Immunology Program, Louis V. Gerstner Jr. Graduate School of Biomedical Sciences, New York, NY.
Immunology Program, Louis V. Gerstner Jr. Graduate School of Biomedical Sciences, New York, NY
J Exp Med. 2019 Jan 7;216(1):10-19. doi: 10.1084/jem.20180399. Epub 2018 Oct 11.
The emergence of antibiotic-resistant bacterial pathogens is an all-too-common consequence of antibiotic use. Although antibiotic resistance among virulent bacterial pathogens is a growing concern, the highest levels of antibiotic resistance occur among less pathogenic but more common bacteria that are prevalent in healthcare settings. Patient-to-patient transmission of these antibiotic-resistant bacteria is a perpetual concern in hospitals. Many of these resistant microbes, such as vancomycin-resistant and carbapenem-resistant , emerge from the intestinal lumen and invade the bloodstream of vulnerable patients, causing disseminated infection. These infections are associated with preceding antibiotic administration, which changes the intestinal microbiota and compromises resistance to colonization by antibiotic-resistant bacteria. Recent and ongoing studies are increasingly defining commensal bacterial species and the inhibitory mechanisms they use to prevent infection. The use of next-generation probiotics derived from the intestinal microbiota represents an alternative approach to prevention of infection by enriching colonization with protective commensal species, thereby reducing the density of antibiotic-resistant bacteria and also reducing patient-to-patient transmission of infection in healthcare settings.
抗生素耐药细菌病原体的出现是抗生素使用的常见后果。虽然毒力细菌病原体中的抗生素耐药性是一个日益令人关注的问题，但在医疗机构中更为常见但致病性较低的细菌中，抗生素耐药性水平最高。这些抗生素耐药细菌在患者之间的传播是医院中持续存在的问题。许多这些耐药微生物，如万古霉素耐药和碳青霉烯耐药，从肠道腔中出现并侵入易感染患者的血液，导致播散性感染。这些感染与先前的抗生素治疗有关，抗生素治疗会改变肠道微生物群并损害对抗生素耐药细菌定植的抵抗力。最近和正在进行的研究越来越多地定义了共生细菌物种及其使用的抑制机制，以防止感染。使用源自肠道微生物群的下一代益生菌是一种替代方法，可以通过丰富保护性共生物种的定植来预防感染，从而降低抗生素耐药细菌的密度，并减少医疗机构中患者之间感染的传播。
