepti 2

    bility to azithromycin and erythromycin mediated by a novel mtr(R)

    promoter mutation in Neisseria gonorrhoeae. J Antimicrob Chemother

    2001 ;47 :651 - 654.

    6 Hagman KE , Shafer WM. Transcriptional control of the mtr efflux

    system of Neisseria gonorrhoeae. J Bacteriol 1995 ; 177 : 4162 -

    4165.

    7 Hagman KE , Lucas CE , Balthazar JT, et al . The MtrD protein of

    Neisseria gonorrhoeae is a member of the resistance/ nodulation/ divi 2

    sion protein family constituting part of an efflux system. Microbiology

    1997 ;143 :2117 - 2125.

    8 Delahay RM, Robertson BD , Balthazar JT. et al . Involvement of

    the gonococcal MtrE protein in the resistance of Neisseria gonor 2

    rhoeae to toxic hydrophobic agents. Microbiology 1997 ;143 :2127 -

    2133.

    9 Veal WL , Yellen A , Balthazar JT, et al . Loss - of - function muta 2

    tions in the mtr efflux system of Neisseria gonorrhoeae. Microbiology

    1998 ;144 :621 - 627.

    10 Veal WL , Nicholas RA , Shafer WM. Overexpression of the MtrC

    - MtrD - MtrE efflux pump due to an mtrR mutation is required for

    chromosomally mediated penicillin resistance in Neisseria gonor 2

    rhoeae. J Bacteriol 2002 ;184 :5619 - 5624.

    11 Johnson SR , Sandul AL , Parekh M, et al . Mutations causing in

    vitro resistance to azithromycin in Neisseria gonorrhoeae. Int J An 2

    timicrob Agents 2003 ;21 :414 - 419.

    12 Cousin S Jr , Roberts MC , Whittington WL. Insertion of a thymine

    ( + T) in the 13 base pair inverted repeat of the Neisseria gonor 2

    rhoeae mtr promoter region and antibiotic susceptibility. Int J An 2

    timicrob Agents 2004 ;23 :418 - 419.

    13 Rouquette C , Harmon JB , Shafer WM. Induction of the mtrCDE -

    encoded efflux pump system of Neisseria gonorrhoeae requires

    MtrA , an AraC - like protein. Mol Microbiol 1999 ;33 :651 - 658.

    14 Lee EH , Shafer WM. The farAB - encoded efflux pump mediates

    resistance of gonococci to long - chained antibacterial fatty acids.

    Mol Microbiol 1999 ;33 :839 - 845.

    15 Jerse AE , Sharma ND , Simms AN , et al . A gonococcal efflux

    pump system enhances bacterial survival in a female mouse model

    of genital tract infection. Infect Immun 2003 ;71 :5576 - 5582.

    (收稿:2005 - 03 - 22 修回:2005 - 05 - 08)

    成人Still 病的研究现状

    李久宏 李 波 综述 宋芳吉 审校

    摘要 成人 Still 病临床上较少见 ,近年来 ,发病率有逐渐增高的趋势 ,由于临床表现复杂 ,故极易

    造成误诊或漏诊 ......