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大肠杆菌中的喹诺酮耐药性。

Quinolone resistance in Escherichia coli.

作者信息

Webber M, Piddock L J

机构信息

Division of Immunity and Infection, The Medical School, University of Birmingham, United Kingdom.

出版信息

Vet Res. 2001 May-Aug;32(3-4):275-84. doi: 10.1051/vetres:2001124.

Abstract

Escherichia coli is an important pathogen of animals and humans that causes great financial cost in food production by causing disease in food animals. The quinolones are a class of synthetic antimicrobial agents with excellent activity against Escherichia coli and other Gram-negative bacteria used in human and veterinary medicine. Different quinolones are used to treat various conditions in animals in different parts of the world. All members of this class of drug have the same mode of action: inhibition of topoisomerase enzymes, DNA Gyrase and Topoisomerase IV. Escherichia coli can become resistant to quinolones by altering the target enzymes, reducing permeability of the cell to inhibit their entry, or by actively pumping the drug out of the cell. All these resistance mechanisms can play a role in high-level fluoroquinolone resistance, however target site mutations appear to be most important. As all quinolones act in the same way resistance to one member of the class will also confer decreased susceptibility to all members of the family. Quinolone resistant Escherichia coli in animals have increased in numbers after quinolone introduction in a number of different case studies. The resistance mechanisms in these isolates are the same as those in resistant strains found in humans. Care needs to be taken to ensure that quinolones are used sparingly and appropriately as highly resistant strains of Escherichia coli can be selected and may pass into the food chain. As these drugs are of major therapeutic importance in human medicine, this is a public health concern. More information as to the numbers of quinolone resistant Escherichia coli and the relationship between resistance and quinolone use is needed to allow us to make better informed decisions about when and when not to use quinolones in the treatment of animals.

摘要

大肠杆菌是人和动物的一种重要病原体,它通过使食用动物患病,给食品生产造成巨大经济损失。喹诺酮类是一类合成抗菌剂,对大肠杆菌和其他革兰氏阴性菌具有优异活性,用于人类和兽医学。在世界不同地区,不同的喹诺酮类药物用于治疗动物的各种病症。这类药物的所有成员具有相同的作用方式:抑制拓扑异构酶、DNA旋转酶和拓扑异构酶IV。大肠杆菌可通过改变靶酶、降低细胞通透性以抑制药物进入或通过将药物主动泵出细胞而对喹诺酮类产生耐药性。所有这些耐药机制都可能在高水平氟喹诺酮耐药中起作用,然而靶位点突变似乎最为重要。由于所有喹诺酮类药物的作用方式相同,对该类中一种药物的耐药性也会导致对该家族所有成员的敏感性降低。在一些不同的案例研究中,喹诺酮类药物引入后,动物体内耐喹诺酮的大肠杆菌数量有所增加。这些分离株中的耐药机制与在人类中发现的耐药菌株相同。需要谨慎确保喹诺酮类药物谨慎且适当地使用,因为可能会选择出高耐药性的大肠杆菌菌株,并且这些菌株可能进入食物链。由于这些药物在人类医学中具有重要治疗意义,这是一个公共卫生问题。需要更多关于耐喹诺酮大肠杆菌数量以及耐药性与喹诺酮类药物使用之间关系的信息,以便我们在何时对动物使用喹诺酮类药物以及何时不使用做出更明智的决策。

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