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动物源分离革兰氏阴性病原菌的β-内酰胺类耐药性。

β-lactam resistance in gram-negative pathogens isolated from animals.

机构信息

School of Animal and Veterinary Sciences, The University of Adelaide, Roseworthy, South Australia.

出版信息

Curr Pharm Des. 2013;19(2):239-49.

PMID:22894614
Abstract

Although β-lactams remain a cornerstone of veterinary therapeutics, only a restricted number are actually approved for use in food-producing livestock in comparison to companion animals and wildlife. Nevertheless, both registered and off-label use of third and fourth-generation cephalosporins in livestock may have influenced the emergence of plasmid-encoded AmpC β-lactamases (pAmpC) (mainly CMY-2) and CTX-M extended-spectrum β-lactamases (ESBLs) in both Gram-negative pathogens and commensals isolated from animals. This presents a public health concern due to the potential risk of transfer of β-lactam-resistant pathogens from livestock to humans through food. The recent detection of pAmpC and ESBLs in multidrug-resistant Enterobacteriaceae isolated from dogs has also confirmed the public health importance of β-lactam resistance in companion animals, though in this case, human-to-animal transmission may be equally as relevant as animal-to-human transmission. Identification of pAmpC and ESBLs in Enterobacteriaceae isolated from wildlife and aquaculture species may be evidence of environmental selection pressure arising from both human and veterinary use of β- lactams. Such selection pressure in animals could be reduced by the availability of reliable alternative control measures such as vaccines, bacteriophage treatments and/or competitive exclusion models for endemic production animal diseases such as colibacillosis. The global emergence and pandemic spread of extraintestinal pathogenic E. coli O25-ST131 strains expressing CTX-M-15 ESBL in humans and its recent detection in livestock, companion animals and wildlife is a major cause for concern and goes against the paradigm that Gramnegative pathogens do not necessarily have to lose virulence in compensation for acquiring resistance.

摘要

尽管β-内酰胺类抗生素仍然是兽医治疗学的基石,但与伴侣动物和野生动物相比,实际上只有少数几种被批准用于生产食用动物。然而,无论是在注册和非注册使用第三和第四代头孢菌素在牲畜中,都可能影响到质粒编码的 AmpCβ-内酰胺酶(pAmpC)(主要是 CMY-2)和 CTX-M 扩展谱β-内酰胺酶(ESBLs)在革兰氏阴性病原体和从动物分离的共生菌中的出现。由于从牲畜到人类通过食物转移β-内酰胺耐药病原体的潜在风险,这引起了公共卫生关注。最近在从狗中分离的多药耐药肠杆菌科中检测到 pAmpC 和 ESBLs 也证实了伴侣动物中β-内酰胺耐药的公共卫生重要性,尽管在这种情况下,人与动物的传播可能与动物与人的传播同样相关。从野生动物和水产养殖物种中分离的肠杆菌科中鉴定出 pAmpC 和 ESBLs 可能是由于人类和兽医使用β-内酰胺类抗生素而产生的环境选择压力的证据。通过使用可靠的替代控制措施,如疫苗、噬菌体治疗和/或竞争排除模型,来控制地方性生产动物疾病(如大肠杆菌病),可以减少动物中的这种选择压力。在人类中表达 CTX-M-15 ESBL 的肠外致病性大肠杆菌 O25-ST131 菌株在全球的出现和流行传播及其在牲畜、伴侣动物和野生动物中的最近检测,是一个主要的关注原因,这违背了革兰氏阴性病原体不一定必须失去毒力以补偿获得耐药性的范式。

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