Russell A D
Welsh School of Pharmacy, Cardiff University, UK.
Symp Ser Soc Appl Microbiol. 2002(31):1S-3S.
Drug resistance in bacteria is increasing and the pace at which new antibiotics are being produced is slowing. It is now almost commonplace to hear about methicillin-resistant Staphylococcus aureus (MRSA), vancomycin-resistant enterococci (VRE), multi-drug resistance in Mycobacterium tuberculosis (MDRTB) strains and multi-drug-resistant (MDR) gram-negative bacteria. So-called new and emerging pathogens add to the gravity of the situation. Reduced susceptibility to biocides is also apparently increasing, but is more likely to be low level in nature and to concentrations well below those used in hospital, domestic an industrial practice. A particular problem, however, is found with bacteria and other micro-organisms present in biofilms, where a variety of factors can contribute to greater insusceptibility compared with cells in planktonic culture. Also of potential concern is the possibility that widespread usage of biocides is responsible for the selection and maintenance of antibiotic-resistant bacteria. The basic mechanisms of action of, and bacterial resistance to, antibiotics are generally well documented, although data continue to accumulate about the nature and importance of efflux systems. In contrast, the modes of action of most biocides are poorly understood and consequently, detailed evaluation of bacterial resistance mechanisms is often disappointing. During this Symposium, the mechanisms of bacterial resistance to antibiotics and biocides are discussed at length. It is hoped that this knowledge will be used to develop newer, more effective drugs and biocides that can be better and perhaps, on occasion, more logically used to combat the increasing problem of bacterial resistance.
细菌耐药性正在增强,而新抗生素的生产速度却在放缓。如今,耐甲氧西林金黄色葡萄球菌(MRSA)、耐万古霉素肠球菌(VRE)、结核分枝杆菌多重耐药菌株(MDRTB)以及多重耐药革兰氏阴性菌等情况几乎屡见不鲜。所谓的新出现病原体更是加剧了这种形势的严峻性。对杀菌剂敏感性降低的情况显然也在增多,但这种情况在实际中更可能处于低水平,且低于医院、家庭和工业实践中所使用的浓度。然而,生物膜中存在的细菌和其他微生物却存在一个特殊问题,与浮游培养中的细胞相比,生物膜中的多种因素会导致其更不易受到影响。另一个潜在问题是,杀菌剂的广泛使用可能导致对抗生素耐药细菌的选择和维持。抗生素的基本作用机制以及细菌对其的耐药性通常已有充分记录,尽管关于外排系统的性质和重要性的数据仍在不断积累。相比之下,大多数杀菌剂的作用方式却知之甚少,因此,对细菌耐药机制的详细评估往往不尽人意。在本次研讨会上,详细讨论了细菌对抗生素和杀菌剂的耐药机制。希望这些知识能用于研发更新、更有效的药物和杀菌剂,从而能更好地,或许有时能更合理地用于应对日益严重的细菌耐药问题。