Department of Microbiology and Immunology, University of Michigan Medical School, Michigan, USA.
Division of Infectious Diseases/Department of Medicine, University of Michigan Medical School, Michigan, USA.
Ann N Y Acad Sci. 2019 Jan;1435(1):39-56. doi: 10.1111/nyas.13672. Epub 2018 Mar 31.
The emergence and spread of antibiotic-resistant Gram-negative bacteria (rGNB) across global healthcare networks presents a significant threat to public health. As the number of effective antibiotics available to treat these resistant organisms dwindles, it is essential that we devise more effective strategies for controlling their proliferation. Recently, whole-genome sequencing has emerged as a disruptive technology that has transformed our understanding of the evolution and epidemiology of diverse rGNB species, and it has the potential to guide strategies for controlling the evolution and spread of resistance. Here, we review specific areas in which genomics has already made a significant impact, including outbreak investigations, regional epidemiology, clinical diagnostics, resistance evolution, and the study of epidemic lineages. While highlighting early successes, we also point to the next steps needed to translate this technology into strategies to improve public health and clinical medicine.
抗生素耐药革兰氏阴性菌(rGNB)在全球医疗保健网络中的出现和传播对公共卫生构成了重大威胁。随着可用于治疗这些耐药菌的有效抗生素数量不断减少,我们必须制定更有效的策略来控制它们的繁殖。最近,全基因组测序作为一种颠覆性技术出现,改变了我们对不同 rGNB 物种的进化和流行病学的理解,并且有可能指导控制耐药性进化和传播的策略。在这里,我们回顾了基因组学已经产生重大影响的特定领域,包括暴发调查、区域流行病学、临床诊断、耐药进化以及流行谱系的研究。在强调早期成功的同时,我们还指出了将这项技术转化为改善公共卫生和临床医学策略所需的下一步措施。