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治疗耐多药(MDR)病原体时的抗生素考虑因素:基于案例的综述。

Antibiotic considerations in the treatment of multidrug-resistant (MDR) pathogens: a case-based review.

机构信息

Division of Infectious Diseases, Feinberg School of Medicine, Northwestern University, Chicago, Illinois 60611, USA.

出版信息

J Hosp Med. 2009 Jul;4(6):E8-15. doi: 10.1002/jhm.505.

Abstract

The recent rise in antimicrobial resistance among health-care associated pathogens is a growing public health concern. According to the National Nosocomial Infections Surveillance System, rates of methicillin-resistant Staphylococcus aureus (MRSA) in intensive care units have nearly doubled over the last decade. Of equal importance, gram-negative agents such as Pseudomonas aeruginosa, Acinetobacter baumannii, and extended-spectrum beta lactamase-producing Enterobacteriaceae demonstrate increasing resistance to third-generation cephalosporins, fluoroquinolones, and, in some cases, carbapenems. As a consequence, hospitalists may find themselves utilizing new antibiotics in the treatment of bacterial infections. This case-based review will highlight 8 antibiotics that have emerging clinical indications in treating these multidrug-resistant (MDR) pathogens.

摘要

近年来,与医疗保健相关的病原体对抗菌药物的耐药性不断增加,成为日益严重的公共卫生问题。根据全国医院感染监测系统的数据,过去十年间重症监护病房耐甲氧西林金黄色葡萄球菌(MRSA)的发生率几乎翻了一番。同样重要的是,革兰氏阴性菌如铜绿假单胞菌、鲍曼不动杆菌和产超广谱β-内酰胺酶的肠杆菌科对第三代头孢菌素、氟喹诺酮类药物的耐药性不断增加,在某些情况下甚至对碳青霉烯类药物也耐药。因此,医院医生在治疗细菌感染时可能会发现自己正在使用新的抗生素。本案例综述将重点介绍 8 种在治疗这些多药耐药(MDR)病原体方面具有新的临床适应证的抗生素。

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