Pediatric Infectious Diseases Unit, Gregorio Marañón Hospital, Madrid, Spain
Department of Infectious Diseases and Tropical Pediatrics, La Paz Hospital, Madrid, Spain.
Antimicrob Agents Chemother. 2020 Feb 21;64(3). doi: 10.1128/AAC.02183-19.
Carbapenem-resistant organisms (CRO) are a major global public health threat. hydrolyze almost all β-lactams through carbapenemase production. Infections caused by CRO are challenging to treat due to the limited number of antimicrobial options. This leads to significant morbidity and mortality. Over the last few years, several new antibiotics effective against CRO have been approved. Some of them (e.g., plazomicin or imipenem-cilastatin-relebactam) are currently approved for use only by adults; others (e.g., ceftazidime-avibactam) have recently been approved for use by children. Recommendations for antibiotic therapy of CRO infections in pediatric patients are based on evidence mainly from adult studies. The availability of pediatric pharmacokinetic and safety data is the cornerstone to broaden the use of proposed agents in adults to the pediatric population. This article provides a comprehensive review of the current knowledge regarding infections caused by CRO with a focus on children, which includes epidemiology, risk factors, outcomes, and antimicrobial therapy management, with particular attention being given to new antibiotics.
耐碳青霉烯类药物的生物体（CRO）是一个主要的全球公共卫生威胁。它们通过产生碳青霉烯酶几乎可以水解所有β-内酰胺类抗生素。由于可供选择的抗菌药物数量有限，由 CRO 引起的感染难以治疗。这导致了发病率和死亡率的显著增加。在过去的几年中，已经批准了几种针对 CRO 的新抗生素。其中一些（例如，帕拉米韦或亚胺培南-西司他丁-雷巴他定）目前仅批准成人使用；其他一些（例如，头孢他啶-阿维巴坦）最近已被批准用于儿童。儿科患者 CRO 感染抗生素治疗的建议主要基于成人研究的证据。儿科药代动力学和安全性数据的可用性是将拟议药物在成人中的使用扩大到儿科人群的基石。本文全面回顾了耐碳青霉烯类药物的生物体引起的感染，重点是儿童，包括流行病学、危险因素、结局和抗菌治疗管理，并特别关注新抗生素。
