Publication: Mecanismos emergentes de resistencia a antibióticos en enterobacterias de origen humano, animal y ambiental
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2018-02-08
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Universidad Complutense de Madrid
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Abstract
La introducción de los antibióticos en la práctica clínica supuso una auténtica revolución en la medicina. Su utilización no solo sirvió para convertir a una de las principales causas de muerte del siglo XX, las enfermedades infecciosas, en enfermedades curables, si no que propició el avance de la medicina y la cirugía. Por todo ello, los antibióticos han permitido el alcance de hitos médicos que han mejorado sustancialmente la calidad de vida de las personas, permitiendo el aumento de la esperanza de vida. No obstante, poco tiempo después de empezar a utilizarse los antibióticos, se observó la aparición de bacterias capaces de sobrevivir al efecto antibacteriano de los mismos. En principio, la aparición de estas resistencias antimicrobianas fue una consecuencia natural asociada al uso de los antibióticos. Sin embargo, a raíz de su uso incorrecto e indiscriminado, tanto en medicina humana, veterinaria como en agricultura, este fenómeno natural se aceleró de tal forma, que la velocidad de aparición de las resistencias superó la velocidad de descubrimiento de nuevas moléculas antimicrobianas. Consecuentemente, la situación actual a nivel mundial es crítica, puesto que nos enfrentamos a patógenos que son capaces de resistir a la totalidad de antibióticos disponibles, lo cual amenaza con acercarnos a la era post-antibiótica. Para poder frenar el avance de las resistencias, es necesario conocer cómo éstas evolucionan y se transmiten, con el fin de predecir la emergencia de nuevos medios de propagación y de nuevos mecanismos de resistencia. Las resistencias no se circunscriben a un determinado nicho, sino que son capaces de seleccionarse, evolucionar y diseminarse entre distintos ambientes. Además hay que tener en cuenta que los antibióticos que se usan en medicina humana, son los mismos que se utilizan en medicina veterinaria y en agricultura, si bien es cierto que actualmente en animales de abasto y en agricultura, su uso está más regulado y solo se pueden utilizar antibióticos que hayan sido autorizados. Es por tanto fundamental para conocer la verdadera ecología de los mecanismos de resistencia, estudiarlos, no solo en el ámbito de la medicina humana, sino también en el animal y en el ambiental...
The inclusion of antibiotics in clinical practice lead to a major revolution in medicine. Their use not only made infectious diseases curable, one of the main death causes of the 20th Century, but also enabled great advances in medicine and surgery. Ergo, antibiotics have helped achieve medical milestones which have substantially improved human quality of life, and increased life expectancy. Albeit, shortly after starting using them, it was observed how certain bacteria were surviving the antibiotics. At first it was thought that this antibacterial resistance was a natural consequence, linked to the use of antibiotics. However, due to the incorrect and indiscriminate use of antibiotics in human medicine, veterinary and agriculture, this natural phenomenon sped up in such way that the rate of resistance overcame that of the discovery of new antibiotic molecules. Consequently, the current worldwide situation is critical, as we are fighting pathogens which are able to resist the totality of available antibiotics, and threatens to put an end to the antibiotic era. In order to be able to stop the advance of antibiotic resistance, it is necessary to understand how it evolves and transmits, with the goal of predicting the emergence of of new resistance mechanisms. Resistances are not circumscribed to a certain niche, as they are able to discriminate, evolve and disseminate among different environments. It’s important to bear in mind that antibiotics are also used in veterinary medicine and agriculture, where their use is on the other hand more strictly regulated, and only those authorized can be used. It is fundamental, therefore, to study resistance mechanisms in order to understand their true ecology not only in human medicine, but in animals and environments...
The inclusion of antibiotics in clinical practice lead to a major revolution in medicine. Their use not only made infectious diseases curable, one of the main death causes of the 20th Century, but also enabled great advances in medicine and surgery. Ergo, antibiotics have helped achieve medical milestones which have substantially improved human quality of life, and increased life expectancy. Albeit, shortly after starting using them, it was observed how certain bacteria were surviving the antibiotics. At first it was thought that this antibacterial resistance was a natural consequence, linked to the use of antibiotics. However, due to the incorrect and indiscriminate use of antibiotics in human medicine, veterinary and agriculture, this natural phenomenon sped up in such way that the rate of resistance overcame that of the discovery of new antibiotic molecules. Consequently, the current worldwide situation is critical, as we are fighting pathogens which are able to resist the totality of available antibiotics, and threatens to put an end to the antibiotic era. In order to be able to stop the advance of antibiotic resistance, it is necessary to understand how it evolves and transmits, with the goal of predicting the emergence of of new resistance mechanisms. Resistances are not circumscribed to a certain niche, as they are able to discriminate, evolve and disseminate among different environments. It’s important to bear in mind that antibiotics are also used in veterinary medicine and agriculture, where their use is on the other hand more strictly regulated, and only those authorized can be used. It is fundamental, therefore, to study resistance mechanisms in order to understand their true ecology not only in human medicine, but in animals and environments...
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Tesis inédita de la Universidad Complutense de Madrid, Facultad de Veterinaria, Departamento de Sanidad Animal, leída el 29-09-2017