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[呼吸道感染的发展与进展]

[Development and progress in respiratory tract infections].

作者信息

Pletz Mathias W

机构信息

Institut für Infektionsmedizin und Krankenhaushygiene, Universitätsklinikum Jena/Friedrich Schiller Universität Jena, 07740 Jena, Deutschland.

出版信息

Pneumologe (Berl). 2022;19(2):63-73. doi: 10.1007/s10405-022-00434-4. Epub 2022 Feb 11.

Abstract

The pandemic and the spread of multidrug-resistant pathogens impressively demonstrate that despite all medical and technical progress, infectious diseases still represent a global threat. The occurrence of new or difficult to treat infections due to resistance is determined by the dynamic evolution of pathogens, which can often have an erratic course and is not easily predictable. Coronavirus disease 2019 (COVID-19) has improved the understanding of airway infections and in addition to strategies targeted against the pathogen, has again demonstrated the importance of immunomodulation. Pathogen sequencing, point of care testing and decision aids based on artificial intelligence are some of the innovative techniques which will improve the management of airway infections in the coming years. In addition to viral airway infections, bacterial carbapenem-resistant pathogens (CRE) increasingly represent a therapeutic barrier in cases of nosocomial pneumonia. In recent years approval was given to beta lactams that are effective against CRE; however, their effectiveness is dependent on the underlying mechanism of resistance to carbapenem. An extended 20-valent pneumococcal conjugate vaccine will become available in 2022 for adults. A high-dose vaccine against influenza has been in use since 2021 for older adults. This article provides a highlighted overview of selected significant innovations in recent years in the field of airway infections.

摘要

大流行和多重耐药病原体的传播令人印象深刻地表明,尽管取得了所有医学和技术进步,但传染病仍然是全球威胁。由于耐药性导致的新的或难以治疗的感染的发生取决于病原体的动态演变,其过程往往不稳定且不易预测。2019年冠状病毒病(COVID-19)增进了人们对气道感染的理解,除了针对病原体的策略外,还再次证明了免疫调节的重要性。病原体测序、即时检测和基于人工智能的决策辅助工具是未来几年将改善气道感染管理的一些创新技术。除了病毒性气道感染外,耐碳青霉烯类细菌病原体(CRE)在医院获得性肺炎病例中越来越成为治疗障碍。近年来,对CRE有效的β-内酰胺类药物已获批准;然而,它们的有效性取决于对碳青霉烯类耐药的潜在机制。一种扩展的20价肺炎球菌结合疫苗将于2022年用于成人。一种高剂量流感疫苗自2021年起用于老年人。本文重点概述了近年来气道感染领域的一些重大创新。

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