Colistin Update on Its Mechanism of Action and Resistance, Present and Future Challenges.
Colistin Update on Its Mechanism of Action and Resistance, Present and Future Challenges.
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DOI：
10.3390/microorganisms8111716
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发表时间：
2020-11-02
期刊：
影响因子：
4.5
通讯作者：
Pina-Vaz C
中科院分区：
文献类型：
--
作者：
Andrade FF;Silva D;Rodrigues A;Pina-Vaz C
自上个世纪中期以来，粘菌素已广泛用于动物，特别是猪，以控制肠道感染。粘菌素目前被认为是抵抗由多重耐药革兰氏阴性微生物（如产碳青霉烯酶的肠球菌、鲍曼不动杆菌和铜绿假单胞菌）引起的人类感染的最后一道防线。在人类和动物的分离株中报告了可转移的细菌耐药性，如mcr基因。研究人员积极寻求减少粘菌素耐药性的策略。因此，在兽医和人类医学中定义粘菌素治疗指南至关重要。禁止在猪中使用粘菌素作为生长促进剂和预防目的，以及在农场动物中实施可持续措施以预防感染，将有助于避免耐药性，应该受到鼓励。人-动物-环境界面中的粘菌素耐药性强调了“一个健康”方法的相关性，以实现其有效控制。这些措施应该以合作的方式解决，需要多个学科的努力，并在医生、兽医和环境专业人员之间达成共识。修订的机制，粘菌素的行动，耐药性，动物和人类的使用，以及粘菌素的敏感性评估进行辩论。
Colistin has been extensively used since the middle of the last century in animals, particularly in swine, for the control of enteric infections. Colistin is presently considered the last line of defense against human infections caused by multidrug-resistant Gram-negative organisms such as carbapenemase-producer Enterobacterales, Acinetobacter baumanni, and Pseudomonas aeruginosa. Transferable bacterial resistance like mcr-genes was reported in isolates from both humans and animals. Researchers actively seek strategies to reduce colistin resistance. The definition of guidelines for colistin therapy in veterinary and human medicine is thus crucial. The ban of colistin use in swine as a growth promoter and for prophylactic purposes, and the implementation of sustainable measures in farm animals for the prevention of infections, would help to avoid resistance and should be encouraged. Colistin resistance in the human–animal–environment interface stresses the relevance of the One Health approach to achieve its effective control. Such measures should be addressed in a cooperative way, with efforts from multiple disciplines and with consensus among doctors, veterinary surgeons, and environment professionals. A revision of the mechanism of colistin action, resistance, animal and human use, as well as colistin susceptibility evaluation is debated here.
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DOI：
10.1016/j.ijantimicag.2016.09.025
发表时间：
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影响因子：
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作者：
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