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产碳青霉烯酶肠杆菌科导致的 HAP/VAP 我们应当如何治疗?

How Should We Treat HAP/VAP Caused by Carbapenemase-Producing Enterobacteriaceae?

机构信息

Infectious Disesaes Clinic, Department of Medicine University of Udine and Santa Maria Misericordia Hospital, Udine, Italy.

出版信息

Semin Respir Crit Care Med. 2017 Jun;38(3):301-310. doi: 10.1055/s-0037-1602656. Epub 2017 Jun 4.

Abstract

Hospital-acquired pneumonia (HAP) and ventilator-associated pneumonia (VAP) represent a common problem in hospital setting worldwide. Infections caused by carbapenem-resistant Enterobacteriaceae (CRE) are an emergent problem due to the lack of therapeutic options available, leading to significant increases in morbidity and mortality. CRE have frequently been reported both in HAP/VAP, but limited data regarding the optimal treatment strategy in this setting are available. This review focuses on the current epidemiology of CRE, with a specific focus on HAP/VAP. Moreover, we will suggest a possible strategy for the empiric and targeted treatment of HAP and VAP in which the involvement of CRE is suspected or is confirmed.

摘要

医院获得性肺炎(HAP)和呼吸机相关性肺炎(VAP)是全球医院环境中常见的问题。由于缺乏可用的治疗选择,碳青霉烯类耐药肠杆菌科(CRE)引起的感染是一个紧急问题,导致发病率和死亡率显著增加。CRE 经常在 HAP/VAP 中被报道,但在这种情况下,关于最佳治疗策略的有限数据。本综述重点介绍了 CRE 的当前流行病学,特别关注 HAP/VAP。此外,我们将提出一种可能的策略,用于经验性和靶向治疗 HAP 和 VAP,当怀疑或确认 CRE 参与其中时。

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