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抗生素耐药性的紧急危机:21 世纪无声的大流行病威胁。

Emergent crisis of antibiotic resistance: A silent pandemic threat to 21 century.

机构信息

Institute of Industrial Biotechnology, Government College University, Lahore, 54000, Pakistan.

Institute of Industrial Biotechnology, Government College University, Lahore, 54000, Pakistan.

出版信息

Microb Pathog. 2023 Jan;174:105923. doi: 10.1016/j.micpath.2022.105923. Epub 2022 Dec 13.

DOI:10.1016/j.micpath.2022.105923
PMID:36526035
Abstract

Antibiotic resistance has become an indispensably alarming menace to the global community. The primary factors are overuse and abuse of antibiotics, lack of novel medicines under development, the health care industry's focus on profit, and the absence of diagnostic testing prior to the prescription of antibiotics. Additionally, over the past few decades, the main factors contributing to the global spread of antibiotic resistance have been the overuse of antibiotics in livestock and other animals, drug efficacy, development of fewer new vaccines, environmental toxicity, transmission through travel, and lack of funding for healthcare research and development. These factors have accelerated resistance in microorganisms through structural and functional modifications in bacteria such as reduced drug permeability, increased efflux pumps, enzymatic antibiotic modification, and change in drug target, intracellular infection, and biofilm creation. There has been an increase in resistance during the pandemic and among cancer patients due to improper prescriptions. A number of modern therapeutic alternatives have been developed to curb widespread antibiotic resistance such as nanoparticle, bacteriophage, and antimicrobial biochemical approaches. It is high time to explore new alternatives to curtail enormous increase in resistant pathogens which could be an incurable global confrontation. This review highlights the complete insight on the global drivers of resistance along with the modes of action and impacts, finally discussing the latest therapeutic alternatives.

摘要

抗生素耐药性已经成为全球社会不可忽视的威胁。主要原因是抗生素的过度使用和滥用、缺乏新的研发药物、医疗保健行业关注利润以及在开处方抗生素之前缺乏诊断测试。此外,在过去几十年中,导致抗生素耐药性在全球范围内传播的主要因素是在牲畜和其他动物中过度使用抗生素、药物疗效、较少新疫苗的开发、环境毒性、通过旅行传播以及医疗保健研发资金不足。这些因素通过细菌的结构和功能改变(如降低药物通透性、增加外排泵、酶促抗生素修饰和药物靶标改变、细胞内感染和生物膜形成)加速了微生物的耐药性。由于处方不当,大流行期间和癌症患者中耐药性增加。已经开发了许多现代治疗替代方法来抑制广泛的抗生素耐药性,例如纳米颗粒、噬菌体和抗菌生化方法。现在是时候探索新的替代方法来遏制耐药病原体的巨大增长了,这可能是一场无法治愈的全球对抗。这篇综述重点介绍了抗生素耐药性的全球驱动因素以及作用模式和影响的全面见解,最后讨论了最新的治疗替代方法。

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