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耐碳青霉烯类肠杆菌科细菌:新型抗菌药物时代及酶学不断演变背景下的治疗考量

Carbapenem-Resistant Enterobacterales: Considerations for Treatment in the Era of New Antimicrobials and Evolving Enzymology.

作者信息

Lasko Maxwell J, Nicolau David P

机构信息

Center for Anti-Infective Research and Development, Hartford Hospital, 80 Seymour Street, Hartford, CT, 06102, USA.

Division of Infectious Diseases, Hartford Hospital, Hartford, CT, USA.

出版信息

Curr Infect Dis Rep. 2020 Feb 7;22(3):6. doi: 10.1007/s11908-020-0716-3.

Abstract

PURPOSE OF REVIEW

Gram-negative resistance is a growing concern globally. Enterobacterales, formerly Enterobacteriaceae, have developed resistance mechanisms to carbapenems that leave very few antimicrobial options in the clinician's armamentarium.

RECENT FINDINGS

New antimicrobials like ceftazidime-avibactam, meropenem-vaborbactam, imipenem-relebactam, cefiderocol, and plazomicin have the potential to overcome resistance mechanisms in Enterobacterales including different classes of carbapenemases. Novel β-lactam/β-lactamase inhibitors, plazomicin, and cefiderocol give the clinician options that were once not available. Utilizing these options is of the utmost importance when treating carbapenem-resistant Enterobacterales.

摘要

综述目的

革兰氏阴性菌耐药性在全球范围内日益受到关注。肠杆菌目细菌(以前称为肠杆菌科)已对碳青霉烯类药物产生耐药机制,这使得临床医生可用的抗菌药物选择非常有限。

最新研究结果

新型抗菌药物如头孢他啶-阿维巴坦、美罗培南-瓦博巴坦、亚胺培南-瑞来巴坦、头孢地尔和普拉佐米星有可能克服肠杆菌目中的耐药机制,包括不同类型的碳青霉烯酶。新型β-内酰胺/β-内酰胺酶抑制剂、普拉佐米星和头孢地尔为临床医生提供了曾经没有的选择。在治疗耐碳青霉烯类肠杆菌目细菌时,使用这些选择至关重要。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d60c/7223591/3fecb1f33864/11908_2020_716_Fig1_HTML.jpg

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