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耐药性:临床医生面临的真正挑战。

Resistance: A Real Challenge for Clinicians.

作者信息

Vázquez-López Rosalino, Solano-Gálvez Sandra Georgina, Juárez Vignon-Whaley Juan José, Abello Vaamonde Jorge Andrés, Padró Alonzo Luis Andrés, Rivera Reséndiz Andrés, Muleiro Álvarez Mauricio, Vega López Eunice Nabil, Franyuti-Kelly Giorgio, Álvarez-Hernández Diego Abelardo, Moncaleano Guzmán Valentina, Juárez Bañuelos Jorge Ernesto, Marcos Felix José, González Barrios Juan Antonio, Barrientos Fortes Tomás

机构信息

Departamento de Microbiología del Centro de Investigación en Ciencias de la Salud (CICSA), FCS, Universidad Anáhuac México Norte, Huixquilucan 52786, Mexico.

Departamento de Microbiología y Parasitología, Facultad de Medicina, Universidad Nacional Autónoma de México, Ciudad de Mexico 04510, Mexico.

出版信息

Antibiotics (Basel). 2020 Apr 23;9(4):205. doi: 10.3390/antibiotics9040205.

Abstract

(named in honor of the American bacteriologists Paul and Linda Baumann) is a Gram-negative, multidrug-resistant (MDR) pathogen that causes nosocomial infections, especially in intensive care units (ICUs) and immunocompromised patients with central venous catheters. has developed a broad spectrum of antimicrobial resistance, associated with a higher mortality rate among infected patients compared with other non- species. In terms of clinical impact, resistant strains are associated with increases in both in-hospital length of stay and mortality. can cause a variety of infections; most involve the respiratory tract, especially ventilator-associated pneumonia, but bacteremia and skin wound infections have also been reported, the latter of which has been prominently observed in the context of war-related trauma. Cases of meningitis associated with have been documented. The most common risk factor for the acquisition of MDR is previous antibiotic use, following by mechanical ventilation, length of ICU/hospital stay, severity of illness, and use of medical devices. Current efforts focus on addressing all the antimicrobial resistance mechanisms described in , with the objective of identifying the most promising therapeutic scheme. Bacteriophage- and artilysin-based therapeutic approaches have been described as effective, but further research into their clinical use is required.

摘要

(以美国细菌学家保罗和琳达·鲍曼的名字命名)是一种革兰氏阴性、多重耐药(MDR)病原体,可引起医院感染,尤其是在重症监护病房(ICU)以及患有中心静脉导管的免疫功能低下患者中。已产生广泛的抗菌耐药性,与其他非该菌种感染患者相比,感染患者的死亡率更高。就临床影响而言,耐药菌株与住院时间延长和死亡率增加有关。可引起多种感染;大多数涉及呼吸道,尤其是呼吸机相关性肺炎,但也有菌血症和皮肤伤口感染的报道,后者在与战争相关的创伤背景下尤为常见。已记录到与相关的脑膜炎病例。获得多重耐药的最常见危险因素是先前使用过抗生素,其次是机械通气、ICU/医院住院时间、疾病严重程度以及使用医疗设备。目前的努力集中在解决中描述的所有抗菌耐药机制,目标是确定最有前景的治疗方案。基于噬菌体和溶菌酶的治疗方法已被描述为有效,但需要对其临床应用进行进一步研究。

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