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抗菌耐药性:这一复杂现象背后隐藏着什么?

Antimicrobial Resistance: What Lies Beneath This Complex Phenomenon?

作者信息

Sakalauskienė Giedrė Valdonė, Radzevičienė Aurelija

机构信息

Institute of Physiology and Pharmacology, Medical Academy, Lithuanian University of Health Sciences, LT-44307 Kaunas, Lithuania.

出版信息

Diagnostics (Basel). 2024 Oct 18;14(20):2319. doi: 10.3390/diagnostics14202319.

Abstract

Antimicrobial Resistance (AMR) has evolved from a mere concern into a significant global threat, with profound implications for public health, healthcare systems, and the global economy. Since the introduction of antibiotics between 1945 and 1963, their widespread and often indiscriminate use in human medicine, agriculture, and animal husbandry has led to the emergence and rapid spread of antibiotic-resistant genes. Bacteria have developed sophisticated mechanisms to evade the effects of antibiotics, including drug uptake limitation, drug degradation, target modification, efflux pumps, biofilm formation, and outer membrane vesicles production. As a result, AMR now poses a threat comparable to climate change and the COVID-19 pandemic, and projections suggest that death rates will be up to 10 million deaths annually by 2050, along with a staggering economic cost exceeding $100 trillion. Addressing AMR requires a multifaceted approach, including the development of new antibiotics, alternative therapies, and a significant shift in antibiotic usage and regulation. Enhancing global surveillance systems, increasing public awareness, and prioritizing investments in research, diagnostics, and vaccines are critical steps. By recognizing the gravity of the AMR threat and committing to collaborative action, its impact can be mitigated, and global health can be protected for future generations.

摘要

抗菌药物耐药性(AMR)已从一个单纯令人担忧的问题演变成一个重大的全球威胁,对公共卫生、医疗系统和全球经济产生深远影响。自1945年至1963年抗生素问世以来,它们在人类医学、农业和畜牧业中的广泛使用且往往是滥用,导致了抗生素耐药基因的出现和迅速传播。细菌已经发展出复杂的机制来逃避抗生素的作用,包括药物摄取限制、药物降解、靶点修饰、外排泵、生物膜形成和外膜囊泡产生。因此,AMR现在构成的威胁可与气候变化和新冠疫情相提并论,预测表明,到2050年,每年的死亡率将高达1000万,同时还将带来超过100万亿美元的惊人经济成本。应对AMR需要采取多方面的方法,包括开发新抗生素、替代疗法,以及在抗生素使用和监管方面进行重大转变。加强全球监测系统、提高公众意识,以及优先投资于研究、诊断和疫苗是关键步骤。通过认识到AMR威胁的严重性并致力于采取合作行动,可以减轻其影响,并为子孙后代保护全球健康。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9da1/11506786/6486157f36a1/diagnostics-14-02319-g001.jpg

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