Oteo Jesús, Belén Aracil María
Laboratorio de Antibióticos, Servicio de Bacteriología, Centro Nacional de Microbiología, Majadahonda, Madrid, España.
Laboratorio de Antibióticos, Servicio de Bacteriología, Centro Nacional de Microbiología, Majadahonda, Madrid, España.
Enferm Infecc Microbiol Clin. 2015 Jul;33 Suppl 2:27-33. doi: 10.1016/S0213-005X(15)30012-4.
Multi-drug resistance in bacterial pathogens increases morbidity and mortality in infected patients and it is a threat to public health concern by their high capacity to spread. For both reasons, the rapid detection of multi-drug resistant bacteria is critical. Standard microbiological procedures require 48-72 h to provide the antimicrobial susceptibility results, thus there is emerging interest in the development of rapid detection techniques. In recent years, the use of selective and differential culture-based methods has widely spread. However, the capacity for detecting antibiotic resistance genes and their low turnaround times has made molecular methods a reference for diagnosis of multidrug resistance. This review focusses on the molecular methods for detecting some mechanisms of antibiotic resistance with a high clinical and epidemiological impact: a) Enzymatic resistance to broad spectrum β-lactam antibiotics in Enterobacteriaceae, mainly extended spectrum β-lactamases (ESBL) and carbapenemases; and b) methicillin resistance in Staphylococcus aureus.
细菌病原体中的多重耐药性增加了感染患者的发病率和死亡率，并且由于其高传播能力，对公共卫生构成威胁。出于这两个原因，快速检测多重耐药细菌至关重要。标准微生物学程序需要48-72小时才能提供抗菌药物敏感性结果，因此人们对快速检测技术的开发越来越感兴趣。近年来，基于选择性和鉴别性培养的方法得到了广泛应用。然而，检测抗生素耐药基因的能力及其较短的周转时间使分子方法成为诊断多重耐药性的参考方法。本综述重点关注检测具有高临床和流行病学影响的一些抗生素耐药机制的分子方法：a）肠杆菌科对广谱β-内酰胺抗生素的酶促耐药性，主要是超广谱β-内酰胺酶（ESBL）和碳青霉烯酶；b）金黄色葡萄球菌中的耐甲氧西林性。
