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Multiple Resistant Bacteria
Jan 26, 2018

Multiple resistant bacteria (MDR) are pathogenic bacteria with multiple resistance.Multidrug resistance refers to the drug resistance of many commonly used antimicrobial agents, the main mechanism is the mutagenesis of the external membrane pump gene, and the second is the change of the outer membrane permeability and the production of ultra wide spectrum enzyme.Most MDR conditional pathogenic bacteria and gram negative bacilli (GNR) represents a significant share, such as enterobacteriaceae in klebsiella pneumoniae, escherichia coli, sewer bacillus, glue Mr Charest bacteria, folic acid bacteria genera, shigella, salmonella, etc., and p. aeruginosa, acinetobacter, influenza bacillus, etc.There are MRSA and MRSE in gram-positive bacteria, especially MRSA and MRSE.Vancomycin resistant enterococcus (VRE) was significantly increased in the intensive care unit (ICU).Penicillin-resistant streptococcus pneumoniae (PRSP) often causes pneumonia, meningitis, bacteremia and otitis media, and mycobacterium tuberculosis.In addition, there are gonorrhoeae, meningococcal, vibrio cholerae, etc.

Multiple drug resistance (multiple hold, MDR) refers to the at the same time, in a variety of commonly used antimicrobial drug resistance, is the main mechanism of efflux pump membrane gene mutations, followed by the change of the outer membrane permeability and produce broad-spectrum enzyme.At most, mdr-tb and mdr-mrsa of gram-positive bacteria, as well as acinetobacter baumannii and pseudomonas aeruginosa in ICU, were only sensitive to penicillium.All the antimicrobial resistance of the malt narrow-food monocytosis was almost complete.The emergence of MDR determines the necessity of combined drug use.The high frequency of MDR strains means that the era of antimicrobial drugs is coming to an end.Microbial resistance increasing main reason is that not reasonable use and abuse, such as the United States for human anti-infection and agriculture application each accounted for 50%, which is used for nosocomial infection accounted for only 20% of resistance, and the community is accounted for 80%, abuse at a rate of 20% ~ 50%;In agriculture and animal husbandry, the therapeutic application accounts for only 20%, while the prevention and growth application accounts for 80%, the abuse rate is 40%~80%, and 40,000 deaths per year are caused by drug-resistant bacteria.China's abuse is more serious than in the United States. The WHO's assessment of China's abuse of antimicrobials is that 97 percent of Chinese patients with viral bronchial infections use antibacterial drugs.In the primary health care system, 30 to 60 percent of patients use antimicrobials.There are many kinds of antimicrobial resistance mechanisms of bacteria, and the most important ones are the production of inactivated enzymes such as beta-lactamase and aminoglycoside passivation enzyme.The secondary target changes such as penicillin binding protein (PBPs);Other membrane permeability changes, making the drug difficult to enter;The bacteria pump out the system to increase, enhance, to expel the drugs that have entered the bacterium;As well as the reduction in the active transport of the membrane, the establishment of new metabolic pathways, and the addition of antagonistic drugs, the two mechanisms can often be started simultaneously.