Genetik ve Epigenetik Değişiklikler, Mikrobiyal Adaptasyon ve Değişim Antimikrobiyel Direnç
Özet
Antimikrobiyal ilaçların keşfi, insan ve hayvan sağlığında enfeksiyonların tedavisi açısından önemli olmasına rağmen, bakterilerin bu ilaçlara karşı direnç geliştirme yeteneği, antimikrobiyal direnç (AMD) sorununu küresel bir halk sağlığı tehdidi haline gelmesine neden olmuştur. Bu kitap bölümünde, AMD gelişiminde rol oynayan mekanizmalar, yayılım yolları ve veteriner halk sağlığı açısından önemi ele alınmaktadır. Direnç mekanizmaları arasında ilaç alımının sınırlandırılması, hedef modifikasyonu, enzimatik inaktivasyon, efluks pompaları ve alternatif metabolik yol kullanımı bulunmaktadır. Antimikrobiyallerin hayvancılıkta (son yıllarda özellikle su ürünleri yetiştiriciliğinde) kontrolsüz kullanımı, dirençli bakterilerin ve direnç genlerinin çevreye yayılımını artırmakta, bu durum hem insan sağlığını hem de ekosistem dengesini tehdit etmektedir. Bu bağlamda, Tek Sağlık yaklaşımı çerçevesinde insan, hayvan ve çevre sağlığının bütüncül olarak antibiyotik yönetimi prensibi çerçevesinde ele alınması gerekmektedir. Direnç gelişimini önlemeye yönelik antibiyotik yönetim stratejileri, sürveyans sistemleri ve yeni tedavi yöntemlerinin geliştirmek için disiplinler arası iş birliğinin gerekliliği vurgulanmaktadır.
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