【讨论】NDM-1是一株新型耐药菌吗？
这个帖子发布于 15 年零 97 天前，其中的信息可能已发生改变或有所发展。
最近，对印度发现最新病菌的关注度很高。
本版也有关注：
http://labmed.dxy.cn/bbs/topic/17989695?tpg=1&age=0
那么，对于这个所谓的新型的超级耐药菌，各大媒体争相报道，CCTV也播了，今天下午本省的媒体也来到我们科室，针对这一问题进行采访......
我觉得好奇，查到了英文原文，先“扫描”了一下。
首先，我想提一点我个人的看法：这并非一个新的什么超级耐药菌，而就是一个对碳青霉烯类耐药的产金属酶的阴沟肠杆菌。
原始文献的摘要：
Emergence of a new antibiotic resistance mechanism in India, Pakistan, and the UK: a molecular, biological, and epidemiological study
Karthikeyan K Kumarasamy, Mark A Toleman, Timothy R Walsh, Jay Bagaria, Fafh ana Butt, Ravikumar Balakrishnan, Uma Chaudhary, Michel Doumith, Christian G Giske, Seema Irfan, Padma Krishnan, Anil V Kumar, Sunil Maharjan, Shazad Mushtaq, Tabassum Noorie, David L Paterson, Andrew Pearson, Claire Perry, Rachel Pike, Bhargavi Rao, Ujjwayini Ray, Jayanta B Sarma, Madhu Sharma, Elizabeth Sheridan, Mandayam A Thirunarayan, Jane Turton, Supriya Upadhyay, Marina Warner, William Welfare, David M Livermore, Neil Woodford
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-fi eld 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 identifi ed 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.
针对这个问题，有很多值得我们讨论的地方：
1.对原始文献的深入分析与讨论，完整翻译接要的战友将获得1分奖励！对这一问题有深入讨论的战友均可获得加分鼓励！
2.一个并不新的问题，得以在著名的lancet infectious disease （影响因子10分以上）的期刊上发表，就必然有我们可取的地方。这篇文章中，有哪些“亮点”呢？在我们今后的研究中，是否可以借鉴呢？
3.就这件事情本身，媒体报道中有哪些误导呢？
欢迎广大战友积极参与讨论！
本版也有关注：
http://labmed.dxy.cn/bbs/topic/17989695?tpg=1&age=0
那么，对于这个所谓的新型的超级耐药菌，各大媒体争相报道，CCTV也播了，今天下午本省的媒体也来到我们科室，针对这一问题进行采访......
我觉得好奇，查到了英文原文，先“扫描”了一下。
首先，我想提一点我个人的看法：这并非一个新的什么超级耐药菌，而就是一个对碳青霉烯类耐药的产金属酶的阴沟肠杆菌。
原始文献的摘要：
Emergence of a new antibiotic resistance mechanism in India, Pakistan, and the UK: a molecular, biological, and epidemiological study
Karthikeyan K Kumarasamy, Mark A Toleman, Timothy R Walsh, Jay Bagaria, Fafh ana Butt, Ravikumar Balakrishnan, Uma Chaudhary, Michel Doumith, Christian G Giske, Seema Irfan, Padma Krishnan, Anil V Kumar, Sunil Maharjan, Shazad Mushtaq, Tabassum Noorie, David L Paterson, Andrew Pearson, Claire Perry, Rachel Pike, Bhargavi Rao, Ujjwayini Ray, Jayanta B Sarma, Madhu Sharma, Elizabeth Sheridan, Mandayam A Thirunarayan, Jane Turton, Supriya Upadhyay, Marina Warner, William Welfare, David M Livermore, Neil Woodford
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-fi eld 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 identifi ed 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.
针对这个问题，有很多值得我们讨论的地方：
1.对原始文献的深入分析与讨论，完整翻译接要的战友将获得1分奖励！对这一问题有深入讨论的战友均可获得加分鼓励！
2.一个并不新的问题，得以在著名的lancet infectious disease （影响因子10分以上）的期刊上发表，就必然有我们可取的地方。这篇文章中，有哪些“亮点”呢？在我们今后的研究中，是否可以借鉴呢？
3.就这件事情本身，媒体报道中有哪些误导呢？
欢迎广大战友积极参与讨论！
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