Chroma Magdalena, Kolar Milan
Department of Microbiology, Faculty of Medicine and Dentistry, Palacky University Olomouc, Czech Republic.
Biomed Pap Med Fac Univ Palacky Olomouc Czech Repub. 2010 Dec;154(4):289-96. doi: 10.5507/bp.2010.044.
In 1928, the first antibiotic, penicillin, was discovered. That was the beginning of a great era in the development and prescription of antibiotics. However, the introduction of these antimicrobial agents into clinical practice was accompanied by the problem of antibiotic resistance. Currently, bacterial resistance to antibiotics poses a major problem in both hospital and community settings throughout the world.
This review provides examples of modern genetic methods and their practical application in the field of extended-spectrum β-lactamase detection. Since extended-spectrum β-lactamases are the main mechanism of Gram-negative bacterial resistance to oxyimino-cephalosporins, rapid and accurate detection is requested in common clinical practice.
Currently, the detection of extended-spectrum β-lactamases is primarily based on the determination of bacterial phenotypes rather than genotypes. This is because therapeutic decisions are based on assessing the susceptibility rather than presence of resistance genes. One of the main disadvantages of genetic methods is high costs, including those of laboratory equipment. On the other hand, if these modern methods are introduced into diagnostics, they often help in rapid and accurate detection of certain microorganisms or their resistance and pathogenic determinants.
1928年，第一种抗生素青霉素被发现。那是抗生素研发与应用的伟大时代的开端。然而，这些抗菌药物引入临床实践后出现了抗生素耐药性问题。目前，细菌对抗生素的耐药性在全球医院和社区环境中都是一个主要问题。
本综述提供了现代基因方法及其在超广谱β-内酰胺酶检测领域实际应用的实例。由于超广谱β-内酰胺酶是革兰氏阴性菌对氧亚氨基头孢菌素耐药的主要机制，因此在常规临床实践中需要快速准确的检测。
目前，超广谱β-内酰胺酶的检测主要基于细菌表型的测定而非基因型。这是因为治疗决策是基于评估药敏性而非耐药基因的存在。基因方法的主要缺点之一是成本高昂，包括实验室设备成本。另一方面，如果将这些现代方法引入诊断，它们通常有助于快速准确地检测某些微生物或其耐药性及致病决定因素。
