天然产品解决超级细菌:生物多样性在公共卫生问题上的挑战

J. Bueno
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引用次数: 0

摘要

抗微生物药物耐药性目前是对人群健康的最大挑战和威胁之一,其中两个基本问题同时存在,例如抗生素的不当使用以及控制感染措施的实施不足。由于抗菌药物的使用不可避免地导致耐药性的出现,因此需要不断寻找新的分子来应对疫情并降低感染率。这种在人类和农业中不加区分地使用抗感染药物的做法,使得出现耐多药菌株(MDR)成为可能。其中报告最多的耐多药微生物是耐甲氧西林金黄色葡萄球菌(MRSA)、耐万古霉素肠球菌(VRE)、对氟喹诺酮类药物耐药的大肠杆菌和铜绿假单胞菌、对头孢他啶耐药的肺炎克雷伯菌、鲍曼不动杆菌和对异烟肼-利福平耐药的结核分枝杆菌。此外,由于缺乏针对耐多药微生物的新活性药物的供应和研究,这一非常严重的公共卫生问题变得更加复杂。因此,美国传染病学会(Infectious Disease Society of America)提出了10 × 20倡议,建议全球多家领先机构联合起来,到2020年开发出10种新的抗菌药物[5,6]。按照这种思路,要承担这一巨大挑战,就有必要克服微生物防御机制,即诱导耐药性的生物膜,使微生物能够通过化学诱导的环境变化在其内部生存,从而有利于其适应[7-9]。此外,对新型抗生素的研究也有所减少,因为它们的回报率低于用于治疗慢性疾病的药物[10,11]。
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Natural Products Solution against Superbugs: A Challenge of Biodiversity in a Public Health Issue
Antimicrobial resistance is currently one of the greatest challenges and threats to the health of populations, in which two fundamental problems come together, such as the inappropriate use of antibiotics as well as the implementation of deficient measures for the control of infections [1]. Because the use of an antimicrobial inevitably leads to the emergence of resistance, a constant search for new molecules is required with which to deal with outbreaks and decrease the infection rate [2]. This indiscriminate use of anti-infectives both in humans and in agriculture makes possible the appearance of multidrug-resistant strains (MDR). Between them the most reported MDR microorganisms are methicillin-resistant Staphylococcus aureus (MRSA), vancomycin-resistant enterococci (VRE), Escherichia coli and Pseudomonas aeruginosa resistant to fluoroquinolones, Klebsiella pneumonia resistant to ceftazidime, Acinetobacter baumannii, and isoniazid-rifampicin resistant Mycobacterium tuberculosis [3]. Additionally, this very serious public health problem is complicated by the lack of availability and research into new active medicines against MDR microorganisms [4]. So several initiatives have been proposed as 10 × 20 initiative from Infectious Disease Society of America that propose the global union of several leading institutions in order to develop 10 new antimicrobial drugs by 2020 [5,6]. In this order of ideas, to assume this great challenge makes it necessary to overcome the mechanisms of microbial defense that induce resistance as biofilms that allows the survival of microorganisms in their interior through chemically induced environmental changes that favor their adaptation [7-9]. Also, research into new antibiotics has decreased because they have a lower rate of return than drugs used to treat chronic diseases [10,11].
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