Bevan Edward R, Jones Annie M, Hawkey Peter M
Institute of Microbiology and Infection, University of Birmingham, Edgbaston, Birmingham B15 2TT, UK.
Public Health England, West Midlands Public Health Laboratory, Heart of England NHS Foundation Trust, Birmingham B5 9SS, UK.
J Antimicrob Chemother. 2017 Aug 1;72(8):2145-2155. doi: 10.1093/jac/dkx146.
Globally, rates of ESBL-producing Enterobacteriaceae are rising. We undertook a literature review, and present the temporal trends in blaCTX-M epidemiology, showing that blaCTX-M-15 and blaCTX-M-14 have displaced other genotypes in many parts of the world. Explanations for these changes can be attributed to: (i) horizontal gene transfer (HGT) of plasmids; (ii) successful Escherichia coli clones; (iii) ESBLs in food animals; (iv) the natural environment; and (v) human migration and access to basic sanitation. We also provide explanations for the changing epidemiology of blaCTX-M-2 and blaCTX-M-27. Modifiable anthropogenic factors, such as poor access to basic sanitary facilities, encourage the spread of blaCTX-M and other antimicrobial resistance (AMR) genes, such as blaNDM, blaKPC and mcr-1. We provide further justification for novel preventative and interventional strategies to reduce transmission of these AMR genes.
在全球范围内,产超广谱β-内酰胺酶(ESBL)的肠杆菌科细菌发生率正在上升。我们进行了一项文献综述,并呈现了blaCTX-M流行病学的时间趋势,表明blaCTX-M-15和blaCTX-M-14在世界许多地区已取代了其他基因型。这些变化的原因可归因于:(i)质粒的水平基因转移(HGT);(ii)成功的大肠杆菌克隆;(iii)食用动物中的ESBLs;(iv)自然环境;以及(v)人类迁移和基本卫生设施的可及性。我们还对blaCTX-M-2和blaCTX-M-27不断变化的流行病学情况做出了解释。一些可改变的人为因素,如基本卫生设施的可及性差,促使blaCTX-M以及其他抗微生物耐药性(AMR)基因(如blaNDM、blaKPC和mcr-1)的传播。我们为减少这些AMR基因传播的新型预防和干预策略提供了进一步的依据。