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您搞清楚超级细菌 NDM-1,究竟是怎么回事吗?

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发表于 2010-8-15 02:24 | 显示全部楼层 |阅读模式
感觉媒体的力量很强大。

NDM-1,并不是一种新的细菌,而是细菌如大肠杆菌、克雷伯杆菌等普通细菌,携带了耐药基因。这个基因,是一种金属酶,β-内酰胺酶的一种。携带这种酶的细菌,将对青霉素类、头孢菌素类和碳青霉烯类等抗菌药物耐药。NDM-1的全称是:New Delhi metallo-β-lactamase 1 (NDM-1),即新德里金属β内酰胺酶-型。因为最先从印度检出并报告,所以以新德里命名。但是印度不开心,担心影响声誉和旅游业。

下面是该杂志刊登的原文摘要。

The Lancet Infectious Diseases, Early Online Publication, 11 August 2010

doi:10.1016/S1473-3099(10)70143-2 Cite or Link Using DOI

Emergence of a new antibiotic resistance mechanism in India, Pakistan, and the UK: a molecular, biological, and epidemiological study

Original Text

Karthikeyan K Kumarasamy MPhil a, Mark A Toleman PhD b, Prof Timothy R Walsh PhD b

, Jay Bagaria MD c, Fafhana Butt MD d
, Ravikumar Balakrishnan MD c, Uma Chaudhary MD e, Michel Doumith PhD c, Christian G Giske MD f
, Seema Irfan MD g
, Padma Krishnan PhD a
, Anil V Kumar MD h
, Sunil Maharjan MD c, Shazad Mushtaq MD c, Tabassum Noorie MD c, David L Paterson MD i
, Andrew Pearson PhD c, Claire Perry PhD c, Rachel Pike PhD c, Bhargavi Rao MD c, Ujjwayini Ray MD j
, Jayanta B Sarma MD k
, Madhu Sharma MD e
, Elizabeth Sheridan PhD c, Mandayam A Thirunarayan MD l
, Jane Turton PhD c, Supriya Upadhyay PhD m
, Marina Warner PhD c, William Welfare PhD c, David M Livermore PhD c, Neil Woodford PhD c

Summary


Background

Gram-negative Enterobacteriaceae with resistance to carbapenem conferred by New Delhi metallo-β-lactamase 1 (NDM-1) are potentially a major global health problem. We investigated the prevalence of NDM-1, in multidrug-resistant Enterobacteriaceae in India, Pakistan, and the UK.

Methods

Enterobacteriaceae isolates were studied from two major centres in India—Chennai (south India), Haryana (north India)—and those referred to the UK's national reference laboratory. Antibiotic susceptibilities were assessed, and the presence of the carbapenem resistance gene blaNDM-1 was established by PCR. Isolates were typed by pulsed-field gel electrophoresis of XbaI-restricted genomic DNA. Plasmids were analysed by S1 nuclease digestion and PCR typing. Case data for UK patients were reviewed for evidence of travel and recent admission to hospitals in India or Pakistan.

Findings

We identified 44 isolates with NDM-1 in Chennai, 26 in Haryana, 37 in the UK, and 73 in other sites in India and Pakistan. NDM-1 was mostly found among Escherichia coli (36) and Klebsiella pneumoniae (111), which were highly resistant to all antibiotics except to tigecycline and colistin. K pneumoniae isolates from Haryana were clonal but NDM-1 producers from the UK and Chennai were clonally diverse. Most isolates carried the NDM-1 gene on plasmids: those from UK and Chennai were readily transferable whereas those from Haryana were not conjugative. Many of the UK NDM-1 positive patients had travelled to India or Pakistan within the past year, or had links with these countries.

Interpretation

The potential of NDM-1 to be a worldwide public health problem is great, and co-ordinated international surveillance is needed.

Funding

European Union, Wellcome Trust, and Wyeth.

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参与人数 1 +10 威望 +2 金币 +10 收起 理由
茶韵幽香 + 10 + 2 + 10 非常及时的资料,辛苦了!

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 楼主| 发表于 2010-8-15 02:32 | 显示全部楼层
NDM-1 was mostly found among Escherichia coli (36) and Klebsiella pneumoniae (111), which were highly resistant to all antibiotics except to tigecycline and colistin.

NDM-1绝大多数在大肠杆菌和肺炎克雷伯菌中发现。对除了替加环素和多粘菌素以外的抗生素,高度耐药。

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 楼主| 发表于 2010-8-15 02:40 | 显示全部楼层

英国及美国等国家相继发现由印度传入的新型抗生素耐药性超级恶菌NDM-1,却原来香港早在去年10月已经发生一宗病例,但香港卫生防护中心到了12日,即事发10个月后才予以证实。感染到这种几乎是无药可治的末日细菌,是一名曾向普通科门诊求诊的印度男子,他被证实感染带有该抗药基因的大肠杆菌。

香港卫生署表示,正与英国卫生部门了解情况,呼籲市民做好个人卫生措施。有微生物学专家促请政府加强监察曾在印度、巴基斯坦和英国入住医院的入境人士。也有专家家表示,恶菌入血更可夺命。

这种源自南亚国家的抗药基因名为NDM-1,即新德里金属β-内酰胺酶1。该基因一旦依附在细菌上,会令细菌出现严重抗药性,甚至最后防线的碳氢黴烯类及滭内胺抗生素也无药效,变成无药可治。

全球首宗个案,是前年在一名瑞典病人身上发现,该病人曾在印度新德里的医院接受治疗。这种末日细菌起源于印度及巴基斯坦,令不少当地病人出现尿道炎、肺炎及入血的感染。

末日细菌至今传入最少七个国家,其中美国有3宗,英国有50宗、加拿大有2宗,荷兰及瑞典亦有出现,当中不少病人曾在印度或巴基斯坦入院治疗,如进行整容及器官移植手术。

但根据国际权威《刺针》医学杂志刊登的研究显示,部份病患在印、巴时其实没有入院,然而该杂志没有交代是否在社区感染,这些病患主要感染抗药性大肠杆菌及克雷伯氏肺炎菌。

在香港出现的病例,患者是一名66岁印度男子,他去年10月在公立医院普通科门诊求诊,其尿液样本显示带有含NDM-1的大肠杆菌。但该男子服食常用于治疗尿道炎的抗生素后已康复。但该中心未能解释为何病人早于去年求诊,但相隔10个月才公布结果,亦未有交代病人家属有否病征等资料。

防护中心表示,正与世界衞生组织跟进事件,会与医院实验室联络,制订加强监测恶菌的安排。中心已去信香港医生,通知他们最新情况,但没要求他们若发现恶菌个案需呈报。

香港大学感染及传染病中心总监何栢良表示,末日细菌相信已杀入社区,可能于过去10个月已静悄悄在香港扩散,并已传入零星个案。该菌传播速度非常快,因大部份人只是带菌而没有病发,在没有药可治疗下,恶菌不断在社区传播。抗药基因NDM-1可依附在不同细菌上,现时最常见是大肠杆菌家族,可引致病人出现尿道炎;手术后感染恶菌更可引致血中毒或败血症而致命,如果依附在其他细菌身上,无药可医的恶菌便会越来越多。

病人病征主要视乎感染细菌的种类,如感染带有NDM-1的大肠杆菌可引致尿道炎,病人会尿频及尿急等。抗药大肠杆菌可透过口粪传播,如病人如厕后没有洗手再煮食,其他人进食受污染的食物后就会受感染。

何栢良表示,政府应该趁末日细菌仍然未落地生根,重新评估形势以及制订预防措施。该菌主要透过医疗旅游传播,玛丽医院去年起实施监察机制,若病人曾经在海外入住医院,玛丽会为病人测试是否带有抗药恶菌,如社区感染抗药性金黄葡萄球菌或抗万古霉素大肠杆菌,并会安排带菌病人接受隔离。玛丽医院从13日开始,加入监察病人有否带有NDM-1的抗药恶菌。何栢良认为,措施应在所有的公立医院推行,所需资源不太多,主要视乎管理层的意向。

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 楼主| 发表于 2010-8-15 02:44 | 显示全部楼层

英国科学家发现名为NDM-1的超级细菌,图为英网路杂志The First Post 报导此研究(http://www.thefirstpost.co.uk/

医疗旅游感染超级细菌 澳增3例 印度否认



一种能抵抗药物的“超级细菌”,在数十名英国赴印度民众被感染之后,今天传出3名曾前往印度的澳洲民众也受到感染,港媒也披露去年10月香港曾发生首宗案例,加拿大也传出2例,比利时2例。这对印度日渐兴盛的医疗旅游而言,无疑是一项打击,印度当局对此研究感到相当不悦。

澳洲新增3名病例 根据中央社报导,澳洲的坎培拉医院感染科主任柯利格侬(Peter Collignon)8月13日证实有3名曾前往印度的澳洲民众已受到感染。其中包括一名赴孟买(Mumbai)接受美容手术的案例。柯利格侬说:“我们在患者尿液中检测出这种具多重抗药性、无法治疗的超级细菌,所幸对他们没有造成太大问题。” 他担心这可能只是冰山一角,柯利格侬接受法新社访问时表示:“由于除非进行非常复杂的检验,否则无法检出这个特定的基因,因此可能有更多的案例。” 他表示,他的病人在印度一家医院接受美容手术出问题后,在加护病房里被这个细菌感染。但3名患者中也有一人是社区感染,显示问题的严重性。他说可能正有人因此死亡,但由于发生在开发中国家,无法确知它的传播情况。 这种超级细菌中有一种称为NDM-1的酵素,其本身并不是细菌。它是以基因的结构出现,可以在许多不同的细菌中自由复制和移动,从而使这种细菌拥有极强的抗药性,令常见的感染,如大肠杆菌感染成为不治之症。 柯利格侬说,超级细菌是由于在医疗及农业上滥用抗生素所致,例如有些国家的鸡农使用抗生素,透过食物链回到人类身上。柯利格侬同时也是世界卫生组织在抗生素方面的咨询专家。他呼吁世界必须全面严格限制抗生素的使用,以阻止病菌的传播。

英研究:南亚超级细菌透过手术传播 据英国《卫报》报导,医学期刊《刺胳针--传染病》(The Lancet Infectious Diseases)的研究发现,一种新型的“超级细菌”正透过印度的外科治疗传播到英、美、加等先进国家。 这项研究由英国卡迪夫大学的研究员沃尔什(Timothy Walsh)发现,去年首次在一名曾到印度接受手术的瑞典病人身上发现一种特殊的酵素,存活在克雷伯氏肺炎菌(Klebsiella pneumoniae)和大肠杆菌(Escherichiacoli)上,使这些细菌几乎对所有的抗生素产生抵御能力,将此命名为NDM-1(新德里金属β-内醯胺脢1,New Delhi metallo-beta-lactamase)。 该项研究发现37位英国病人中,至少有17人在过去一年中曾经前往印度或巴基斯坦,他们中又至少有14人曾在这两个国家接受包含肾脏移植手术、骨髓移植手术、透析、生产、烧伤治疗或整容手术等治疗。研究显示,携带有NDM-1的大肠杆菌感染,导致病人出现尿路感染和血液中毒。 该研究并提出NDM-1可能蔓延到全球的警告:“除了英国,印度也向其它欧洲国家和美国人提供整形手术。NDM-1超级病菌可能将在全球蔓延。”

医疗旅游渐兴 印斥阴谋 由于印度医疗已具国际水准,但价格仅为已开发国家的十分之一左右,全球每年有数千观光客赴印医疗旅游。但英国科学家公布这项37名感染带有基因细菌患者中,部分是赴印度接受医疗的游客,引发印度当局相当不悦。 印度卫生部昨天深夜发表措词严厉的声明,批评这项报告制造恐慌。该部表示,国际旅游日益普及后,这种细菌可能更广泛流传,但“引据个别病例,将它与在印度医院接受手术安全性作连结,则是错误的”。 《经济时报》(The Economic Times)引述印度医学研究委员会(Indian Council of Medical Research)主委卡图契(V.M. Katoch)说,抗生素无效确实值得顾虑,但就此非难1个国家并不公平,他认为“根本无需恐慌”。 而印度国会有部分议员则愤怒斥之为全球制药业者的阴谋。议员阿许鲁瓦利亚(SS Ahluwalia)表示:“在印度医学旅游市场日渐兴盛时,这种消息非常不幸。它可能是部分跨国公司的恶意栽赃。”

加拿大、香港、比利时各有病例 根据港媒报导,香港卫生署8月12日发布消息指出,早于2009年10月,香港已有首宗感染NDM-1个案,是1名66岁印度裔男子,去年在医管局辖下普通科门诊求诊时,其尿液样本发现带含有NDM-1大肠杆菌。虽然该病患目前已康复。 加拿大卑诗省公共卫生官肯德尔(Perry Kendall)博士说,在卑诗省出现一宗确诊病例,该病例是2010年春天在温哥华总医院的病人身上发现的,他曾去印度整容,目前已经治愈,但没有人知道是否会复发。卡加利大学的皮托特医生说,在亚伯达省也有一人被感染,他建议对在印巴接受治疗,回国的人检查。 比利时报导,该国一名男子受到NDM-1超级病菌感染死亡,他是在巴基斯坦旅行时,因车祸住院治疗后,回国被查出感染超级病菌。比国媒体称,这是该国第二例感染“超级病菌”的病例。

超级细菌NDM-1 英国健康保护署专家利弗莫尔表示,2009年英国就已经出现了NDM-1感染病例的增加,其中包括一些致死病例,而大部分的NDM-1感染者都与曾前往印度等南亚国家旅行或接受当地治疗的人有关。 最严重的是NDM-1超级细菌是以DNA的结构出现,被称为质体。它可以在细菌中自由复制和移动,从而使这种细菌拥有传播和变异的惊人潜能。研究人员说:“空中旅行和移居使这种超级细菌在不同国家和大陆之间迅速传播。其中大多数已经存在这种细菌的国家尚未被发现。” 这种新发现的超级细菌NDM-1生存于大肠杆菌中,是造成尿道感染的主因;该细菌容易复制,并且能转移到其他病菌上。 NDM-1它最早出现在印度、巴基斯坦等南亚国家,后来有不少英美等国的游客前往这些南亚国家接受价格低廉的整形手术,使得这种基因得以传播。 研究人员在印度钦奈市确认了44名患者,在印度哈里亚纳邦确认了26名患者。 英国健康保护署报告指出,到目前为止,这种病菌是通过医院中的病人传染的,现在还没任何万无一失的方法杀死它们。英国卫生部宣布,开始研讨制新抗生素的办法,但是科学家警告说,可能10年内都不会有对NDM-1有效的新的抗生素出现。 有报导称,这种变种基因目前已经传播到英国、美国、加拿大、澳大利亚、荷兰等国家,英国已经出现了5例感染死亡者。 英国卡迪夫大学专家蒂莫西.沃尔什认为,这种病菌将迅速成为全球性问题。因为这种病菌正通过跨国旅游向全球扩散,一旦达到临界点,它将像“萨斯”(SARS)和其他流感病菌那样迅速传播。

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 楼主| 发表于 2010-8-15 02:57 | 显示全部楼层
New Delhi Metallo-beta-lactamase (NDM-1)[1] is a newly-identified enzyme that makes bacteria resistant to broad range of beta-lactam antibiotics. This includes antibiotics of the carbapenem family that were a mainstay for the treatment of other antibiotic-resistant bacteria. The gene for NDM-1 is one member of a large gene family that encode beta-lactamase enzymes called carbapenemases. Bacteria that carry such genes are often referred to in the news media as "superbugs", since infections with these bacteria are very hard to treat successfully. Indeed, the United Kingdom Health Protection Agency has stated that "most isolates with NDM-1 enzyme are resistant to all standard intravenous antibiotics for treatment of severe infections."[2]
NDM-1 was first identified in December 2009 in a patient who was hospitalised in New Delhi with a Klebsiella pneumoniae infection. It has since been detected in bacteria in India, Pakistan, the United Kingdom and the United States. The most common organisms expressing this enzyme are the Gram-negative bacteria Escherichia coli and Klebsiella pneumoniae, but the gene for NDM-1 can be transmitted from one strain of bacteria to another through horizontal gene transfer. The emergence of resistant Gram-negative bacteria is in contrast to the more familiar antibiotic resistant bacteria such as Methicillin-resistant Staphylococcus aureus (MRSA), which are Gram-positive.

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 楼主| 发表于 2010-8-15 02:59 | 显示全部楼层

Function

Structure of the carbapenem backbone.

Carbapenems are a class of beta-lactam antibiotics were, until recently, capable of killing most bacteria by inhibiting the synthesis of one of their cell wall layers. The carbapenems were developed to be less sensitive to inactivation by the beta-lactamase enzymes that had evolved in bacteria resistant to antibiotics such as penicillin. The blaNDM-1 gene produces NDM-1, which is a carbapenemase beta-lactamase - an enzyme that hydrolyzes and inactivates these carbapenem antibiotics.

Carbapenemases are particularly dangerous resistance mechanisms, since they can inactivate a wide range of different antibiotics.[3] The NDM-1 enzyme one of the class B metallo-beta-lactamase, other types of carbapenemase are class A or class D beta-lactamases.[4] The class A Klebsiella pneumoniae carbapenemase (KPC) is currently the most common type of this enzyme, which was first detected in North Carolina, USA, in 1996 and has since spread worldwide.[5] A later publication indicated that Enterobacteriaceae that produce KPC were becoming common in the United States.[6]

The following antibiotics are inactivated by the enzyme:

The resistance conferred by this gene therefore aids the expansion of bacteria that carry it throughout a human host, since they will face less opposition/competition from populations of antibiotic-sensitive bacteria, which will be diminished by the original antibacterial treatment.

Origin and spread

The NDM-1 enzyme was named after New Delhi, the capital city of India, as it was first described by Yong et al. in December 2009 in a Swedish national who fell ill with an antibiotic-resistant bacterial infection that he acquired in India.[7] The infection was unsuccessfully treated in a New Delhi hospital and after the patient's repatriation to Sweden, a carbapenem-resistant Klebsiella pneumoniae strain bearing the novel gene was identified. The authors concluded that the new resistance mechanism "clearly arose in India, but there are few data arising from India to suggest how widespread it is."[7] In March 2010 a study in a hospital in Mumbai found that the majority of carbapenem-resistant bacteria isolated from patients carried the blaNDM-1 gene.[8]

In May 2010 a case of infection with E. coli expressing NDM-1 was reported in Coventry in the United Kingdom.[9] The patient was a man of Indian origin who had visited India 18 months previously, where he had undergone dialysis. In initial assays the bacteria was fully resistant to all antibiotics tested, while later tests found that it was susceptible to tigecycline and colistin. The authors warned that international travel and patients' use of multiple countries' healthcare systems could lead to the "rapid spread of NDM-1 with potentially serious consequences".

As of June 2010, there were three reported cases of Enterobacteriaceae isolates bearing this newly described resistance mechanism in the US, the CDC stated that "All three U.S. isolates were from patients who received recent medical care in India."[10] However, US experts have stated that it is unclear if this strain is any more dangerous than existing antibiotic-resistant bacteria such as methicillin-resistant Staphylococcus aureus, which are already common in the USA.[11]

Structure of colistin, one of the few antibiotics able to treat NDM-1 positive bacterial infections.

In July 2010 a team in New Deli reported a cluster of three cases of Acinetobacter baumannii bearing blaNDM-1 that were found in the intensive care unit of a hospital in Chennai, India in April 2010. As previously, the bacteria were fully resistant to all the aminoglycoside β-lactam and quinolone antibiotics, but were susceptible to tigecycline and colistin. This particularly broad spectrum of antibiotic resistance was heightened by the strain bearing expressing several different resistance genes in addition to blaNDM-1.[12]

A study by a multi-national team was published in the August 2010 issue of the journal The Lancet Infectious Diseases. This examined the emergence and spread of bacteria carrying the blaNDM-1 gene. This reported on 37 cases in the United Kingdom, 44 isolates with NDM-1 in Chennai, 26 in Haryana and 73 in various other sites in Pakistan and India.[1] The authors' analysis of the strains showed that many carried blaNDM-1 on plasmids, which will allow the gene to be readily transferred between different strains of bacteria by horizontal gene transfer. All the isolates were resistant to multiple different classes of antibiotics, including beta-lactam antibiotics, fluoroquinolones, and aminoglycosides, but most were still susceptible to the polymyxin antibiotic colistin.

In early August 2010 a chemical compound, GSK-299423, was found to significantly fight against antibiotic-resistant bacteria by making such bacteria unable to reproduce, citing a likely treatment to the NDM-1 strain.[13][14][15][16]

Indian response

The Indian health ministry has disputed the conclusion of the August 2010 Lancet study that the gene originated in India or Pakistan, describing this conclusion as "unfair" and stating that Indian hospitals are perfectly safe for treatment.[17] Indian politicians have described linking this new drug resistance gene to India as “malicious propaganda” and blamed multinational corporations for what they describe as selective malignancy.[17][18] A Bharatiya Janata Party politician has instead argued that the journal article is bogus and represented an attempt to scare medical tourists away from India.[19] The Indian Ministry of Health released a statement "strongly refut[ing]" naming the enzyme "New Delhi".[20] The primary author of the 2010 Lancet study, who is based in the University of Madras, has stated that he does not agree with the part of the article that advises people to avoid elective surgeries in India.[21]

In contrast, an editorial in the March 2010 issue of the Journal of Association of Physicians of India blamed the emergence of this gene on the widespread misuse of antibiotics in the Indian healthcare system, stating that Indian doctors have "not yet taken the issue of antibiotic resistance seriously" and noting little control over the prescription of antibiotics by doctors and even pharmacists.[22] The Times of India states that there is general agreement among experts that India needs both an improved policy to control the use of antibiotics and a central registry of antibiotic-resistant infections.[21]

See also

References

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 楼主| 发表于 2010-8-15 03:05 | 显示全部楼层

Q&A: NDM-1 superbugs

By Michelle Roberts Health reporter, BBC News

NDM-1 is carried by Gram-negative bacteria like Klebsiella

Experts have warned that a new type of drug-resistant superbug is emerging in UK hospitals.

Q: What is NDM-1?

New Delhi metallo-ß-lactamase-1, or NDM-1 for short, is a gene carried by bacteria that makes the strain resistant to carbapenem antibiotics. This is concerning because these antibiotics are some of the most powerful ones, used on hard-to-treat infections that evade other drugs.

Q: Why is this a problem?

NDM-1 (or more precisely the DNA code for this enzyme) can easily now jump from one strain of bacteria to another.

Experts are worried that it may end up in another bacterium which is already resistant to many other antibiotics.

Ultimately, it could produce dangerous infections that would spread rapidly from person to person and be almost impossible to treat.

Q: Can it be treated?

Other treatment options are available to fight these infections but they present major challenges for clinicians and will often demand combinations of antibiotics are used.

Scientists have identified some strains that have been resistant to all known antibiotics.

Q: How would I know if I had it?

So far, many of the UK cases have been in patients who have recently travelled to India or Pakistan for medical treatment and who caught the infection while there.

But, some of these patients have passed the infection on to others in UK hospitals upon their return.

The infections have ranged from mild to severe - and some have been fatal.

Two types of bacteria have been host to NDM-1: the gut bacterium E.coli and another that can invade the lungs called Klebsiella pneumonia. Both can lead to urinary tract infections and blood poisoning.

Infections such as these would usually be spotted in patients by medics.

Q: Can its spread be stopped?

Experts say the way to stop it is through surveillance, rapid identification and isolation of any hospital patients who are infected.

Normal infection control measures, such as disinfecting hospital equipment and doctors and nurses washing their hands with antibacterial soap, can stop the spread.

NDM-1 is already widespread in the Indian subcontinent and has also reached countries including the US, Canada, Australia and the Netherlands. Scientists believe it has the potential to become a global public health issue.

And they say we now need new drugs to treat resistant strains.

Q: Are there new antibiotics that could help?

While there is a great deal of investment in research to find new antibiotics, experts say that most of the drugs currently in the pipeline will be useless for treating NDM-1 positive patients.

This is because the bacteria that carry NDM-1 are Gram-negative, while most of the work is being carried out for Gram-positive bugs like MRSA.

The Health Protection Agency says "multi-resistant Gram-negative bacteria pose a notable public health risk and it remains important that the pharmaceutical industry continues to work towards developing new treatment options".

The Department of Health said it was investigating ways of encouraging the development of new antibiotics with European colleagues.

Q: What will happen now?

The government said HPA would continue to monitor the situation and would regularly review the data and the need for further action.

In the meantime, hospitals should ensure they continue to provide good infection control to prevent any spread, and consider whether patients have recently been treated abroad and send samples to HPA for testing if necessary.

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 楼主| 发表于 2010-8-15 03:09 | 显示全部楼层

Q: Can its spread be stopped?

Experts say the way to stop it is through surveillance, rapid identification and isolation of any hospital patients who are infected.

Normal infection control measures, such as disinfecting hospital equipment and doctors and nurses washing their hands with antibacterial soap, can stop the spread.

NDM-1 is already widespread in the Indian subcontinent and has also reached countries including the US, Canada, Australia and the Netherlands. Scientists believe it has the potential to become a global public health issue.

And they say we now need new drugs to treat resistant strains.

如何阻断传播?

监测、快速鉴定和隔离

普通感控措施,如消毒医疗设备、医生和护士用抗菌皂液洗手。


NDM-1是坏消息,但对促进感控工作,无疑是一次良好的机会。

  • TA的每日心情
    开心
    2020-12-5 08:05
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    [LV.10]以坛为家III

    发表于 2010-8-15 06:22 | 显示全部楼层
    回复 8# icchina

    我也在昨天看了新闻报道,当时的反应是院感人的机会来了,抓住机遇是关键,好好学习,感谢您及时提供详细资料,您的专注和用心让人感动!谢谢您!
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    慵懒
    2020-11-16 08:45
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    [LV.8]以坛为家I

    发表于 2010-8-15 07:13 | 显示全部楼层
    又一场人与细菌大战的到来!
  • TA的每日心情
    慵懒
    2020-11-16 08:45
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    [LV.8]以坛为家I

    发表于 2010-8-15 07:16 | 显示全部楼层
    NDM-1绝大多数在大肠杆菌和肺炎克雷伯菌中发现。对除了替加环素和多粘菌素以外的抗生素,高度耐药。监测、快速鉴定和隔离

    普通感控措施,如消毒医疗设备、医生和护士用抗菌皂液洗手。

    非常感谢胡教授提供的资料!

    该用户从未签到

    发表于 2010-8-15 07:42 | 显示全部楼层
    昨天中央电视台新闻中播报了,还想在网上找找呢,没想到这么快就出来了,胡教授真是辛苦啦!
  • TA的每日心情
    郁闷
    2019-6-25 09:20
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    [LV.4]偶尔看看III

    发表于 2010-8-15 07:46 | 显示全部楼层
    “良好的监控和疾病控制程序可以阻止超级细菌传播。”在新闻里看到英国的专家说的这句话,在这过程中,应该就有我们这些院感人的付出在里面了。谢谢胡教授的专业精神。

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    发表于 2010-8-15 08:49 | 显示全部楼层
    回复 1# icchina

    “NDM-1,并不是一种新的细菌,而是细菌如大肠杆菌、克雷伯杆菌等普通细菌,携带了耐药基因。这个基因,是一种金属酶,β-内酰胺酶的一种。携带这种酶的细菌,将对青霉素类、头孢菌素类和碳青霉烯类等抗菌药物耐药。”
       谢谢胡教授为我们揭开“NDM-1"的神秘面纱!对于携带该基因的耐药菌,咱们院感人要积极行动起来,谨防院内感染!
  • TA的每日心情
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    [LV.10]以坛为家III

    发表于 2010-8-15 09:08 | 显示全部楼层
    目前国内尚无报道,是否与检测技术有关?
    一旦发现,应该按多重耐药菌的隔离措施实施,是吗?

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    发表于 2010-8-15 09:56 | 显示全部楼层
    回复 15# 风雨同舟


        是的,一旦发现也要采取多重耐药菌的接触隔离预防措施和标准预防措施!

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    发表于 2010-8-15 10:49 | 显示全部楼层
    这种超级细菌怎么监测到的?普通医院有这样的条件吗?

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    发表于 2010-8-15 11:35 | 显示全部楼层
    最讨厌,也是最坏的研究结果:“Most isolates carried the NDM-1 gene on plasmids”,这将导致耐药的迅速扩散。真的是一种灾难。
    KPC酶风波还未平息,NDM-1又掀起新的风波。

    该用户从未签到

    发表于 2010-8-15 11:52 | 显示全部楼层
    不知一般医院的微生物室能否检测到该细菌?还是检测到“大肠杆菌、克雷伯杆菌等普通细菌”再进行分析?
    对“青霉素类、头孢菌素类和碳青霉烯类等抗菌药物耐药”的大肠杆菌、克雷伯杆菌,是否就得考虑“NDM-1”?

    该用户从未签到

    发表于 2010-8-15 11:56 | 显示全部楼层
    院感监控工作的担子又添了重量!谢谢胡教授及时提供如此详细的资料!
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