本帖最后由 焚膏继晷 于 2016-5-30 19:55 编辑
无药可救？！首例“超级细菌” ？！2016-05-30 SIFIC热点团队 SIFIC官微
超级细菌来袭 并非全球首例 2015年11月，我国首次报告在牲畜和人身上发现了带MCR-1基因的细菌，引起全球高度关注。此后，欧盟与加拿大也相继发现了带有这种基因的细菌。截至目前，全球已有28个国家宣布发现了携带MCR-1基因的细菌。 并非“超级细菌” MCR-1是一种可以让细菌对黏菌素产生抗药性的新基因，倘若一个携带MCR-1的细菌又有其他的耐药基因，并对所有药物耐药，那么就可能真的无药可用，成为名副其实的超级耐药菌。 并非无药可救 美国的首例mcr-1耐药菌，其E.coli MRSN 388634并非对所有抗生素都不敏感，比如它的质粒上就没有发现碳青霉烯酶。所以，使用碳青霉烯类抗生素治疗是有效的。真正无药可救的“超级细菌”的数量极其有限，大家不必过度恐慌。
热点小组为您带来最详尽解读→ First US Case of E.coli Resistant to Last-Resort Antibiotic 美国首现最强抗生素耐药的大肠杆菌 作者：Robert Lowes罗伯特·洛斯 检索：唐文瑞 翻译：唐文瑞、陈志锦 编写：陈志锦 审核：唐文瑞、臧金成、陈志锦
Researchers have spotted the first known instance of bacteria impervious to the last-resort antibiotic colistin in the United States, exacerbating fears of superbugs that can turn an ordinary infection deadly. 在美国，研究人员发现了首例最强抗生素—粘菌素也无效的细菌，这种超级细菌可能加剧普通感染致命性的担忧。 The case involves a 49-year-old woman treated at a clinic in April for a urinary tract infection. A urine culture revealed a strain of Escherichia coli that was later found to be resistant to colistin. The findings were published online today in Antimicrobial Agents and Chemotherapy. 这个病例来源于今年4月份，一名49岁的女子因尿路感染前往一家诊所治疗，其尿培养分离到的大肠杆菌对粘菌素有耐药性，这一发现发表在《抗菌剂和化疗》在线版期刊上。 In a speech at the National Press Club today, the head of the Centers for Disease Control and Prevention (CDC) said the study is a call to develop new antibiotics and use them wisely. 今日，在全国记者俱乐部的演讲中，疾病预防与控制中心的主任表示，这项研究呼吁我们开发并合理使用抗生素。 "The medicine cabinet is empty for some patients," said CDC Director Thomas Frieden, MD, MPH. "It is the end of the road for antibiotics unless we act urgently." CDC的主任托马斯·弗里登博士说：“对于有些病人，已无药可救，抗生素的使用也已走到尽头，除非我们立即采取措施。” What is even more alarming about the case of the Pennsylvania woman is that the E coli became resistant to colistin not through mutation, but by acquiring a snippet of DNA called a plasmid that carries the resistance-conferring gene. Such plasmids easily spread from bacterium to bacterium. 关于宾夕法尼亚这位妇女的病例，更让我们担忧的是，大肠杆菌对粘菌素耐药不是因为突变，而是获得了被称为携带耐药基因质粒的一个DNA片段，这种质粒很容易在细菌间相互传播。 "The recent discovery of a plasmid-borne colistin-resistance gene, mcr-1, heralds the emergence of truly pan-drug resistant bacteria," write the authors, all associated with Walter Reed National Military Medical Center in Maryland. 所有马里兰沃尔特·里德国家军事医疗中心的作者联合阐述：“最近，质粒传播的耐粘菌素基因mcr-1的发现，预示着真正的泛耐药细菌的出现。” Although the authors say this is the first report of mcr-1 in the United States, the colistin-resistance gene has surfaced in bacteria in other countries, notably China.
尽管研究者称这是mcr-1基因在美国的首例报道，但是耐粘菌素基因的细菌在其他国家已经浮出水面，尤其是中国。 The Pennsylvania woman had not reported any travel during the previous 5 months. The study does not describe her current condition. 在过去的5个月内，宾夕法尼亚这名女子没有任何旅游史，该研究没有描述她目前的状况。 "Continued surveillance to determine the true frequency for this gene in the USA is critical," the authors write. 作者写道：“现在最要紧的是，持续监测以确定美国这种基因出现的真正频率。” In his speech today, Dr Frieden described colistin as the only antibiotic left "for what I call the nightmare bacteria, carbapenem-resistant enterobacteriaceae (CRE)." 弗里登博士在今天演讲中，描述粘菌素为“被称为噩梦细菌—耐碳青霉烯肠杆菌”的最后唯一防线。 It turns out that the Pennsylvania woman''s infection was not resistant to carbapenem antibiotics, another CDC official told Medscape Medical News. However, Christopher Braden, MD, deputy director of the agency's National Center for Emerging and Zoonotic Infectious Diseases, warned that the plasmid-borne colistin-resistance gene could transfer to CRE or any other superbug, making them deadlier. CDC另一位负责人告诉Medscape医学新闻，原来宾夕法尼亚女子的感染并不是对碳青霉烯类抗生素耐药。尽管如此，国家新发和动物传染病中心的副主任克里斯多夫·布雷登博士警告说，质粒传播的耐粘菌素基因可以转移为耐碳青霉烯肠杆菌或者任何其他超级细菌，从而致命。 The CDC and the US Department of Defense are working with the Pennsylvania Department of Health (DPH) to investigate the case of colistin-resistant E coli, according to a DPH news release. The DPH said that state law prevents it from disclosing specific details about the inquiry or the patient. 据宾夕法尼亚卫生部新闻报道，CDC和美国国防部正与宾夕法尼亚卫生部门合作，调查耐粘菌素大肠杆菌病例。宾夕法尼亚卫生部门表示，本州法律禁止泄露有关调查或患者的具体细节。 Antimicrob Agents Chemother. Published online May 26, 2016. 2016年5月26日发表在《抗菌剂和化疗》在线版期刊上。 摘自：http://www.medscape.com/viewarticle/863896 图文编辑：那颜 审稿：孙庆芬 赵静
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