Stefani S, Campana S, Cariani L, Carnovale V, Colombo C, Lleo M M, Iula V D, Minicucci L, Morelli P, Pizzamiglio G, Taccetti G
Department of Biomedical and Biotechnological Sciences, Division of Microbiology, University of Catania, Catania, Italy.
Department of Paediatric Medicine, Cystic Fibrosis Centre, Anna Meyer Children's University Hospital, Florence, Italy.
Int J Med Microbiol. 2017 Sep;307(6):353-362. doi: 10.1016/j.ijmm.2017.07.004. Epub 2017 Jul 19.
Multidrug-resistant (MDR) Pseudomonas aeruginosa is an important issue for physicians who take care of patients with cystic fibrosis (CF). Here, we review the latest research on how P. aeruginosa infection causes lung function to decline and how several factors contribute to the emergence of antibiotic resistance in P. aeruginosa strains and influence the course of the infection course. However, many aspects of the practical management of patients with CF infected with MDR P. aeruginosa are still to be established. Less is known about the exact role of susceptibility testing in clinical strategies for dealing with resistant infections, and there is an urgent need to find a tool to assist in choosing the best therapeutic strategy for MDR P. aeruginosa infection. One current perception is that the selection of antibiotic therapy according to antibiogram results is an important component of the decision-making process, but other patient factors, such as previous infection history and antibiotic courses, also need to be evaluated. On the basis of the known issues and the best current data on respiratory infections caused by MDR P. aeruginosa, this review provides practical suggestions to optimize the diagnostic and therapeutic management of patients with CF who are infected with these pathogens.
多重耐药（MDR）铜绿假单胞菌对于照料囊性纤维化（CF）患者的医生而言是一个重要问题。在此，我们综述了关于铜绿假单胞菌感染如何导致肺功能下降以及多种因素如何促成铜绿假单胞菌菌株抗生素耐药性的出现并影响感染病程的最新研究。然而，多重耐药铜绿假单胞菌感染的CF患者实际管理的许多方面仍有待确定。关于药敏试验在应对耐药感染的临床策略中的确切作用了解较少，并且迫切需要找到一种工具来协助选择针对多重耐药铜绿假单胞菌感染的最佳治疗策略。目前的一种观点认为，根据抗菌谱结果选择抗生素治疗是决策过程的一个重要组成部分，但其他患者因素，如既往感染史和抗生素疗程，也需要进行评估。基于已知问题以及关于多重耐药铜绿假单胞菌引起的呼吸道感染的当前最佳数据，本综述提供了实用建议，以优化感染这些病原体的CF患者的诊断和治疗管理。
