Aljohni Mamdouh S, Harun-Ur-Rashid Mohammad, Selim Samy
Department of Clinical Laboratory Sciences, College of Applied Medical Sciences, Jouf University, Sakaka, 72388, Saudi Arabia.
Department of Chemistry, International University of Business Agriculture and Technology (IUBAT), Dhaka, 1230, Bangladesh.
Microb Pathog. 2025 Mar;200:107275. doi: 10.1016/j.micpath.2024.107275. Epub 2025 Jan 9.
Antimicrobial resistance (AMR) in Escherichia coli strains, particularly those producing Extended-Spectrum Beta-Lactamase (ESBL) and Carbapenemase (CR-Ec), represents a serious global health threat. These resistant strains have been associated with increased morbidity, mortality, and healthcare costs, as they limit the effectiveness of standard antibiotic therapies. The prevalence of ESBL- and CR-Ec-producing strains continues to rise, driven by the overuse and misuse of antibiotics in healthcare and agricultural settings, and facilitated by global interconnectedness through international travel, trade, and food distribution. This review article examines the molecular mechanisms behind ESBL and CR resistance, focusing on the key genes involved in these processes, such as bla, bla, and bla, and the clinical challenges posed by these strains. Additionally, the public health impact, including the spread of infections in hospital and community environments, is highlighted. The discussion emphasizes the urgent need for improved diagnostic tools, robust surveillance systems, and innovative therapeutic strategies. Emerging treatments, including phage therapy and novel antibiotic combinations, show promise in addressing these challenges and offer potential breakthroughs in combating resistant strains. Lastly, the review calls for stronger antimicrobial stewardship and policy reforms to mitigate the spread of resistant E. coli strains and protect global public health. Effective intervention at multiple levels, from diagnostics to policy, is critical to controlling the threat posed by AMR.
大肠杆菌菌株中的抗菌药物耐药性(AMR),尤其是那些产生超广谱β-内酰胺酶(ESBL)和碳青霉烯酶(CR-Ec)的菌株,对全球健康构成严重威胁。这些耐药菌株与发病率、死亡率的增加以及医疗成本的上升有关,因为它们限制了标准抗生素疗法的有效性。在医疗保健和农业环境中抗生素的过度使用和滥用,以及通过国际旅行、贸易和食品分销的全球互联性,推动了产ESBL和CR-Ec菌株的流行率持续上升。这篇综述文章研究了ESBL和CR耐药背后的分子机制,重点关注这些过程中涉及的关键基因,如bla、bla和bla,以及这些菌株带来的临床挑战。此外,还强调了公共卫生影响,包括在医院和社区环境中的感染传播。讨论强调迫切需要改进诊断工具、强大的监测系统和创新的治疗策略。包括噬菌体疗法和新型抗生素组合在内的新兴治疗方法,在应对这些挑战方面显示出前景,并为对抗耐药菌株提供了潜在的突破。最后,综述呼吁加强抗菌药物管理和政策改革,以减轻耐药大肠杆菌菌株的传播并保护全球公共卫生。从诊断到政策的多层次有效干预对于控制AMR构成的威胁至关重要。