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非洲产超广谱β-内酰胺酶(ESBLs)肠杆菌科的流行情况和耐药模式。

The prevalence and drug resistance pattern of extended spectrum β-lactamases (ESBLs) producing Enterobacteriaceae in Africa.

机构信息

Department of Medical Microbiology and Immunology, Institute of Biomedical Sciences, College of Health Science, Mekelle University, Mekelle 1871, Ethiopia.

Department of Chemistry, University of Southern California, Los Angeles, CA 90089, USA.

出版信息

Microb Pathog. 2018 Jan;114:180-192. doi: 10.1016/j.micpath.2017.11.061. Epub 2017 Nov 28.

Abstract

Extended spectrum β-lactamases (ESBLs) are a group of enzymes that can hydrolyze a variety of β-lactams including fourth generation cephalosporins and compromise the efficacy of all β-lactams, except cephamycins and carbapenems. In the worldwide, the ESBL group of enzymes are found widely and causes a severe infection on human health which leads to various diseases. This review primarily focusses on analyzing the prevalence and drug resistance patterns in the African continent. From the earlier reported data shown only the minimal amount of surveillance information's has been summarized with respect to antimicrobial resistance on ESBLs producing Enterobacteriaceae both in hospital and community settings. To bring the present scenario in limelight, the present study explores the prevalence of ESBL-producing Enterobacteriaceae in various countries in Africa and specifically, to identify most common ESBL genes in hospital and community. The observation was initiated with the exhaustive literature search using PubMed and other databases to broaden the study from the earlier investigations in the African countries concerned about the prevalence rate of ESBL producing Enterobacteriaceae. Further, this study was extended to review various hypothesis of the hydrolytic mechanism, which was detailed by several authors performed earlier through computational approaches. Interestingly, the ESBLs class A and D were found to be common classes in Africa, with the gene CTX-M-15 being most prevalent. Notably, the present review highlights the prevalence on individual countries in Africa and it is extremely significant to prevent the dissemination of ESBL-producing Enterobacteriaceaea. Hence, this review on surveillance will be the benchmark to enhance the research on antimicrobial resistance patterns for all classes and genes. Furthermore, explored in-sights in this paper will be helpful for the further investigations to develop quicker, cost effective, and reliable diagnostic strategies and new effective therapies.

摘要

扩展谱β-内酰胺酶(ESBLs)是一组能够水解多种β-内酰胺类抗生素的酶,包括第四代头孢菌素,从而降低所有β-内酰胺类抗生素的疗效,除头孢菌素和碳青霉烯类抗生素外。在全球范围内,ESBL 酶广泛存在,并对人类健康造成严重感染,导致各种疾病。本综述主要侧重于分析非洲大陆的流行情况和耐药模式。从早期报道的数据来看,仅对医院和社区环境中产生 ESBL 的肠杆菌科的抗生素耐药性的监测信息进行了简要总结。为了使目前的情况更加突出,本研究探讨了非洲各国中产生 ESBL 的肠杆菌科的流行情况,特别是确定医院和社区中最常见的 ESBL 基因。通过使用 PubMed 和其他数据库进行详尽的文献搜索,开始进行观察,以扩大对有关非洲国家中产生 ESBL 的肠杆菌科流行率的早期调查的研究。此外,本研究还扩展到了对水解机制的各种假设进行综述,这是由几位作者通过计算方法早期详细阐述的。有趣的是,在非洲发现 ESBLs 类 A 和 D 是常见的类别,CTX-M-15 基因最为普遍。值得注意的是,本综述突出了非洲个别国家的流行情况,对于防止 ESBL 产生的肠杆菌科的传播至关重要。因此,本综述对监测的研究将成为提高所有类别和基因的抗生素耐药模式研究的基准。此外,本文中探讨的见解将有助于进一步研究,以开发更快、更具成本效益和更可靠的诊断策略和新的有效治疗方法。

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