Pace Maria Caterina, Corrente Antonio, Passavanti Maria Beatrice, Sansone Pasquale, Petrou Stephen, Leone Sebastiano, Fiore Marco
Department of Women, Child and General and Specialized Surgery, University of Campania "Luigi Vanvitelli", Naples 80138, Italy.
Department of Emergency Medicine, University of California San Francisco, San Francisco, CA 94143, United States.
World J Clin Cases. 2023 May 6;11(13):2874-2889. doi: 10.12998/wjcc.v11.i13.2874.
Intensive care units (ICU) for various reasons, including the increasing age of admitted patients, comorbidities, and increasingly complex surgical procedures ( transplants), have become "the epicenter" of nosocomial infections, these are characterized by the presence of multidrug-resistant organisms (MDROs) as the cause of infection. Therefore, the perfect match of fragile patients and MDROs, as the cause of infection, makes ICU mortality very high. Furthermore, carbapenems were considered for years as last-resort antibiotics for the treatment of infections caused by MDROs; unfortunately, nowadays carbapenem resistance, mainly among Gram-negative pathogens, is a matter of the highest concern for worldwide public health. This comprehensive review aims to outline the problem from the intensivist's perspective, focusing on the new definition and epidemiology of the most common carbapenem-resistant MDROs ( and ) to emphasize the importance of the problem that must be permeating clinicians dealing with these diseases.
由于多种原因,包括收治患者年龄增长、合并症以及手术程序(移植)日益复杂,重症监护病房(ICU)已成为医院感染的“中心”,这些感染的特征是存在多重耐药菌(MDROs)作为感染原因。因此,脆弱患者与作为感染原因的MDROs完美匹配,导致ICU死亡率极高。此外,多年来碳青霉烯类抗生素一直被视为治疗MDROs所致感染的最后一道防线;不幸的是,如今碳青霉烯类耐药,主要是革兰氏阴性病原体中的耐药问题,已成为全球公共卫生最为关注的问题。这篇综述旨在从重症监护医生的角度概述这一问题,重点关注最常见的耐碳青霉烯MDROs的新定义和流行病学,以强调这一问题对于治疗这些疾病的临床医生的重要性。