Pletz Mathias W, Eckmann Christian, Hagel Stefan, Heppner Hans Jürgen, Huber Kora, Kämmerer Wolfgang, Schmitz Franz-Josef, Wilke Michael, Grabein Béatrice
Zentrum für Infektionsmedizin und Krankenhaushygiene, Universitätsklinikum Jena.
Klinik für Allgemein-, Viszeral- und Thoraxchirurgie, Klinikum Peine.
Dtsch Med Wochenschr. 2015 Jun;140(13):975-81. doi: 10.1055/s-0041-102452. Epub 2015 Jun 26.
The global spread of multi-drug resistant organisms (MDRO) is a major threat to public health. Fighting MDRO spread requires a multi-faceted approach as summarized in the German Antibiotic Resistance Strategy (DART). In the hospital, this includes antibiotic stewardship concepts and strict infection control measures. Treatment of MDRO is sophisticated. Within the last years, several antibiotics with activity against MRSA were launched and facilitate an individual therapy according to site of infection and co-morbidities. In contrast, novel antibiotics against carbapenemase producing Gram-negatives are still lacking. Current studies have shown, that a colistin-based combination treatment can improve the prognosis in these patients. The following article reviews MDRO definitions, burden of disease, treatment options and general strategies against MDRO.
多重耐药菌(MDRO)的全球传播是对公共卫生的重大威胁。正如德国抗生素耐药性战略(DART)中所总结的,对抗MDRO的传播需要多方面的方法。在医院里,这包括抗生素管理理念和严格的感染控制措施。MDRO的治疗很复杂。在过去几年里,几种对耐甲氧西林金黄色葡萄球菌(MRSA)有活性的抗生素被推出,并根据感染部位和合并症促进个体化治疗。相比之下,针对产碳青霉烯酶革兰氏阴性菌的新型抗生素仍然匮乏。目前的研究表明,基于黏菌素的联合治疗可以改善这些患者的预后。以下文章综述了MDRO的定义、疾病负担、治疗选择以及对抗MDRO的一般策略。