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【資源】關(guān)于能夠抵御所有抗生素的超級病菌的柳葉刀論文,新鮮送上
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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. 全文下載地址 http://www.91box.net/?B60NOMJHOWETK6YA7ECW [ Last edited by liuxingxp on 2010-8-12 at 20:31 ] |
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我個人對此問題的認識是以下三點: 抗生素濫用是外部原因,而非臨床環(huán)境中存在著耐藥基因才是內(nèi)因。此外,目前超級細菌無藥可治,也凸顯了抗生素研發(fā)的不足。 關(guān)于此三點詳細論述,請參考 前幾天發(fā)的兩篇科技評述。 南方周末 http://www.infzm.com/content/49096 科技日報 http://www.stdaily.com/kjrb/content/2010-08/19/content_220405.htm 希望戰(zhàn)友,批評指導 說的有道理,請投票。謝謝 |
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弗萊明發(fā)現(xiàn)青霉素后,人類曾以為找到對付病原菌的利器。但是,隨著耐藥菌的不斷出現(xiàn),有人甚至悲觀地認為,抗生素時代終究會被耐藥菌的出現(xiàn)所終結(jié)。地球上微生物的種類大于其他所有的物種數(shù)目之和,而人類自身攜帶的細菌數(shù)目,又遠超過其所有的細胞。生物學家不禁感嘆:人類可能只是外來生物,而微生物才是地球的主人。 2008年《科學》雜志在“細菌的反擊”一文中曾這樣描述:1943年青霉素大規(guī)模使用,1945年院內(nèi)感染的20%金黃色葡球菌對其產(chǎn)生抗性;1947年鏈霉菌素上市,同年該藥耐藥菌出現(xiàn);1952年四環(huán)菌素上市,1956年其耐藥菌出現(xiàn);1959年甲氧西林上市,1961年其耐藥菌出現(xiàn);1964年頭孢噻吩上市,1966年其耐藥菌出現(xiàn);1967年慶大霉素上市,1970年其耐藥菌出現(xiàn);1981年頭孢噻肟上市,1983年其耐藥菌出現(xiàn);1996年,發(fā)現(xiàn)萬古霉素耐藥菌;2001年利奈唑胺上市,2002年其耐藥菌出現(xiàn)。此后數(shù)年里,僅有達托霉素等寥寥數(shù)種新型抗生素問世。 以上摘自我寫的一篇科學評述“耐藥病原菌的肆虐與抗藥基因的產(chǎn)生(刊于南方周末)http://www.infzm.com/content/49096 |
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