Galani Irene, Karaiskos Ilias, Giamarellou Helen
Medicine, Infectious Diseases Laboratory, 4thDepartment of Internal Medicine, National and Kapodistrian University of Athens, Athens, Greece.
1st Department of Internal Medicine-Infectious Diseases, Hygeia General Hospital, Athens, Greece.
Expert Rev Anti Infect Ther. 2021 Nov;19(11):1457-1468. doi: 10.1080/14787210.2021.1924674. Epub 2021 May 24.
: Multi-drug-resistant is currently one of the most pressing emerging issues in bacterial resistance. Treatment of infections is often problematic due to the lack of available therapeutic options, with a relevant impact in terms of morbidity, mortality and healthcare-associated costs. Soon after the launch of Ceftazidime-Avibactam, one of the approved new β-lactam/β-lactamase inhibitor combinations, reports of ceftazidime-avibactam-resistant strains developing resistance during treatment were published. Being a hospital-associated pathogen, is continuously exposed to multiple antibiotics resulting in constant selective pressure, which in turn leads to additional mutations that are positively selected.: Herein the authors present the mechanisms of resistance to different antimicrobials, including updated data for ceftazidime-avibactam.: is a nosocomial pathogen commonly implicated in hospital outbreaks with a propensity for antimicrobial resistance toward mainstay β-lactam antibiotics and multiple other antibiotic classes. Following the development of drug resistance and understanding the mechanisms involved, we can improve the efficacy of current antimicrobials, by applying careful stewardship and rational use to preserve their potential utility. The knowledge on antibiotic resistance mechanisms should be used to inform the design of novel therapeutic agents that might not be subject to, or can circumvent, mechanisms of resistance.
多重耐药性是目前细菌耐药性中最紧迫的新出现问题之一。由于缺乏可用的治疗选择，多重耐药菌感染的治疗往往存在问题，在发病率、死亡率和医疗相关成本方面产生了重大影响。在获批的新型β-内酰胺/β-内酰胺酶抑制剂组合之一头孢他啶-阿维巴坦推出后不久，就有关于治疗期间出现头孢他啶-阿维巴坦耐药菌株的报道。作为一种医院相关病原体，多重耐药菌持续接触多种抗生素，导致持续的选择压力，进而导致更多被正向选择的突变。
在此，作者介绍了多重耐药菌对不同抗菌药物的耐药机制，包括头孢他啶-阿维巴坦的最新数据。
多重耐药菌是一种医院病原体，通常与医院感染暴发有关，对主要的β-内酰胺类抗生素和多种其他抗生素类别具有耐药倾向。在耐药性产生并了解其涉及的机制后，我们可以通过谨慎管理和合理使用来提高当前抗菌药物的疗效，以保留其潜在效用。关于抗生素耐药机制的知识应用于指导新型治疗药物的设计，这些药物可能不会受到耐药机制的影响，或者可以规避耐药机制。
