Bacteral Resistance课件.ppt

Bacterial Resistance（细菌的耐药性） 资料显示 中国是抗生素使用大国，也是抗生素生产大国：年产抗生素原料大约21万吨，出口3万吨给世界人民，其余18万吨留给自己用（包括医疗与农业使用），人均年消费量138克左右（美国仅13克）。据统计，每年因抗生素滥用导致医疗费用增长800亿元，仅超前使用第三代头孢菌素，全中国一年就多花费7亿多元人民币。 资料显示 据2006—2007年度卫生部全国细菌耐药监测结果显示，全国医院抗菌药物年使用率高达74％。 住院患者中，抗生素的使用率则高达70%，其中外科患者几乎人人都用抗生素，比例高达97%。 每年8万人因滥用抗生素死亡 全球关注的多重耐药细菌 产超广谱酶大肠埃细菌 多重耐药铜绿假单细胞菌 多重耐药结核杆菌 泛耐药肺炎球菌 泛耐药绿脓杆菌等 Section 1  types and mechanism of antibacterials 1、 concept of antibacterials (1) antibacterial agents（抗菌药物） Those drugs that can Inhibit or kill pathogenic bacteria, in order to prophylaxis and cure Bacterial infection, including antibiotics and chemical synthesis drugs. (2) antibiotics （抗生素） products that microbes produce in metabolic process can Inhibit or kill pathogenic bacteria . It have two kinds: natural and artificial synthesis. 1、concept of Bacterial Resistance in genetics, bacterial drug resistance is divided into intrinsic resistance and acquired resistance. (1) intrinsic resistance natural insensitivity of bacterium against certain antibacterials. drug resistance gene origin from gene mutation or to obtain new gene. mode of action have conjugation、transduction and transformation. It May happen to such structural gene as chromosome DNA、plasmid and transposon, also some regulatory gene. There are three factors about incidence rate of affecting Acquired drug resistance: drug use dose, spontaneous mutation of bacterial resistance and Shift state of drug resistance gene . (1) chromosomal mutation： 自然发生，突变率10-12-10-7 与抗菌药物无必然关系 相对稳定，结核杆菌例外 可回复突变 (2) transmissible antibiotic resistance（可转移的耐药性）: ①plasmid： ②transposon：transposon, Tn also called jumping gene，to multiply structural gene products in great quantity. ③integron ： 3、biochemistry mechanism of Bacterial Resistance include： ? Enzymatic inactivation ? Target alteration ? decrease permeab