Innovaciones en la terapia antimicrobiana
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Guevara Agudelo, F., Muñoz Molina, L., Navarrette Ospina, J., Salazar Pulido, L., & Bermúdez, G. (2020). Innovaciones en la terapia antimicrobiana. NOVA, 18(34), 9-25. https://doi.org/10.22490/24629448.3921
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Autores
Fredy Alexander Guevara Agudelo
Liliana Constanza Muñoz Molina
Jeannette Navarrette Ospina
Luz Mary Salazar Pulido
https://orcid.org/0000-0002-7869-0991
https://orcid.org/0000-0002-7869-0991
Gladys Pinilla Bermúdez
https://orcid.org/0000-0002-3548-344X
https://orcid.org/0000-0002-3548-344X
Resumen
La resistencia microbiana ha llevado a la búsqueda de innovadoras alternativas para su contención y dentro de las más promisorias están el uso de péptidos sintéticos, no sólo por sus características intrínsecas antimicrobianas, sino por las interacciones sinérgicas y antagónicas que presenta con otros mediadores inmunológicos. Estas propiedades han permitido crear péptidos sintéticos reguladores de defensa innata que representan un nuevo enfoque inmunomodulador para el tratamiento de infecciones; sin embargo, sólo los diseñados con alto score antimicrobiano, han demostrado eficacia en estudios clínicos de Fase 3. Debido a su amplio espectro de actividad, un único péptido puede actuar contra bacterias Gram negativas, Gram positivas, hongos, e incluso virus y parásitos, aumentando el interés por investigar estas dinámicas moléculas.
Por otra parte, se encuentra el sistema CRISPR, para la edición de genomas bacterianos, permitirá reducir su actividad virulenta y diseñar antimicrobianos basados en nucleasas CRISPR-Cas 9 programables contra dianas específicas, las que representan un promisorio camino en el estudio de nuevas alternativas con alto potencial para eliminar la resistencia a antibióticos de bacterias altamente patógenas. Asimismo, se aborda la terapia con fagos, referida a la accion de virus que infectan bacterias, usados solos o en cocteles para aumentar el espectro de acción de estos, aprovechando su abundacia en la naturaleza, ya que se ha considerado que cada bacteria tiene un virus específico que podría emplearse como potente agente antibacteriano.
Finalmente, mientras se usen como principal medio de contención solo tratamientos convencionales antimicrobianos, incluso de manera oportuna y acertada, la microevolución en las bacterias se asegurará de seguir su curso
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2. Laxminarayan R, Duse A, Wattal C, Zaidi A K M, Wertheim H F L, Sumpradit N, Cars, O. Antibiotic resistance-the need for global solutions. Lancet Infect Dis. 2013;13(12): 1057–98. http://doi.org/10.1016/S1473-3099(13)70318-9
3. Brian D, Carole F, Johnson A. The Control of Methicillin-Resistant Staphylococcus aureus. Blood Stream Infec Eng. 2015; Ofid: 1–8. http://doi.org/10.1093/o
4. Boucher H W, Talbot G H, Bradley J S, Edwards J E, Gilbert D, Rice L B, Bartlett J. Bad bugs, no drugs: no ESKAPE! An update from the Infectious Diseases Society of America. Clin Infect Dis. 2009;48(1):1–12. http://doi.org/10.1086/595011
5. WHO. Antimicrobial resistance: global report on surveillance 2014. Bull World Health Organ. 2014;61(3): 383–94. http://doi.org/10.1007/s13312-014-0374-3
6. D’Costa V M, King C E, Kalan L, Morar M, Sung W W L, Schwarz C, et.al. Antibiotic resistance is ancient. Nature. 2011;477(7365):457–461. http://doi.org/10.1038/nature10388
7. Davies J, Davies D. Origins and Evolution of Antibiotic Resistance. Microbiol Mol Biol Rev. 2010;74(3): 417–433. http://doi.org/10.1128/mmbr.00016-10
8. Wright G D. The antibiotic resistome: the nexus of chemical and genetic diversity. Nat Rev Microbiol. 2007;5:175–186. http://doi.org/10.1038/nrmicro1614
9. Martínez J L. Antibiotics and Antibiotic Resistance Genes in Natural Environments. Science. 2008;321(5887):365 LP-367. Retrieved from http://science.sciencemag.org/content/321/5887/365.abstract
10. Chadha T. Antibiotic Resistant Genes in Natural Environment. Agrotechnol. 2012;1(1):1–3. http://doi.org/10.4172/2168-9881.1000104
11. Berglund B, Gengler S, Batoko H, Wattiau P, Errampalli D, Leung K, Schweizer H P. Environmental dissemination of antibiotic resistance genes and correlation to anthropogenic contamination with antibiotics. J Microbiol Meth. 2015;113: 28564. http://doi.org/10.1016/j.mimet.2015.03.023
12. Seiler C, Berendonk T U. Heavy metal driven co-selection of antibiotic resistance in soil and water bodies impacted by agriculture and aquaculture. Front Microbiol. 2012;3:1–10. http://doi.org/10.3389/fmicb.2012.00399
13. Jury K L, Vancov T, Stuetz RM, Khan S J. Antibiotic resistance dissemination and sewage treatment plants. Applied Microbiol. 2010;3: 509–519.
14. Marti R, Scott A, Tien Y C, Murray R, Sabourin L, Zhang Y, Topp E. Impact of manure fertilization on the abundance of antibiotic-resistant bacteria and frequency of detection of antibiotic resistance genes in soil and on vegetables at harvest. Applied Environ Microbiol. 2013;79(18):5701–5709. http://doi.org/10.1128/AEM.01682-13
15. Van Boeckel T P, Gandra S, Ashok A, Caudron Q, Grenfel, B T, Levin S A, Laxminarayan R. Global antibiotic consumption 2000 to 2010: an analysis of national pharmaceutical sales data. Lancet Infect Dis. 2014; 14(8): 742–750. http://doi.org/10.1016/S1473-3099(14)70780-7
16. Yuen C M, Jenkins H E, Rodriguez C A, Keshavjee S, Becerra MC. Global and Regional Burden of Isoniazid-Resistant Tuberculosis. Pediatr. 2015;136(1): e50-9. http://doi.org/10.1542/peds.2015-0172
17. Zielnik-Jurkiewicz B, Bielicka A. Antibiotic resistance of Streptococcus pneumoniae in children with acute otitis media treatment failure.Inter J Pediatr Otorhinolaryngo. 2017:79(12): 2129–2133. http://doi.org/10.1016/j.ijporl.2015.09.030
18. Temime L, Boëlle P Y, Valleron A J, Guillemot D. Penicillin-resistant pneumococcal meningitis: high antibiotic exposure impedes new vaccine protection. Epidemiol Infect. 2005;133(3): 493–501. http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2870273/
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