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【资源】关于能够抵御所有抗生素的超级病菌的柳叶刀论文,新鲜送上
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Emergence of a new antibiotic resistance mechanism in India, Pakistan, and the UK: a molecular, biological, and epidemiological study Summary Background Gram-negative Enterobacteriaceae with resistance to carbapenem conferred by New Delhi metallo-β- lactamase 1 (NDM-1) are potentially a major global health problem. We investigated the prevalence of NDM-1, in multidrug-resistant Enterobacteriaceae in India, Pakistan, and the UK. Methods Enterobacteriaceae isolates were studied from two major centres in India—Chennai (south India), Haryana (north India)—and those referred to the UK’s national reference laboratory. Antibiotic susceptibilities were assessed, and the presence of the carbapenem resistance gene blaNDM-1 was established by PCR. Isolates were typed by pulsed-fi eld gel electrophoresis of XbaI-restricted genomic DNA. Plasmids were analysed by S1 nuclease digestion and PCR typing. Case data for UK patients were reviewed for evidence of travel and recent admission to hospitals in India or Pakistan. Findings We identifi ed 44 isolates with NDM-1 in Chennai, 26 in Haryana, 37 in the UK, and 73 in other sites in India and Pakistan. NDM-1 was mostly found among Escherichia coli (36) and Klebsiella pneumoniae (111), which were highly resistant to all antibiotics except to tigecycline and colistin. K pneumoniae isolates from Haryana were clonal but NDM-1 producers from the UK and Chennai were clonally diverse. Most isolates carried the NDM-1 gene on plasmids: those from UK and Chennai were readily transferable whereas those from Haryana were not conjugative. Many of the UK NDM-1 positive patients had travelled to India or Pakistan within the past year, or had links with these countries. Interpretation The potential of NDM-1 to be a worldwide public health problem is great, and co-ordinated international surveillance is needed. Funding European Union, Wellcome Trust, and Wyeth. 全文下载地址 http://www.91box.net/?B60NOMJHOWETK6YA7ECW [ Last edited by liuxingxp on 2010-8-12 at 20:31 ] |
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我个人对此问题的认识是以下三点： 抗生素滥用是外部原因，而非临床环境中存在着耐药基因才是内因。此外，目前超级细菌无药可治，也凸显了抗生素研发的不足。 关于此三点详细论述，请参考 前几天发的两篇科技评述。 南方周末 http://www.infzm.com/content/49096 科技日报 http://www.stdaily.com/kjrb/content/2010-08/19/content_220405.htm 希望战友，批评指导 说的有道理，请投票。谢谢  |
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