重症患者难治性感染：综述与治疗建议

Vidal-Cortés Pablo, Campos-Fernández Sandra, Cuenca-Fito Elena, Del Río-Carbajo Lorena, Fernández-Ugidos Paula, López-Ciudad Víctor J, Nieto-Del Olmo Jorge, Rodríguez-Vázquez Ana, Tizón-Varela Ana I

Intensive Care Unit, Complexo Hospitalario Universitario de Ourense, 32003 Ourense, Spain.

Hospital Pharmacy, Complexo Hospitalario Universitario de Ourense, 32003 Ourense, Spain.

Antibiotics (Basel). 2025 Feb 11;14(2):178. doi: 10.3390/antibiotics14020178.

The management of infections caused by difficult-to-treat in critically ill patients poses a significant challenge. Optimal antibiotic therapy is crucial for patient prognosis, yet the numerous resistance mechanisms of , which may even combine, complicate the selection of an appropriate antibiotic. In this review, we examine the epidemiology, resistance mechanisms, risk factors, and available and future therapeutic options, as well as strategies for treatment optimization. Finally, we propose a treatment algorithm to facilitate decision making based on the resistance patterns specific to each Intensive Care Unit.

危重症患者中由难治疗病原体引起的感染管理构成了重大挑战。最佳抗生素治疗对患者预后至关重要，然而病原体的多种耐药机制（甚至可能合并存在）使合适抗生素的选择变得复杂。在本综述中，我们研究了流行病学、耐药机制、危险因素、现有及未来的治疗选择以及治疗优化策略。最后，我们提出一种治疗算法，以促进基于每个重症监护病房特定耐药模式的决策制定。