Moyens de défense des bactéries.

Détails

ID Serval
serval:BIB_BD447075E4C8
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
Moyens de défense des bactéries.
Périodique
Revue Médicale de la Suisse Romande
Auteur(s)
Moreillon P.
ISSN
0035-3655 (Print)
ISSN-L
0035-3655
Statut éditorial
Publié
Date de publication
2000
Volume
120
Numéro
8
Pages
641-650
Langue
français
Résumé
Fifty 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 confronted us with the illusion that bacterial infections were all but vanquished. However, the widespread and sometimes uncontrolled usage of these agents has led to the selection of bacteria resistant to practically all available antibiotics. Bacteria utilize three main resistance strategies: (i) decrease in drug accumulation, (ii) modification of target, and (iii) modification of the antibiotic. Bacteria can decrease drug accumulation 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 bacteria--and thus escape the drug's toxic effect. Lastly, they can produce enzymes capable of modifying and directly inactivating the 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 enterococci are now resistant to almost all available antibiotics. Vancomycin is the only non-experimental drug left to treat severe infections due to such organisms. However, vancomycin resistance has already appeared several years ago in enterococci, and was also recently described in staphylococci, in Japan, France and the United-States. Antibiotics are 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.: (i) choose the most efficient antibiotic according to clinical and local epidemiological data, (ii) target the bacteria according to the microbiological data at hand, and (iii) administer the antibiotic at an adequate dose which will leave the pathogen no chance to develop any resistance.
Mots-clé
Anti-Bacterial Agents/pharmacology, Anti-Bacterial Agents/therapeutic use, Bacterial Physiological Phenomena/drug effects, Cell Membrane Permeability/drug effects, Cell Membrane Permeability/physiology, Drug Resistance, Microbial/physiology, Humans, Patient Selection, R Factors/drug effects, R Factors/physiology
Pubmed
Création de la notice
24/01/2008 14:57
Dernière modification de la notice
03/03/2018 20:58
Données d'usage