Veeraraghavan Balaji, Pragasam Agila Kumari, Bakthavatchalam Yamuna Devi, Anandan Shalini, Swaminathan Subramanian, Sundaram Balasubramanian
Department of Clinical Microbiology, Christian Medical College, Vellore, Tamil Nadu, India.
Department of Infectious Diseases, Global Hospital, Chennai, Tamil Nadu, India.
Indian J Med Microbiol. 2019 Jan-Mar;37(1):72-90. doi: 10.4103/ijmm.IJMM_19_215.
Antimicrobial resistance is on the rise across the globe. Increasing incidence of infections due to carbapenem resistance organisms is becoming difficult to treat, due to the limited availability of therapeutic agents. Very few agents such as colistin, fosfomycin, tigecycline and minocycline are widely used, despite its toxicity. However, with the availability of novel antimicrobials, beta-lactam/beta-lactamase inhibitor-based and non-beta-lactam-based agents could be of great relief. This review covers three important aspects which include (i) current management of carbapenem-resistant infections, (ii) determination of specific types of carbapenemases produced by multidrug-resistant and extensively drug-resistant Gram-negative pathogens and (iii) the currently available novel beta-lactam/beta-lactamase inhibitors and non-beta-lactam-based agents' laboratory findings, clinical outcome and implications.
全球范围内抗菌药物耐药性正在上升。由于碳青霉烯耐药菌导致的感染发病率不断增加，由于治疗药物有限，这些感染变得难以治疗。尽管有毒性，但很少有药物如黏菌素、磷霉素、替加环素和米诺环素被广泛使用。然而，随着新型抗菌药物的出现，基于β-内酰胺/β-内酰胺酶抑制剂和非β-内酰胺类药物可能会带来极大的缓解。本综述涵盖三个重要方面，包括（i）碳青霉烯耐药感染的当前管理，（ii）多药耐药和广泛耐药革兰氏阴性病原体产生的特定类型碳青霉烯酶的测定，以及（iii）目前可用的新型β-内酰胺/β-内酰胺酶抑制剂和非β-内酰胺类药物的实验室研究结果、临床结果及意义。
