State Key Laboratory for Diagnosis and Treatment of Infectious Diseases; Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, the First Affiliated Hospital of Medical School, College of medicine, Zhejiang University, Hangzhou, People's Republic of China.
Emerg Microbes Infect. 2024 Dec;13(1):2317915. doi: 10.1080/22221751.2024.2317915. Epub 2024 Feb 23.
The escalation of antibiotic resistance and the diminishing antimicrobial pipeline have emerged as significant threats to public health. The ESKAPE pathogens - Enterococcus faecium, Staphylococcus aureus, Klebsiella pneumoniae, Acinetobacter baumannii, Pseudomonas aeruginosa, and Enterobacter spp. - were initially identified as critical multidrug-resistant bacteria, demanding urgently effective therapies. Despite the introduction of various new antibiotics and antibiotic adjuvants, such as innovative β-lactamase inhibitors, these organisms continue to pose substantial therapeutic challenges. People's Republic of China, as a country facing a severe bacterial resistance situation, has undergone a series of changes and findings in recent years in terms of the prevalence, transmission characteristics and resistance mechanisms of antibiotic resistant bacteria. The increasing levels of population mobility have not only shaped the unique characteristics of antibiotic resistance prevalence and transmission within People's Republic of China but have also indirectly reflected global patterns of antibiotic-resistant dissemination. What's more, as a vast nation, People's Republic of China exhibits significant variations in the levels of antibiotic resistance and the prevalence characteristics of antibiotic resistant bacteria across different provinces and regions. In this review, we examine the current epidemiology and characteristics of this important group of bacterial pathogens, delving into relevant mechanisms of resistance to recently introduced antibiotics that impact their clinical utility in China.
抗生素耐药性的升级和抗菌药物研发管线的枯竭已成为公共卫生的重大威胁。ESKAPE 病原体——屎肠球菌、金黄色葡萄球菌、肺炎克雷伯菌、鲍曼不动杆菌、铜绿假单胞菌和阴沟肠杆菌——最初被确定为关键的多重耐药菌,迫切需要有效的治疗方法。尽管引入了各种新型抗生素和抗生素佐剂,如创新的β-内酰胺酶抑制剂,但这些生物体仍然构成了重大的治疗挑战。中国作为一个面临严重细菌耐药形势的国家,近年来在抗生素耐药菌的流行、传播特征和耐药机制方面发生了一系列变化和发现。人口流动水平的提高不仅塑造了中国内部抗生素耐药流行和传播的独特特征,也间接地反映了全球抗生素耐药传播的模式。此外,作为一个幅员辽阔的国家,中国不同省份和地区的抗生素耐药水平和耐药菌流行特征存在显著差异。在这篇综述中,我们研究了这组重要细菌病原体的当前流行病学和特征,深入探讨了影响其在中国临床应用的新型抗生素耐药相关机制。