● Threat objects: heavy use of broad-spectrum antibiotics, long-term inpatient and use of mechanical ventilation, central venous catheter insertion for the treatment of patients
● Available drugs: for Kat prostacyclin, stick of
Medical guidance/Guangdong Province Center for microbial detection, Deputy Director, Dr. Tang Ling
A vast majority against existing antibiotics "superbugs," is thrown around the attention!
Guangdong provincial Center for disease control, in fact, multiple drug-resistant bacteria is not the first time, and that is the disclosure of some kind of "superbugs", the main long-term residential attacks are severe ailments, rather than ordinary people.
Multinational medical experts also pointed out that "superbugs" infection with fewer good surveillance and disease control program to prevent its spread, there is no need to panic.
"Superbugs" "super" in which drugs can be used with the estate of confrontation? next "superbugs," what would it look like? this invite experts of "superbugs" context, restore resistant bacteria.
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"Superbugs" debuts in Europe and South Asia, has affected
"Superbugs," the earliest documented United Kingdom Cardiff University School of medicine, Timothy · VAS in the Lancet infectious diseases, journal-published papers.
The report states that the United Kingdom Cardiff University, India Madras University and the United Kingdom Health Protection Agency's medical researchers from one isolation of Sweden patients carry this enzyme bacteria, the patient was hospitalized in New Delhi, India. 2008-2009, the United Kingdom has 29 patients from 37 positive bacteria strains NDM-1, United States in the first half of 2010 and found 3 cases of infection with bacteria, NDM-1 India NDM-1 70 strains isolated from bacteria.
According to estimates, the current global media has 170 people infected "superbugs" NDM-1, major cases in India and the United Kingdom and in other European countries and the United States also have case, many patients have to go to India, Pakistan and Bangladesh, and other South Asian countries travel or operation in history.
Of these, at least in the United Kingdom resulted in 5 fatalities, Belgium Brussels recently reported death cases.
In October last year, the Health Department also has a male patient's urine sample carries a "Super NDM-1 bacteria".
Mainland China has yet to find this type of "superbugs".
Guangdong Province Health Department last week is ready for deployment, requirements related to the relevant departments to pay close attention to the "superbugs" NDM-1 development and testing, laboratory inspection reserves the required material.
New metal enzyme
The bacteria make up the "superbugs"
"NDM-1 is not the name of the bacteria, which is an enzyme that can give bacteria make up the ' superbugs ' ability.
"Guangdong Province Center for microbial detection, Deputy Director, Dr. Tang ling, pointed out that the New Delhi NDM-1 called" metal β-lactamase ", also known as the metal enzyme, from India, Pakistan and South Asian countries tourism history of the patient into a containing enzyme bacteria.
Tang Ling said, once the bacteria produce enzymes that can cause infections on β-lactam antibiotics such as penicillin and cephalosporin, carbapenem resistant etc.
Β-lactam antibiotics broad-spectrum antibiotics, belonging to the treatment of infections most commonly used class of antibiotics.
Of these, carbapenem antibiotic is used primarily to produce ultra broad spectrum β-lactamase of serious bacterial infections, including bacterial on including NDM-1 carbapenem antibiotic also produces, including drug resistance.
Two types of people
Vulnerable to the threat of "superbugs"
In the past, researchers found metal enzyme usually exist only in Pseudomonas aeruginosa, but in recent years, this enzyme in enterobacteria, especially Escherichia coli, Klebsiella pneumoniae DNA structure also appeared.
As hospital-acquired infection in two common bacteria and Escherichia coli, Klebsiella pneumoniae direction "main": the former can cause urinary tract infections, which is the risk of bacterial pneumonia.
New metal enzyme after the "appendage", both of these bacteria are increasingly becoming "superbugs," destruction has soared.
Existing research has found that infected "superbugs" patients mainly two kinds of people, which makes extensive use of broad-spectrum antibiotics, long-term inpatient and use of mechanical ventilation, central venous catheter insertion for the treatment of patients.
These patients the organism immunity, have shown that this type of bacteria although resistance strong, but can ability to relatively weak pathogens. Tang Ling said that from this perspective, "superbugs" attack object is not an ordinary person, so people without tension.
Two types of medication available
Treatment face double trouble
Clinical identifying patients on how the infection is bacterial "super"?, Tang Ling said, the extensive use of broad-spectrum antibiotics on long-term inpatient or the use of mechanical ventilation, central venous catheter insertion for the treatment of patients with high risk of infection symptoms appear, it is recommended that the separation of undertake antibiotic susceptibility of bacteria.
If bacteria isolated from a broad-spectrum resistance phenomenon, follow NDM-1 gene detection methods for identification.
For patients, once infected "superbugs", is not no cure.
The researchers found that the "superbugs" Although many antibiotic resistance, but on behalf of Kat ring and colistin-sensitive.
However, the treatment of "Super germs" often face a double dilemma: either no treatment or drug toxicity than bacteria to "."
Tang Ling said, infection with multiple drug-resistant bacteria in patients or died from bacterial infection caused by a variety of serious or killing the bacteria are antibiotics, died of toxicity and side effects of broad-spectrum antibiotics.
Internal discovery
Multiple drug-resistant strain touchy
In "superbugs" behind, is an increasingly large, growing tolerance of the drug-resistant bacteria.
To Staphylococcus aureus: a case study of drug: 1950 before penicillin to treat Staphylococcal Infections of effective drugs, and to the 1950s began to appear on penicillin-resistant Staphylococcus aureus, broad-spectrum antibiotics but more resistant it is still valid.
But only 20 years later, appeared on Methicillin-resistant Staphylococcus aureus (MRSA).
Tang Ling said, by 1997, Vancomycin moderate resistance in Staphylococcus aureus (VISA), and completely on vancomycin-resistant Staphylococcus aureus (VRSA) also appear in five years.
At present, many hospitals in the patients with severe long-term hospitalization was found a VISA, but not yet in our VRSA was found, "but now for the purposes of drug resistance, the treatment it is very difficult. ”
The next "superbugs" who? "
This is very difficult to predict, humans cannot avoid the emergence of drug resistant bacteria. "Tang Ling said that can firmly say that antibiotic resistance is the 21st century global focus on human life and health of the threat posed by no less than AIDS, cancer and cardiovascular disease.
Prevention
Specifications and the rational use of antibiotics
"Superbugs" why it is considered a human abuse of antibiotics brewed dysfunctions.
Since human invention of antibiotics, antibiotics and germs staged between constantly. "saga"
Human in order to deal with emerging pathogenic micro-organisms, constantly developed all kinds of novel antibiotics. While bacteria to survive, continuous variation of evolutionary, the formation of a new antibiotic tolerance bacteria, thus forming a vicious circle.
"Although mankind has invented so many antibiotics, but the best or penicillin, because it is killing germs, minimum side effects on the human body.
"Tang Ling said, the more the more senior of broad-spectrum, antibiotic, the more likely to induce bacterial resistance, the side effects for patients.
However, in the eyes of patients, penicillin seemed to have "outdated", to act faster and more advanced antibiotics and some favored doctor did not keep "specification for rational drug use" the bottom line.
For example, the bacterial pathogens of tonsillitis is a Gram-positive bacteria, originally by benzylpenicillin therapy can kill. But some doctors opened is simultaneously against gram positive bacteria and negative bacteria's third generation cephalosporins. Tang Ling said, antibiotic use, the more and more strong antimicrobial resistance. But the speed of evolution and bacterium, mankind than research and development of new antibiotics much slower speed.
"With its hopes on the how to develop a stronger antibiotic drug, it is better to consider how existing antibiotic variety not so quickly that ' failure '.
"Tang Ling believes that in order to contain and reduce" superbugs ", should be standardized and the rational use of antibiotics. For normal patients, usually do not take antibiotics itself, while the doctor should standardize medication, do not fall into the worship of "antibiotics".
Reminder
Don't abuse of antibiotics fed to livestock
It should be emphasized that, in our country, a long-neglected source of drug-resistant bacteria is the food chain.
Animal husbandry is to keep the fish, pigs, cattle, sheep and other animals rarely get sick and are growing well, there is abuse of antibiotics.
The "animal drug resistance of bacteria to infect humans, once, the consequences are difficult to control.
"Tang Ling said, for example chicken body of salmonella bacteria are normal, but humans are pathogens, once people ate the chicken, salmonella infection may cause diarrhoea. If you feed the chickens with antibiotics may not be able to kill salmonella, but could cause them to produce resistant and resistant bacteria to humans.
United States Government has observed, people eat feed add excessive antibiotic chicken, to quinolone antibiotics such as ciprofloxacin resistance arising because of salmonella in chicken with resistance.
United States policy for this introduction, the ban on animal feed add antibiotics in excess in order to avoid the drug-resistant bacteria enters the body through the food chain. While China has yet to address this issue to develop specialized policies.
It is understood that this year the Ministry of agriculture will start on chicken special detection of salmonella.
Tang Ling said, hope that this is "too late, still not too late. ”
(Edit: Justin Lin, internships)