Emerging Antibiotic Resistance Unit, Medical and Molecular Microbiology, Department of Medicine, University of Fribourg, Fribourg, Switzerland.
French INSERM European Unit, University of Fribourg (LEA-IAME), Fribourg, Switzerland.
Microbiol Spectr. 2018 Jul;6(4). doi: 10.1128/microbiolspec.ARBA-0026-2017.
Multidrug resistance in has become a worrying issue that is increasingly observed in human but also in veterinary medicine worldwide. is intrinsically susceptible to almost all clinically relevant antimicrobial agents, but this bacterial species has a great capacity to accumulate resistance genes, mostly through horizontal gene transfer. The most problematic mechanisms in correspond to the acquisition of genes coding for extended-spectrum β-lactamases (conferring resistance to broad-spectrum cephalosporins), carbapenemases (conferring resistance to carbapenems), 16S rRNA methylases (conferring pan-resistance to aminoglycosides), plasmid-mediated quinolone resistance (PMQR) genes (conferring resistance to [fluoro]quinolones), and genes (conferring resistance to polymyxins). Although the spread of carbapenemase genes has been mainly recognized in the human sector but poorly recognized in animals, colistin resistance in seems rather to be related to the use of colistin in veterinary medicine on a global scale. For the other resistance traits, their cross-transfer between the human and animal sectors still remains controversial even though genomic investigations indicate that extended-spectrum β-lactamase producers encountered in animals are distinct from those affecting humans. In addition, of animal origin often also show resistances to other-mostly older-antimicrobial agents, including tetracyclines, phenicols, sulfonamides, trimethoprim, and fosfomycin. Plasmids, especially multiresistance plasmids, but also other mobile genetic elements, such as transposons and gene cassettes in class 1 and class 2 integrons, seem to play a major role in the dissemination of resistance genes. Of note, coselection and persistence of resistances to critically important antimicrobial agents in human medicine also occurs through the massive use of antimicrobial agents in veterinary medicine, such as tetracyclines or sulfonamides, as long as all those determinants are located on the same genetic elements.
已经对几乎所有临床相关的抗菌药物具有固有敏感性,但该细菌物种具有很强的积累耐药基因的能力,主要通过水平基因转移。 中最成问题的机制对应于获得编码扩展谱β-内酰胺酶(对广谱头孢菌素具有耐药性)、碳青霉烯酶(对碳青霉烯类具有耐药性)、16S rRNA 甲基酶(对氨基糖苷类具有泛耐药性)、质粒介导的喹诺酮耐药(PMQR)基因(对氟喹诺酮类具有耐药性)和 基因(对多粘菌素类具有耐药性)的基因。虽然碳青霉烯酶基因的传播主要在人类领域中被认识到,但在动物中认识不足,但 对粘菌素的耐药性似乎与粘菌素在全球范围内在兽医中的使用有关。对于其他耐药特性,即使基因组研究表明在动物中遇到的扩展谱β-内酰胺酶产生者与影响人类的产生者不同,但它们在人类和动物部门之间的交叉转移仍然存在争议。此外,动物来源的 通常也对其他-主要是较旧的-抗菌药物具有耐药性,包括四环素类、酚类、磺胺类、甲氧苄啶和磷霉素。质粒,特别是多耐药质粒,但也包括其他移动遗传元件,如转座子和类 1 和类 2 整合子中的基因盒,似乎在耐药基因的传播中发挥主要作用。值得注意的是,通过在兽医中大量使用抗菌药物,如四环素类或磺胺类药物,在人类医学中对抗菌药物至关重要的耐药性也会发生共选择和持续存在,只要所有这些决定因素都位于同一遗传元件上。