对黏菌素的耐药性：一种4.0菌株？
Resistance to Colistin in : A 4.0 Strain?
作者信息
Granata Guido, Petrosillo Nicola
机构信息
Clinical and Research Department, National Institute for Infectious Diseases "L. Spallanzani" - IRCCS, Rome, Italy.
出版信息
Infect Dis Rep. 2017 May 31;9(2):7104. doi: 10.4081/idr.2017.7104.
Abstract
The global rise of multidrug-resistant gram-negative bacteria represents an increasing threat to patient safety. From the first observation of a carbapenem-resistant gram-negative bacteria a global spread of extended-spectrum beta-lactamases and carbapenemases producing has been observed. Treatment options for multidrug-resistant are actually limited to combination therapy with some aminoglycosides, tigecycline and to older antimicrobial agents. Unfortunately, the prevalence of colistin-resistant and tigecycline-resistant is increasing globally. Infection due to colistin-resistant represents an independent risk factor for mortality. Resistance to colistin in may be multifactorial, as it is mediated by chromosomal genes or plasmids. The emergence of transmissible, plasmid-mediated colistin resistance is an alarming finding. The absence of new agents effective against resistant Gram-negative pathogens means that enhanced surveillance, compliance with infection prevention procedures, and antimicrobial stewardship programs will be required to limit the spread of colistin-resistant
摘要
多重耐药革兰氏阴性菌在全球范围内的增多对患者安全构成了日益严重的威胁。自首次观察到耐碳青霉烯类革兰氏阴性菌以来，已观察到产超广谱β-内酰胺酶和碳青霉烯酶的细菌在全球范围内传播。耐多药菌的治疗选择实际上仅限于与某些氨基糖苷类、替加环素以及较老的抗菌药物联合治疗。不幸的是，耐黏菌素和耐替加环素的细菌在全球范围内的流行率正在上升。耐黏菌素菌感染是死亡率的一个独立危险因素。细菌对黏菌素的耐药可能是多因素的，因为它由染色体基因或质粒介导。可传播的、质粒介导的黏菌素耐药性的出现是一个令人担忧的发现。缺乏有效对抗耐药革兰氏阴性病原体的新型药物意味着需要加强监测、遵守感染预防程序以及开展抗菌药物管理计划，以限制耐黏菌素菌的传播。
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