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抗菌药物耐药性的最新进展概述

An Overview of the Recent Advances in Antimicrobial Resistance.

作者信息

Oliveira Manuela, Antunes Wilson, Mota Salete, Madureira-Carvalho Áurea, Dinis-Oliveira Ricardo Jorge, Dias da Silva Diana

机构信息

Associate Laboratory i4HB-Institute for Health and Bioeconomy, University Institute of Health Sciences-CESPU, Avenida Central de Gandra 1317, 4585-116 Gandra, Portugal.

UCIBIO-Research Unit on Applied Molecular Biosciences, Translational Toxicology Research Laboratory, University Institute of Health Sciences (1H-TOXRUN, IUCS-CESPU), Avenida Central de Gandra 1317, 4585-116 Gandra, Portugal.

出版信息

Microorganisms. 2024 Sep 21;12(9):1920. doi: 10.3390/microorganisms12091920.

Abstract

Antimicrobial resistance (AMR), frequently considered a major global public health threat, requires a comprehensive understanding of its emergence, mechanisms, advances, and implications. AMR's epidemiological landscape is characterized by its widespread prevalence and constantly evolving patterns, with multidrug-resistant organisms (MDROs) creating new challenges every day. The most common mechanisms underlying AMR (i.e., genetic mutations, horizontal gene transfer, and selective pressure) contribute to the emergence and dissemination of new resistant strains. Therefore, mitigation strategies (e.g., antibiotic stewardship programs-ASPs-and infection prevention and control strategies-IPCs) emphasize the importance of responsible antimicrobial use and surveillance. A One Health approach (i.e., the interconnectedness of human, animal, and environmental health) highlights the necessity for interdisciplinary collaboration and holistic strategies in combating AMR. Advancements in novel therapeutics (e.g., alternative antimicrobial agents and vaccines) offer promising avenues in addressing AMR challenges. Policy interventions at the international and national levels also promote ASPs aiming to regulate antimicrobial use. Despite all of the observed progress, AMR remains a pressing concern, demanding sustained efforts to address emerging threats and promote antimicrobial sustainability. Future research must prioritize innovative approaches and address the complex socioecological dynamics underlying AMR. This manuscript is a comprehensive resource for researchers, policymakers, and healthcare professionals seeking to navigate the complex AMR landscape and develop effective strategies for its mitigation.

摘要

抗菌药物耐药性(AMR)常被视为全球重大公共卫生威胁,需要全面了解其出现、机制、进展及影响。AMR的流行病学态势表现为广泛流行且模式不断演变,多重耐药菌(MDROs)每天都带来新挑战。AMR的最常见潜在机制(即基因突变、水平基因转移和选择性压力)促使新的耐药菌株出现和传播。因此,缓解策略(如抗生素管理计划-ASPs-和感染预防与控制策略-IPCs)强调合理使用抗菌药物和监测的重要性。“同一健康”方法(即人类、动物和环境健康的相互联系)凸显了跨学科合作和整体策略在抗击AMR中的必要性。新型治疗方法(如替代抗菌剂和疫苗)的进展为应对AMR挑战提供了有前景的途径。国际和国家层面的政策干预也推动旨在规范抗菌药物使用的抗生素管理计划。尽管已取得诸多进展,但AMR仍是紧迫问题,需要持续努力应对新出现的威胁并促进抗菌药物可持续性。未来研究必须优先采用创新方法,并解决AMR背后复杂的社会生态动态问题。本手稿为寻求应对复杂AMR形势并制定有效缓解策略的研究人员、政策制定者和医疗保健专业人员提供了全面资源。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5b8c/11434382/8856fe00f23d/microorganisms-12-01920-g001.jpg

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