Worldwide dissemination of the NDM-type carbapenemases in Gram-negative bacteria.

Worldwide dissemination of the NDM-type carbapenemases in Gram-negative bacteria.
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DOI:
10.1155/2014/249856
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发表时间:
2014
影响因子:
--
通讯作者:
Nordmann P
Nordmann P
中科院分区:
生物学3区
文献类型:
--
作者:
Dortet L;Poirel L;Nordmann P

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最近描述的碳青霉烯酶之一,即新德里金属-内酰胺酶(NDM-1)的出现构成了一个关键且日益重要的医学问题。这种耐药性特征损害了几乎所有内酰胺类药物(氨曲南除外)的疗效,包括最后的碳青霉烯类。治疗选择可能仍然主要限于粘菌素、替加环素和磷霉素。印度次大陆是NDM生产商的主要已知储集层,而巴尔干地区和中东似乎是次要储集层。虽然bla NDM样基因(几种变体)的传播主要是通过肠杆菌科中的接合质粒获得的,但这种碳青霉烯酶也已在铜绿假单胞菌和不动杆菌属中鉴定。不动杆菌可能在传播bla NDM基因方面发挥关键作用,因为它是肠杆菌科的天然宿主。快速诊断技术(Carba NP测试)和携带者筛查是试图遏制这种威胁现代医学功效的爆发的基石。
The emergence of one of the most recently described carbapenemases, namely, the New Delhi metallo-lactamase (NDM-1), constitutes a critical and growingly important medical issue. This resistance trait compromises the efficacy of almost all lactams (except aztreonam), including the last resort carbapenems. Therapeutical options may remain limited mostly to colistin, tigecycline, and fosfomycin. The main known reservoir of NDM producers is the Indian subcontinent whereas a secondary reservoir seems to have established the Balkans regions and the Middle East. Although the spread of bla NDM-like genes (several variants) is derived mostly by conjugative plasmids in Enterobacteriaceae, this carbapenemase has also been identified in P. aeruginosa and Acinetobacter spp. Acinetobacter sp. may play a pivotal role for spreading bla NDM genes for its natural reservoir to Enterobacteriaceae. Rapid diagnostic techniques (Carba NP test) and screening of carriers are the cornerstone to try to contain this outbreak which threatens the efficacy of the modern medicine.
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发表时间: 2012-04-01
影响因子: 4.9
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期刊: PloS one
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