Siciliano Valentina, Passerotto Rosa Anna, Chiuchiarelli Marta, Leanza Gabriele Maria, Ojetti Veronica
Dipartimento di Scienze di Laboratorio e Infettivologiche, Fondazione Policlinico Universitario A. Gemelli IRCCS, 00168 Rome, Italy.
Dipartimento di Sicurezza e Bioetica, Università Cattolica del S. Cuore, 00168 Rome, Italy.
Life (Basel). 2023 May 4;13(5):1126. doi: 10.3390/life13051126.
Multidrug-resistant (MDRSE) is responsible for difficult-to-treat infections in humans and hospital-acquired-infections. This review discusses the epidemiology, microbiology, diagnosis, and treatment of MDRSE infection and identifies knowledge gaps. By using the search term "pan resistant " OR "multi-drug resistant " OR "multidrug-resistant lineages of ", a total of 64 records have been identified from various previously published studies. The proportion of methicillin resistance in has been reported to be as high as 92%. Several studies across the world have aimed to detect the main phylogenetic lineages and antibiotically resistant genes through culture, mass spectrometry, and genomic analysis. Molecular biology tools are now available for the identification of and its drug resistance mechanisms, especially in blood cultures. However, understanding the distinction between a simple colonization and a bloodstream infection (BSI) caused by is still a challenge for clinicians. Some important parameters to keep in mind are the number of positive samples, the symptoms and signs of the patient, the comorbidities of the patient, the presence of central venous catheter (CVC) or other medical device, and the resistance phenotype of the organism. The agent of choice for empiric parenteral therapy is vancomycin. Other treatment options, depending on different clinical settings, may include teicoplanin, daptomycin, oxazolidinones, long-acting lipoglycopeptides, and ceftaroline. For patients with infections associated with the presence of an indwelling device, assessment regarding whether the device warrants removal is an important component of management. This study provides an overview of the MDRSE infection. Further studies are needed to explore and establish the most correct form of management of this infection.
多重耐药性（MDRSE）可导致人类难以治疗的感染以及医院获得性感染。本综述讨论了MDRSE感染的流行病学、微生物学、诊断和治疗，并找出了知识空白。通过使用搜索词“泛耐药”或“多重耐药”或“多重耐药谱系”，从之前发表的各种研究中总共识别出64条记录。据报道，[此处缺失具体内容]中耐甲氧西林的比例高达92%。世界各地的多项研究旨在通过培养、质谱分析和基因组分析来检测主要的系统发育谱系和抗生素耐药基因。现在有分子生物学工具可用于鉴定[此处缺失具体内容]及其耐药机制，尤其是在血培养中。然而，对于临床医生来说，理解由[此处缺失具体内容]引起的单纯定植与血流感染（BSI）之间的区别仍然是一项挑战。需要牢记的一些重要参数包括阳性样本数量、患者的症状和体征、患者的合并症、中心静脉导管（CVC）或其他医疗设备的存在情况以及该生物体的耐药表型。经验性肠外治疗的首选药物是万古霉素。根据不同的临床情况，其他治疗选择可能包括替考拉宁、达托霉素、恶唑烷酮类、长效脂糖肽类和头孢洛林。对于存在留置装置相关的[此处缺失具体内容]感染患者，评估该装置是否需要移除是管理的重要组成部分。本研究概述了MDRSE感染。需要进一步研究以探索并确立这种感染最正确的管理形式。
