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侵袭性感染的抗菌治疗:系统评价

Antimicrobial Treatment of Invasive Infections: Systematic Review.

作者信息

Zivkovic Zaric Radica, Zaric Milan, Sekulic Marija, Zornic Nenad, Nesic Jelena, Rosic Vesna, Vulovic Tatjana, Spasic Marko, Vuleta Marko, Jovanovic Jovan, Jovanovic Dalibor, Jakovljevic Stefan, Canovic Petar

机构信息

Faculty of Medical Sciences, University of Kragujevac, 34000 Kragujevac, Serbia.

Clinical Center Kragujevac, 34000 Kragujevac, Serbia.

出版信息

Antibiotics (Basel). 2023 Feb 9;12(2):367. doi: 10.3390/antibiotics12020367.

Abstract

: (SM) is a Gram-negative pathogen discovered by Italian pharmacist, Bizio, in 1819. According to the literature, is resistant to a wide range of antibiotics, including penicillin, cephalosporin, tetracycline, macrolide, nitrofurantoin, and colistin. We conducted a systematic review of published reports, determined what invasive infections could cause SM, and established the most appropriate antibiotic therapy. : We registered this systematic review on the PROSPERO registry of systematic reviews-meta-analyses before we started our research (registration number CRD42022323159). The online searches of published studies were implemented via MEDLINE, the Cochrane Central Register of Controlled Trials, EBSCO, Scopus, Google Scholar, SCIndex, and the registry of clinical studies of human participants (ClinicalTrials.gov). : Our study included 32 published articles (9 case series and 23 case reports). There were 57 individual cases, respectively. The oldest patient was 97 years and the youngest patient was a newborn. was, in most cases, isolated from blood followed by urine and cerebrospinal fluid. In most cases, sensitivity was tested to cotrimoxazole (from 27 isolates, 10 showed resistance) followed by gentamicin (from 26 isolates, 3 showed resistance) as well as amikacin (from 21 isolates, none showed resistance). Patients died from an infection in 21 cases (31%). : Treatment of SM infections should include carbapenems or aminoglycosides in combination with third-generation (and eventually fourth-generation) cephalosporin. Cotrimoxazole should be considered in cases of uncomplicated urinary infections.

摘要

奇异变形杆菌(SM)是1819年由意大利药剂师比齐奥发现的革兰氏阴性病原体。根据文献记载,它对多种抗生素耐药,包括青霉素、头孢菌素、四环素、大环内酯类、呋喃妥因和黏菌素。我们对已发表的报告进行了系统综述,确定了SM可能导致的侵袭性感染,并确定了最合适的抗生素治疗方法。我们在开始研究之前,在系统评价-荟萃分析的PROSPERO注册库中注册了该系统综述(注册号CRD42022323159)。通过MEDLINE、Cochrane对照试验中央注册库、EBSCO、Scopus、谷歌学术、SCIndex以及人类参与者临床研究注册库(ClinicalTrials.gov)对已发表的研究进行在线检索。我们的研究纳入了32篇已发表的文章(9个病例系列和23个病例报告),分别有57例个体病例。年龄最大的患者为97岁,最小的患者为新生儿。在大多数情况下,SM是从血液中分离出来的,其次是尿液和脑脊液。在大多数情况下,对复方新诺明进行了敏感性测试(27株分离株中,10株显示耐药),其次是庆大霉素(26株分离株中,3株显示耐药)以及阿米卡星(21株分离株中,无耐药)。21例患者(31%)死于感染。SM感染的治疗应包括碳青霉烯类或氨基糖苷类联合第三代(最终是第四代)头孢菌素。对于非复杂性尿路感染,应考虑使用复方新诺明。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2415/9952094/c905d7aad022/antibiotics-12-00367-g001.jpg

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