School of Biomedical Sciences, The University of Western Australia, Crawley, Australia.
Department of Microbiology, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand.
Expert Rev Anti Infect Ther. 2020 Jan;18(1):17-25. doi: 10.1080/14787210.2020.1701436. Epub 2019 Dec 6.
: Antimicrobial resistance (AMR) played an important role in the initial outbreaks of infection (CDI) in the 1970s. ribotype (RT) 017 has emerged as the major strain of in Asia, where antimicrobial use is poorly regulated. This strain has also caused CDI outbreaks around the world for almost 30 years. Many of these outbreaks were associated with clindamycin and fluoroquinolone resistance. AMR and selective pressure is likely to be responsible for the success of this RT and may drive future outbreaks.: This narrative review summarizes the prevalence and mechanisms of AMR in RT 017 and transmission of these AMR mechanisms. To address these topics, reports of outbreaks due to RT 017, epidemiologic studies with antimicrobial susceptibility results, studies on resistance mechanisms found in and related publications available through Pubmed until September 2019 were collated and the findings discussed.: Primary prevention is the key to control CDI. This should be achieved by developing antimicrobial stewardship in medical, veterinary and agricultural practices. AMR is the key factor that drives CDI outbreaks, and methods for the early detection of AMR can facilitate the control of outbreaks.
: 抗生素耐药性(AMR)在 20 世纪 70 年代感染(CDI)的最初爆发中起了重要作用。 核糖体型(RT)017 已成为亚洲地区的主要 菌株,而亚洲的抗生素使用情况没有得到很好的监管。这种菌株也导致了近 30 年来世界各地的 CDI 爆发。这些爆发中有许多与克林霉素和氟喹诺酮耐药性有关。AMR 和选择压力可能是这种 RT 成功的原因,并可能导致未来的爆发。: 本综述总结了 RT 017 中 AMR 的流行情况和机制以及这些 AMR 机制的传播。为了解决这些问题,收集了由于 RT 017 引起的暴发报告、具有抗生素药敏结果的流行病学研究、在 和相关出版物中发现的耐药机制研究,并对研究结果进行了讨论。: 初级预防是控制 CDI 的关键。这可以通过在医疗、兽医和农业实践中制定抗生素管理策略来实现。AMR 是驱动 CDI 爆发的关键因素,早期检测 AMR 的方法可以促进暴发的控制。