Does broad-spectrum β-lactam resistance due to NDM-1 herald the end of the antibiotic era for treatment of infections caused by Gram-negative bacteria?
Does broad-spectrum β-lactam resistance due to NDM-1 herald the end of the antibiotic era for treatment of infections caused by Gram-negative bacteria?
复制标题
DOI：
10.1093/jac/dkq520
复制
发表时间：
2011-04-01
影响因子：
5.2
通讯作者：
Walsh, Timothy R.
中科院分区：
文献类型：
--
作者：
Nordmann, Patrice;Poirel, Laurent;Walsh, Timothy R.
NDM-1基因于2008年在瑞典新德里一名住院患者的肺炎克雷伯菌中首次发现，它编码一种金属β-内酰胺酶，可以灭活除氨曲南以外的所有β-内酰胺类抗生素。这种BLA(NDM-1)基因已经在医院获得性细菌物种中被发现，如肺炎克雷伯菌，但也在典型的社区获得性细菌物种大肠杆菌中被发现。已经在具有其他耐药机制的菌株中发现了该基因，这些机制导致了它们的多药耐药模式。最近，英国、印度和巴基斯坦以及世界上其他一些国家都广泛报道了这一事件。在大多数情况下，还建立了与印度次大陆的联系。为了遏制非糖尿病生产者的攻击，需要及早确定与非糖尿病相关的感染病例，并通过实施筛查、卫生措施和对携带者进行隔离来防止其传播。
The NDM-1 gene, first identified in Sweden in 2008 in Klebsiella pneumoniae from a patient hospitalized in New Delhi, encodes a metallo-beta-lactamase that inactivates all beta-lactams except aztreonam. This bla(NDM-1) gene has been identified in hospital-acquired bacterial species, such as K. pneumoniae, but also in the typical community-acquired species, Escherichia coli. This gene has been identified in strains that possess other resistance mechanisms contributing to their multidrug resistance patterns. It has been recently extensively reported from the UK, India and Pakistan and, albeit to a lesser extent, from a number of other countries worldwide. In most of the cases a link with the Indian subcontinent has also been established. To stem the onslaught of NDM producers, early identification of cases of NDM-related infections and prevention of their spread by implementing screening, hygiene measures and the isolation of carriers is needed.