La résistance bactérienne aux antibiotiques.

Détails

ID Serval
serval:BIB_004E338F8BFE
Type
Article: article d'un périodique ou d'un magazine.
Sous-type
Synthèse (review): revue aussi complète que possible des connaissances sur un sujet, rédigée à partir de l'analyse exhaustive des travaux publiés.
Collection
Publications
Titre
La résistance bactérienne aux antibiotiques.
Périodique
Schweizerische Medizinische Wochenschrift
Auteur(s)
Moreillon P.
ISSN
0036-7672 (Print)
ISSN-L
0036-7672
Statut éditorial
Publié
Date de publication
1995
Volume
125
Numéro
23
Pages
1151-1161
Langue
français
Notes
Conference: Joint Annual Conference of the Swiss-Society-for-Intensive-Care-Medicine/Swiss-Society-for-Infectious-Diseases Location: LAUSANNE-DORIGNY, SWITZERLAND Date: SEP 08-09, 1994
Sponsor(s): Swiss Soc Intens Care Med; Swiss Soc Infectious Dis
Résumé
50 years ago, the introduction of penicillin, followed by many other antibacterial agents, represented an often underestimated medical revolution. Indeed, until that time, bacterial infections were the prime cause of mortality, especially in children and elderly patients. The discovery of numerous new substances and their development on an industrial scale gave us the illusion that bacterial infections were all but vanquished. However, the widespread and sometimes uncontrolled use of these agents has led to the selection of bacteria resistant to practically all available antibiotics. Bacteria utilize three main resistance strategies: (1) modification of their permeability, (2) modification of target, and (3) modification of the antibiotic. Bacteria modify their permeability either by becoming impermeable to antibiotics, or by actively excreting the drug accumulated in the cell. As an alternative, they can modify the structure of the antibiotic's molecular target--usually an essential metabolic enzyme of the bacterium--and thus escape the drug's toxic effect. Lastly, they can produce enzymes capable of modifying and directly inactivating antibiotics. In addition, bacteria have evolved extremely efficient genetic transfer systems capable of exchanging and accumulating resistance genes. Some pathogens, such as methicillin-resistant Staphylococcus aureus and multiresistant Mycobacterium tuberculosis, have become resistant to almost all available antibiotics and there are only one or two substances still active against such organisms. Antibiotics are very precious drugs which must be administered to patients who need them. On the other hand, the development of resistance must be kept under control by a better comprehension of its mechanisms and modes of transmission and by abiding by the fundamental rules of anti-infectious chemotherapy, i.e.: (1) choose the most efficient antibiotic according to clinical and local epidemiological data, (2) target the bacteria according to the microbiological data at hand, and (3) administer the antibiotic in an adequate dose which will leave the pathogen no chance to develop resistance.
Mots-clé
Aged, Bacteria/enzymology, Bacteria/metabolism, Cell Membrane Permeability, Child, Drug Resistance, Microbial/genetics, Drug Resistance, Multiple/genetics, Escherichia coli/drug effects, Humans, Staphylococcus aureus/drug effects, Tuberculosis, Multidrug-Resistant/metabolism
Pubmed
Web of science
Création de la notice
24/01/2008 14:58
Dernière modification de la notice
03/03/2018 13:10
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