PDF(Pubmed)
Abstract：
Carbapenemases, a class of enzymes specialized in the hydrolysis of carbapenems, represent a significant threat to global public health. These enzymes are classified into different Ambler\'s classes based on their active sites, categorized into classes A, D, and B. Among the most prevalent types are IMI/NMC-A, KPC, VIM, IMP, and OXA-48, commonly associated with pathogenic species such as Acinetobacter baumannii, Klebsiella pneumoniae, and Pseudomonas aeruginosa. The emergence and dissemination of carbapenemase-producing bacteria have raised substantial concerns due to their ability to infect humans and animals (both companion and food-producing) and their presence in environmental reservoirs. Adopting a holistic One Health approach, concerted efforts have been directed toward devising comprehensive strategies to mitigate the impact of antimicrobial resistance dissemination. This entails collaborative interventions, highlighting proactive measures by global organizations like the World Health Organization, the Center for Disease Control and Prevention, and the Food and Agriculture Organization. By synthesizing the evolving landscape of carbapenemase epidemiology in Portugal and tracing the trajectory from initial isolated cases to contemporary reports, this review highlights key factors driving antibiotic resistance, such as antimicrobial use and healthcare practices, and underscores the imperative for sustained vigilance, interdisciplinary collaboration, and innovative interventions to curb the escalating threat posed by antibiotic-resistant pathogens. Finally, it discusses potential alternatives and innovations aimed at tackling carbapenemase-mediated antibiotic resistance, including new therapies, enhanced surveillance, and public awareness campaigns.
摘要：
碳青霉烯酶,一类专门水解碳青霉烯类的酶，对全球公共卫生构成重大威胁。这些酶根据其活性位点分为不同的Ambler类，分类为A类，D,最常见的类型是IMI/NMC-A，KPC,VIM,IMP,和OXA-48，通常与致病性物种如鲍曼不动杆菌有关，肺炎克雷伯菌,还有铜绿假单胞菌.产生碳青霉烯酶的细菌的出现和传播由于它们感染人类和动物(伴侣和食物产生)的能力以及它们在环境储库中的存在而引起了大量关注。采用一个整体的健康方法，一致努力旨在制定综合战略，以减轻抗菌素耐药性传播的影响。这需要合作干预，强调世界卫生组织等全球组织的积极措施，疾病预防控制中心,以及粮食和农业组织。通过综合葡萄牙不断发展的碳青霉烯酶流行病学景观，并追踪从最初的孤立病例到当代报告的轨迹，这篇综述强调了驱动抗生素耐药性的关键因素，如抗菌药物的使用和医疗保健实践，并强调了持续保持警惕的必要性，跨学科合作,和创新的干预措施，以遏制抗生素耐药性病原体带来的不断升级的威胁。最后,它讨论了旨在解决碳青霉烯酶介导的抗生素耐药性的潜在替代方案和创新，包括新疗法,加强监视,和公众意识运动。
