NDM-1: a local clone emerges with worldwide aspirations
NDM-1: a local clone emerges with worldwide aspirations
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DOI：
10.2217/fmb.10.171
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发表时间：
2011-02-01
影响因子：
3.1
通讯作者：
Marra, Andrea
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文献类型：
--
作者：
Marra, Andrea
评估：Kumarasamy KK、Toleman MA、Walsh TR 等人：印度、巴基斯坦和英国新抗生素耐药机制的出现：一项分子、生物学和流行病学研究。柳叶刀感染。迪斯。 10(9), 597-602 (2010)。细菌总是比我们聪明吗？随着金属-β-内酰胺酶 bla(NDM-1) 基因的出现，情况似乎确实如此。虽然细菌克隆曾经驻留在医院或长期护理机构中，但现在很明显，它们有能力在社区中繁衍生息，并由于便捷、快速的全球旅行而几乎没有障碍地迅速传播到各个国家和大陆。因此，在有利于微生物的条件下（滥用或不适当的抗生素使用以及不良的感染控制程序），曾经的局部问题可能会迅速成为全球性的健康危机。鉴于新抗生素的发现和开发可能需要十年或更长时间，在成功的新药上市之前，多重耐药病原体可能有充足的时间造成严重破坏。曾经，青霉素这一单一药物就足以让人产生不必要新抗生素的预期。此后我们发现细菌可以快速对每种抗生素产生稳定的耐药性，而不会对其致病性产生不利影响。
Evaluation of: Kumarasamy KK, Toleman MA, Walsh TR etal.: Emergence of a new antibiotic resistance mechanism in India, Pakistan, and the UK: a molecular, biological, and epidemiological study. Lancet Infect. Dis. 10(9), 597-602 (2010). Are bacteria always going to outsmart us? With the emergence of the metallo-beta-lactamase bla(NDM-1) gene, it certainly seems so. Whereas at one time bacterial clones resided in hospitals or long-term care facilities, it is now apparent that they have the capability of thriving in the community and quickly spreading across countries and continents with few impediments, thanks to accessible, rapid global travel. Thus, under conditions favoring the organism (promiscuous or inappropriate antibiotic use and poor infection control procedures), what was at one time a local problem can rapidly become a worldwide health crisis. Given that the discovery and development of a new antibiotic can take a decade or more, multiply resistant pathogens can have ample time to wreak havoc before a successful novel agent comes to market. At one time a single drug, penicillin, was enough to raise expectations that new antibiotics were unnecessary; we have since seen that bacteria can generate stable resistance to every antibiotic in rapid fashion, with no detrimental effects on their pathogenicity.