Lode H
Department of Chest and Infectious Diseases, Helios Klinikum E. v. Behring, Teaching Hospital Charité Berlin, Berlin, Germany.
Clin Microbiol Infect. 2005 Oct;11(10):778-87. doi: 10.1111/j.1469-0691.2005.01220.x.
Hospital-acquired bacterial infections pose a formidable challenge for healthcare providers, as patients often need to be treated empirically, at least initially, although delay of appropriate initial antimicrobial therapy is known to increase morbidity significantly and to increase mortality among affected patients. This elevated risk is compounded by the presence of antibiotic-resistant bacteria, including methicillin-resistant Staphylococcus aureus (MRSA), vancomycin-resistant enterococci (VRE), extended-spectrum beta-lactamase-producing Enterobacteriaceae, Escherichia coli and Klebsiella pneumoniae. Prompt initiation of treatment with an appropriate antimicrobial agent that is active against both Gram-positive and Gram-negative organisms is prudent for patients with nosocomial infections. As the continued usefulness of vancomycin comes into question, the number of alternative agents that provide efficacy equal to that of vancomycin remains limited. The development of novel and effective alternative agents, such as tigecycline, is therefore important.
医院获得性细菌感染对医疗服务提供者构成了巨大挑战，因为患者通常需要至少在初始阶段进行经验性治疗，尽管已知适当的初始抗菌治疗延迟会显著增加发病率并提高受影响患者的死亡率。包括耐甲氧西林金黄色葡萄球菌（MRSA）、耐万古霉素肠球菌（VRE）、产超广谱β-内酰胺酶肠杆菌科细菌、大肠埃希菌和肺炎克雷伯菌在内的耐药菌的存在使这种风险进一步加剧。对于医院感染患者，谨慎地及时开始使用对革兰氏阳性菌和革兰氏阴性菌均有效的适当抗菌药物进行治疗。由于万古霉素的持续有效性受到质疑，提供与万古霉素同等疗效的替代药物数量仍然有限。因此，开发新型有效替代药物，如替加环素，非常重要。
