医院获得性革兰氏阴性菌感染中的抗菌药物耐药性
Antimicrobial resistance in hospital-acquired gram-negative bacterial infections.
作者信息
Mehrad Borna, Clark Nina M, Zhanel George G, Lynch Joseph P
机构信息
Division of Pulmonary and Critical Care Medicine and The Carter Center for Immunology, University of Virginia, Charlottesville, VA.
Division of Infectious Diseases, Department of Medicine, Loyola University, Maywood, IL.
出版信息
Chest. 2015 May;147(5):1413-1421. doi: 10.1378/chest.14-2171.
Abstract
Aerobic gram-negative bacilli, including the family of Enterobacteriaceae and non-lactose fermenting bacteria such as Pseudomonas and Acinetobacter species, are major causes of hospital-acquired infections. The rate of antibiotic resistance among these pathogens has accelerated dramatically in recent years and has reached pandemic scale. It is no longer uncommon to encounter gram-negative infections that are untreatable using conventional antibiotics in hospitalized patients. In this review, we provide a summary of the major classes of gram-negative bacilli and their key mechanisms of antimicrobial resistance, discuss approaches to the treatment of these difficult infections, and outline methods to slow the further spread of resistance mechanisms.
摘要
需氧革兰氏阴性杆菌，包括肠杆菌科以及非发酵乳糖菌（如假单胞菌属和不动杆菌属），是医院获得性感染的主要原因。近年来，这些病原体中的抗生素耐药率急剧上升，已达到全球流行程度。在住院患者中，遇到使用传统抗生素无法治疗的革兰氏阴性感染已不再罕见。在本综述中，我们总结了革兰氏阴性杆菌的主要类别及其抗菌耐药的关键机制，讨论了治疗这些难治性感染的方法，并概述了减缓耐药机制进一步传播的措施。
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