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碳青霉烯类耐药性及其检测技术综述

A Review of Carbapenem Resistance in and Its Detection Techniques.

作者信息

Caliskan-Aydogan Oznur, Alocilja Evangelyn C

机构信息

Department of Biosystems and Agricultural Engineering, Michigan State University, East Lansing, MI 48824, USA.

Global Alliance for Rapid Diagnostics, Michigan State University, East Lansing, MI 48824, USA.

出版信息

Microorganisms. 2023 Jun 3;11(6):1491. doi: 10.3390/microorganisms11061491.

Abstract

Infectious disease outbreaks have caused thousands of deaths and hospitalizations, along with severe negative global economic impacts. Among these, infections caused by antimicrobial-resistant microorganisms are a major growing concern. The misuse and overuse of antimicrobials have resulted in the emergence of antimicrobial resistance (AMR) worldwide. Carbapenem-resistant (CRE) are among the bacteria that need urgent attention globally. The emergence and spread of carbapenem-resistant bacteria are mainly due to the rapid dissemination of genes that encode carbapenemases through horizontal gene transfer (HGT). The rapid dissemination enables the development of host colonization and infection cases in humans who do not use the antibiotic (carbapenem) or those who are hospitalized but interacting with environments and hosts colonized with carbapenemase-producing (CP) bacteria. There are continuing efforts to characterize and differentiate carbapenem-resistant bacteria from susceptible bacteria to allow for the appropriate diagnosis, treatment, prevention, and control of infections. This review presents an overview of the factors that cause the emergence of AMR, particularly CRE, where they have been reported, and then, it outlines carbapenemases and how they are disseminated through humans, the environment, and food systems. Then, current and emerging techniques for the detection and surveillance of AMR, primarily CRE, and gaps in detection technologies are presented. This review can assist in developing prevention and control measures to minimize the spread of carbapenem resistance in the human ecosystem, including hospitals, food supply chains, and water treatment facilities. Furthermore, the development of rapid and affordable detection techniques is helpful in controlling the negative impact of infections caused by AMR/CRE. Since delays in diagnostics and appropriate antibiotic treatment for such infections lead to increased mortality rates and hospital costs, it is, therefore, imperative that rapid tests be a priority.

摘要

传染病暴发已导致数千人死亡和住院,并对全球经济产生了严重的负面影响。其中,由抗菌药物耐药微生物引起的感染日益令人担忧。抗菌药物的滥用和过度使用已导致全球范围内抗菌药物耐药性(AMR)的出现。耐碳青霉烯类肠杆菌科细菌(CRE)是全球急需关注的细菌之一。耐碳青霉烯类细菌的出现和传播主要是由于编码碳青霉烯酶的基因通过水平基因转移(HGT)迅速传播。这种迅速传播使得在未使用抗生素(碳青霉烯类)的人群或住院但与携带产碳青霉烯酶(CP)细菌的环境和宿主接触的人群中出现宿主定植和感染病例。人们一直在努力区分耐碳青霉烯类细菌和敏感细菌,以便进行适当的感染诊断、治疗、预防和控制。本综述概述了导致AMR出现的因素,特别是CRE,报告它们的地点,然后概述碳青霉烯酶以及它们如何通过人类、环境和食品系统传播。接着,介绍了当前和新兴的AMR检测和监测技术,主要是CRE,以及检测技术中的差距。本综述有助于制定预防和控制措施,以尽量减少碳青霉烯耐药性在人类生态系统中的传播,包括医院、食品供应链和水处理设施。此外,开发快速且经济实惠的检测技术有助于控制AMR/CRE引起的感染的负面影响。由于对此类感染的诊断和适当抗生素治疗的延迟会导致死亡率上升和医院成本增加,因此快速检测必须成为优先事项。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b93a/10305383/9a246b1e167e/microorganisms-11-01491-g001.jpg

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