Suppr超能文献

抗真菌耐药性:当前趋势及应对的未来策略

Antifungal resistance: current trends and future strategies to combat.

作者信息

Wiederhold Nathan P

机构信息

Department of Pathology and Laboratory Medicine, Fungus Testing Laboratory, University of Texas Health Science Center at San Antonio, San Antonio, TX, USA.

出版信息

Infect Drug Resist. 2017 Aug 29;10:249-259. doi: 10.2147/IDR.S124918. eCollection 2017.

Abstract

Antifungal resistance represents a major clinical challenge to clinicians responsible for treating invasive fungal infections due to the limited arsenal of systemically available antifungal agents. In addition current drugs may be limited by drug-drug interactions and serious adverse effects/toxicities that prevent their prolonged use or dosage escalation. Fluconazole resistance is of particular concern in non- species due to the increased incidence of infections caused by these species in different geographic locations worldwide and the elevated prevalence of resistance to this commonly used azole in many institutions. resistance to the echinocandins has also been documented to be rising in several US institutions, and a higher percentage of these isolates may also be azole resistant. Azole resistance in due to clinical and environmental exposure to this class of agents has also been found worldwide, and these isolates can cause invasive infections with high mortality rates. In addition, several species of , and other molds, including and species, have reduced susceptibility or pan-resistance to clinically available antifungals. Various investigational antifungals are currently in preclinical or clinical development, including several of them that have the potential to overcome resistance observed against the azoles and the echinocandins. These include agents that also target ergosterol and b-glucan biosynthesis, as well as compounds with novel mechanisms of action that may also overcome the limitations of currently available antifungal classes, including both resistance and adverse effects/toxicity.

摘要

由于全身可用的抗真菌药物种类有限,抗真菌耐药性对负责治疗侵袭性真菌感染的临床医生构成了重大临床挑战。此外,目前的药物可能受到药物相互作用以及严重不良反应/毒性的限制,从而妨碍其长期使用或剂量增加。在非[具体物种]中,氟康唑耐药性尤其令人担忧,因为这些物种在全球不同地理位置引起的感染发病率增加,而且在许多机构中对这种常用唑类药物的耐药率也有所上升。在美国的几家机构中,对棘白菌素的耐药性也被证明在上升,而且这些分离株中更高比例的可能也对唑类耐药。在[具体物种]中,由于临床和环境中接触这类药物而导致的唑类耐药性在世界各地也有发现,这些分离株可引起死亡率很高的侵袭性感染。此外,[具体物种]以及其他霉菌,包括[具体物种]和[具体物种],对临床可用抗真菌药物的敏感性降低或具有泛耐药性。目前有多种研究性抗真菌药物正处于临床前或临床开发阶段,其中包括几种有可能克服对唑类和棘白菌素观察到的耐药性的药物。这些药物包括靶向麦角固醇和β-葡聚糖生物合成的药物,以及具有新作用机制的化合物,这些化合物也可能克服目前可用抗真菌药物类别的局限性,包括耐药性和不良反应/毒性。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/40ac/5587015/3ef894c89612/idr-10-249Fig1.jpg

文献AI研究员

20分钟写一篇综述,助力文献阅读效率提升50倍。

立即体验

用中文搜PubMed

大模型驱动的PubMed中文搜索引擎

马上搜索

文档翻译

学术文献翻译模型,支持多种主流文档格式。

立即体验