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社区获得性肺炎:耐药性趋势、研究及新型抗生素进展

Community-acquired pneumonia: Trends in and research on drug resistance and advances in new antibiotics.

作者信息

Shen Luyan, Wang Lixiang, Liu Cong, Shi Shaomin, Takahashi Tai, Wang Tiejun

机构信息

Laboratory of Pathobiology, Ministry of Education, Department of Pathophysiology, College of Basic Medical Sciences, Jilin University, Changchun, Jilin, China.

Department of Health Policy and Management, International University of Health and Welfare, Tokyo, Japan.

出版信息

Biosci Trends. 2021 Nov 21;15(5):266-275. doi: 10.5582/bst.2021.01342. Epub 2021 Sep 3.

Abstract

Community-acquired pneumonia (CAP) refers to infectious inflammation of the lung parenchyma developing outside of a hospital. CAP has quite a high mortality and morbidity rate worldwide, and especially among elderly patients. The increasing burden of CAP is due to antibiotic resistance, the growth of the elderly population, and underlying comorbidities. Streptococcus pneumoniae remains the most common bacterial pathogen causing CAP, but multi-drug resistance bacteria and potential pathogens have increased the difficulty and challenges of managing CAP. Although preventive measures, diagnostic techniques, and treatment strategies are constantly advancing and improving, the susceptibility of multi-drug resistant pathogens, such as including Methicillin-Resistant Staphylococcus aureus (MRSA), Klebsiella pneumoniae, and Pseudomonas aeruginosa, has not improved significantly in recent decades, thus highlighting the importance and necessity of developing new antibiotics for the treatment of CAP. New antimicrobials have been approved over the past few years that will expand treatment options for CAP, and especially for patients with potential comorbidities. This situation also offers the chance to reduce the abuse of antibiotics, their toxicities, and their adverse reactions and to provide effective personalized antibiotic treatment.

摘要

社区获得性肺炎(CAP)是指在医院外发生的肺实质感染性炎症。在全球范围内,尤其是老年患者中,CAP的死亡率和发病率相当高。CAP负担加重的原因包括抗生素耐药性、老年人口增长以及潜在的合并症。肺炎链球菌仍然是引起CAP最常见的细菌病原体,但多重耐药菌和潜在病原体增加了CAP管理的难度和挑战。尽管预防措施、诊断技术和治疗策略在不断进步和改进,但近几十年来,包括耐甲氧西林金黄色葡萄球菌(MRSA)、肺炎克雷伯菌和铜绿假单胞菌等多重耐药病原体的易感性并未显著改善,这凸显了开发新抗生素治疗CAP的重要性和必要性。在过去几年中,已有新的抗菌药物获批,这将扩大CAP的治疗选择,尤其是对于有潜在合并症的患者。这种情况也为减少抗生素的滥用、其毒性和不良反应以及提供有效的个性化抗生素治疗提供了契机。

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