Goneau Lee W, Delport Johannes, Langlois Luana, Poutanen Susan M, Razvi Hassan, Reid Gregor, Burton Jeremy P
Department of Microbiology and Immunology, Western University, London, Ontario, Canada.
Lawson Health Research Institute, 268 Grosvenor St, London, Ontario, N6A 4V2 Canada.
FEMS Microbes. 2020 Oct 17;1(1):xtaa004. doi: 10.1093/femsmc/xtaa004. eCollection 2020 Sep.
The administration of antibiotics while critical for treatment, can be accompanied by potentially severe complications. These include toxicities associated with the drugs themselves, the selection of resistant organisms and depletion of endogenous host microbiota. In addition, antibiotics may be associated with less well-recognized complications arising through changes in the pathogens themselves. Growing evidence suggests that organisms exposed to antibiotics can respond by altering the expression of toxins, invasins and adhesins, as well as biofilm, resistance and persistence factors. The clinical significance of these changes continues to be explored; however, it is possible that treatment with antibiotics may inadvertently precipitate a worsening of the clinical course of disease. Efforts are needed to adjust or augment antibiotic therapy to prevent the transition of pathogens to hypervirulent states. Better understanding the role of antibiotic-microbe interactions and how these can influence disease course is critical given the implications on prescription guidelines and antimicrobial stewardship policies.
抗生素的使用虽然对治疗至关重要，但可能会伴随潜在的严重并发症。这些并发症包括与药物本身相关的毒性、耐药菌的产生以及内源性宿主微生物群的耗竭。此外，抗生素可能与病原体自身变化引起的较难识别的并发症有关。越来越多的证据表明，接触抗生素的微生物可通过改变毒素、侵袭素、黏附素以及生物膜、耐药性和持续性因子的表达做出反应。这些变化的临床意义仍在探索中；然而，使用抗生素治疗可能会无意中导致疾病临床病程恶化。需要努力调整或加强抗生素治疗，以防止病原体转变为高毒力状态。鉴于其对处方指南和抗菌药物管理政策的影响，更好地理解抗生素与微生物相互作用的作用以及这些相互作用如何影响疾病进程至关重要。
