ACESSO ABERTO
entendendo a formação de populações bacterianas resistentes
A descoberta da penicilina no início do século passado deu início à era dos antibióticos e contribuiu para transformar o mundo rapidamente. Até então, feridas que infecionavam eram praticamente uma sentença de morte para o paciente, enquanto aglomerados humanos ou animais eram ambientes perfeitos para ocorrência de surtos de infecções bacterianas. Na prática, este grupo de moléculas permitiu o rápido crescimento da população humana, o aumento de sua expectativa de vida e a maior produção de proteínas de alto valor biológico para sustentar esta nova ordem mundial. Destarte, além de saúde, os antibióticos geraram riqueza ao longo dos seus anos de uso, contribuindo para o contínuo crescimento da soma dos bens e serviços produzidos no mundo. Todavia, seguindo uma lógica Darwiniana, as bactérias seguiram seus processos evolutivos naturais, porém moldados pela intervenção humana. Assim, inúmeras populações bacterianas que antes eram sensíveis a qualquer antibiótico hoje são multirresistentes, e a humanidade passou a conviver com o risco de retroceder à era pré-antibiótica. Tal condição consolidou a resistência bacteriana aos antibióticos (RBA) como um dos maiores desafios à saúde pública e à economia da humanidade. Em suma, é fácil compreender que ambiente e saúde humana e animal são indissociáveis. Esse cenário desafiador faz com que o uso de antibióticos na buiatria seja “demonizado” por uma parcela crescente da população, a qual desconhece que seu uso racional apresenta baixo risco de seleção de resistência e é uma potente ferramenta para aumentar a produtividade e promover a saúde e bem-estar animal. Neste contexto, onde o uso correto dos antibióticos é dependente de fatores vinculados às bactérias, aos fármacos e às peculiaridades do paciente, o presente artigo objetiva prover informações sobre os mecanismos de seleção da RBA, bem com sobre as características dos ensaios de sensibilidade bacteriana para auxiliar a tomada de decisão do prescritor de antibióticos durante suas atividades de campo.
Palavras-chave: bactérias, resistência antimicrobiana, testes de sensibilidade bacteriana, uso racional de antibióticos.
The discovery of penicillin in the early 20th century marked the beginning of the antibiotic era, triggering a rapid transformation of society. Until then, infected wounds were practically a death sentence, and human or animal populations provided ideal environments for outbreaks of bacterial infections. In practice, antibiotics enabled the rapid growth of the human population, increased life expectancy, and enhanced the production of high-biological-value proteins to sustain this new world order. Thus, beyond their undeniable health benefits, antibiotics also generated wealth through their use, contributing to the continuous growth of global goods and services. However, following Darwinian principles, bacteria have undergone natural evolutionary processes that are now strongly influenced by human intervention. As a result, many bacterial populations that were once highly susceptible to antibiotics have become multidrug-resistant, and humanity faces the risk of a return to the pre-antibiotic era. This scenario has consolidated antibiotic resistance (RBA) as one of the greatest challenges to both public health and the global economy. Ultimately, it is evident that the environment, human health, and animal health are inseparable. This complex situation has fueled the “demonization” of antibiotic use in buiatrics by segments of the population who are unaware that rational antibiotic use carries a low risk of resistance selection and remains a powerful tool for enhancing productivity, animal health, and animal welfare. In this context, where the appropriate use of antibiotics depends on bacterial characteristics, drug properties, and patient-specific factors, this article aims to provide an overview of RBA selection mechanisms and the key features of bacterial susceptibility testing, supporting veterinarians in evidence-based antibiotic prescription in the field.
Keywords: bacteria, antimicrobial resistance, bacterial susceptibility testing, rational use of antibiotics.
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