Clinica Malattie Infettive, Ospedale Policlinico San Martino-IRCCS, Genoa, Italy.
Department of Health Sciences, University of Genoa, Genoa, Italy.
J Antimicrob Chemother. 2021 Nov 22;76(Suppl 4):iv23-iv37. doi: 10.1093/jac/dkab352.
Microbial resistance is a serious threat to human health worldwide. Among the World Health Organisation's list of priority resistant bacteria, three are listed as critical-the highest level of concern-and all three are Gram-negative. Gram-negative resistance has spread worldwide via a variety of mechanisms, the most problematic being via AmpC enzymes, extended-spectrum β-lactamases, and carbapenemases. A combination of older drugs, many with high levels of toxicity, and newer agents are being used to combat multidrug resistance, with varying degrees of success. This review discusses the current treatments for multidrug-resistant Gram-negative bacteria, including new agents, older compounds, and new combinations of both, and some new treatment targets that are currently under investigation.
微生物耐药性是全球范围内人类健康的严重威胁。在世界卫生组织优先耐药细菌名单中,有三种被列为“关键”,即最高级别关注,且均为革兰氏阴性菌。革兰氏阴性耐药性通过多种机制在全球范围内传播,最成问题的机制是通过 AmpC 酶、超广谱β-内酰胺酶和碳青霉烯酶。为了对抗多药耐药,人们正在使用组合使用旧药物(许多具有高毒性)和新型药物,取得了不同程度的成功。本文综述了治疗多重耐药革兰氏阴性菌的现有方法,包括新型药物、旧化合物以及两者的新组合,以及一些目前正在研究的新治疗靶点。