Université de Lorraine, CNRS, L2CM, F-54000 Nancy, France.
ABC Platform®, Faculté de Pharmacie, F-54505 Vandœuvre-lès-Nancy, France.
Molecules. 2019 Aug 29;24(17):3152. doi: 10.3390/molecules24173152.
Antimicrobial resistance in bacteria is frightening, especially resistance in Gram-negative Bacteria (GNB). In 2017, the World Health Organization (WHO) published a list of 12 bacteria that represent a threat to human health, and among these, a majority of GNB. Antibiotic resistance is a complex and relatively old phenomenon that is the consequence of several factors. The first factor is the vertiginous drop in research and development of new antibacterials. In fact, many companies simply stop this R&D activity. The finding is simple: there are enough antibiotics to treat the different types of infection that clinicians face. The second factor is the appearance and spread of resistant or even multidrug-resistant bacteria. For a long time, this situation remained rather confidential, almost anecdotal. It was not until the end of the 1980s that awareness emerged. It was the time of Vancomycin-Resistance Enterococci (VRE), and the threat of Vancomycin-Resistant MRSA (Methicillin-Resistant ). After this, there has been renewed interest but only in anti-Gram positive antibacterials. Today, the threat is GNB, and we have no new molecules with innovative mechanism of action to fight effectively against these bugs. However, the war against antimicrobial resistance is not lost. We must continue the fight, which requires a better knowledge of the mechanisms of action of anti-infectious agents and concomitantly the mechanisms of resistance of infectious agents.
细菌的耐药性令人担忧，尤其是革兰氏阴性菌（GNB）的耐药性。2017 年，世界卫生组织（WHO）发布了一份对人类健康构成威胁的 12 种细菌清单，其中大多数为 GNB。抗生素耐药性是一种复杂且相对较老的现象，是多种因素共同作用的结果。第一个因素是新型抗菌药物研发的急剧下降。事实上，许多公司干脆停止了这项研发活动。原因很简单：有足够的抗生素来治疗临床医生所面临的不同类型的感染。第二个因素是耐药菌甚至多药耐药菌的出现和传播。很长一段时间以来，这种情况一直相当保密，几乎是轶事。直到 20 世纪 80 年代末，人们才开始意识到这一点。当时出现了耐万古霉素肠球菌（VRE），以及耐万古霉素 MRSA（耐甲氧西林金黄色葡萄球菌）的威胁。此后，人们重新产生了兴趣，但仅限于抗革兰氏阳性菌的抗菌药物。如今，威胁来自 GNB，我们没有具有创新作用机制的新分子来有效地对抗这些细菌。然而，与抗菌药物耐药性的斗争并未失败。我们必须继续战斗，这需要更好地了解抗感染药物的作用机制，同时了解感染性疾病的耐药机制。
