Karbapenem, Genişletilmiş Spektrumlu Beta-Laktam ve Kolistin Dirençli Escherıchıa Colı ve Klebsıella Pneumonıa’ya Tek Sağlık Konseptinde Panoramik Bakış
Synopsis
Antimicrobial resistance is a major global public health concern threatening human, animal, and environmental health. The increasing prevalence of carbapenem-, extended-spectrum beta-lactam-, and colistin-resistant Escherichia coli and Klebsiella pneumoniae strains has significantly complicated the treatment of bacterial infections. This review discusses the molecular mechanisms of antimicrobial resistance, the epidemiology of resistance genes, and their transmission among humans, animals, and the environment within the One Health framework. Particular attention is given to carbapenemase genes (blaKPC, blaNDM, blaVIM, blaIMP, and blaOXA-48), extended-spectrum beta-lactamase genes (blaTEM, blaSHV, and blaCTX-M), and plasmid-mediated colistin resistance genes (mcr). The roles of chromosomal mutations, porin loss, efflux pumps, and horizontal gene transfer in resistance development are also emphasized. Furthermore, the potential transmission of resistant bacteria of animal origin to humans through the food chain, direct contact, and environmental pathways is emphasized. In conclusion, rational antimicrobial use, improved biosecurity practices, molecular epidemiological investigations, and integrated surveillance programs involving human, animal, and environmental health are essential for controlling antimicrobial resistance.
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