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细菌耐药性产生的原因_机制及防治措施_赵明秋.pdf

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1、% ) 00 3ya#n u l, +Z , ,D, ;,( 2 jr, B- = V h ) B- =7 P0 rb V 8 ( B,2002)b , f| ) 3 F 3 , V e F )0s0 t F ) Ay, P T8 T v,V7 % )Tb3.2 细菌体内抗菌药物作用的靶位结构改变,使之不与抗菌药物结合 F 3 % )TM% ) F0Bob F 3 YVT+sA1%Fs% ) 3NbNFsM VE0?T,y7 P% )0 3 F0b V F0,“% )823SFwJ, P0 ?% ) b3. 3 形成代谢颉颃剂与药物争夺靶酶 % ) VYV4 9F F )0T, $ o ) 0

2、Q(,traNtraG s8 )W 1, ? 3DNA.; traYatraZy(+Y = ) P DNA g , traMatraI5 P g 5c y3cYV ) b5 s8 ) =, DNAMb ESBLs d ,1 V )88Mb SHV-12 ESBLs vl614 kb ld k X u ).l,. kTV ,l ? )tra :“d %M s8 )-v )K-12 =,i Phoah J w 2 F0,CV0(Tn)0(Int) , VM+ yDNA b“ -$ 00y W 8WM# 1 b4.2 转座子( transpon) V0 By0, ? M ,z ?1y, 00y, B

3、V2kbb “ -XV040,ISy0aTnAV0BtB V0,X?CV0v 001bV0 ?7I Q_ ( in-verted repeat, IR), IRWc31 ?y: tnpAy3I V , ?+s MYTn# s8 DNA , PTn ; tnpRyI tnpAy c tnpRy cE3 ?; y % ) F0# t y0b “ -X?CAaBaCaDFB- = y V0 ,TEMESBLs 8 TEM-1/2I yTn1 Tn3y b4. 3 细菌基因盒- 整合子系统与细菌耐药性 %) 00 M 6 00 y .l M X“5 %h 45,% )Kn F uh ) 00( Nie

4、derman,2003) ; 7 S ;1 F )0 I n/+Z y :Tah )MICar 1i ? (L ,2004) ; # HM “S ; F )0b5. 5 严格执行消毒隔离制度 h = 00 ) 1n ,h 00 ) 5 ,D h1, I,i m 3, = 00 ).lb5. 6 建立细菌耐药监测网 g ua1nh ) F )0 00M %, “5 F )04 Ib5. 7 研制开发新型抗菌药物 “ -1 f ) ? F )0 ) aSynercidb5. 8 破坏耐药基因 “yFZ,?C 00y V P% ) F )0, “ -Nb6 00 ).l6. 1 建立细菌耐药监测系统

5、 00 )B V uaSEW .lbyN,y uaSE .S=W% ) 00S , ?# H?Ci e 00 ).l( ,2005)b120 W90 M 7Z% ) 00S , v B m ,% )k 9A4,0 kZES, 00S 5 9 LC b “ - 00Si“ 00S “5C, 00ST “5 rB5,B( , 2005)b6. 2 加强教育和宣传 F )0 P,“ - D 3y, Y CD0 M,#180#%hS $ uD 2011 M38 5 F )0 . ,9 B1ybM1 1 s? 8 ,| P F )0 M_.b 1 s? 8 , n51 8Z .,4 8 P F )0 M

6、,P ? .r S,V74 X P F )0i M,V 3 F )0 5b ID1 , d ,E/.% )y-0“d% ) 00J.S u h, 2005, 21(1): 85 88.2 ,I b.= S% ) 00 F 0 “5 p1J.D, 2003, 83(5): 362 364.3 L ,f + .S% ) 00Si+5J._D, 2004, 27(1): 56.4 , +).% ) 00 e J. 2D,2005, 14(1): 77 79.5 .% ) F )0 % ) 00SJ. S Ll, 2005, 10(5): 23 25.6 B, .% ) 00S F M.: +D, 2

7、002, 26 45.7 , ,.% ) 00# e J.S $ uD, 2005, 32(11): 52 53.8 a. % ) 00J.D , 2004, 31(21): 46 47.9 .% ) 00CJ.SD 3s,2000, 23(1): 24 26.10 Cantn R, Novais A, Valverde A, et al. Prevalence and spread ofextended-spectrum beta-lactamase-producing Enterobacteriaceaein EuropeJ. Clin Microbiol Infect, 2008, 14

8、(Suppl 1): 144153.11 Dunbar L M. Current issues in the management of bacterial re-spiratory tract disease: the challenge of antibacterial resistanceJ. Am J Med Sci, 2003, 326(6):360 368.12 Leclercq R. Safeguarding future antimicrobial options: strategiesto minimize resistance J. Clin M icrobiol Infe

9、ct, 2001, 7: 1823.13 Martinezo-Freijo P, Fluit A C, et al. Class integrons in gram-negativeisolates from different European hospital and associationwith decreased susceptibility to multiple antibiotic compoundsJ. J Antimicrob Chemother, 1998,42(6): 689 696.14 McKeegan K S, Borges-Walmsley M I, Walms

10、ley A R. Thestructure and function of drug pumps: an updateJ. TrendsMicrobiol, 2003, 11(1): 21 29.15 Niederman M S. Appropriate use of antimicrobial agents: chal-lenges and strategies for improvementJ. Crit Care Med, 2003,31(2): 608 616.16 Poly M C, Denis F, Courvalin P, et al. M olecular characteri

11、zationof integrons in A cinetobacter baumannii: description of a hybridclass 2 integron J. Antimicrobial Agents and Chemotherapy,2000, 44(10): 2684 2688.17 Ross S, Rodroguez W, Controni G, et al. Staphylococcal suscep-tibility to penicillin G: The changing pattern among communityisolatesJ. JAMA, 197

12、4, 229(8): 1075 1077.TheCauses, MechanismandPreventiveMeasuresof BacterialResistanceZHAO Ming-qiu, SHEN Ha-i yan, PAN Wen, WANG Jia-ying, LI Yin-guang, CHANG Yan(College of Veterinary Medicine, South China Agricultural U niversity, Guangzhou 510642, China)Abstract: With the advent of penicillin in t

13、he 1940s an era of antibiotics was started, ant-i infection treatment thus entereda new era, the mortality rate of infectious diseases decreased dramatically. For a half century, humans have always consideredantibacterial drugs as the most powerful weapon of ant-i infection treatment. However, with

14、thewideapplication of antimicrob-ial agents, the treatment of infectious diseases also meet the new challenges-bacterial resistance to antibiotics, which becomemore serious as the usage of antimicrobial is increased. Currently some bacteria have been found susceptible to almost all theantimicrobial

15、agents, theappearance of super bacteriamay bring humans back to the dilemma of no medicine for infectious dis-eases, so the control of the increase of bacterial resistancehas becomeurgent for medicine and humankind. Our country is grad-ually building our own monitoring network of bacterial resistance, monitoring of the current epidemic status and trends of bac-teria resistant, studying on the mechanism of bacteria resistant.Keywords: bacteria; drug resistance; prevention 5 _ m6 35,5 s_6 34, , h :100193 S j S $ uD 5S $ uD6I lb#181#S $ uD 2011 M38 5 %h

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