Department of Pathology, Christiana Care, Wilmington, Delaware.
Department of Pathology and Laboratory Medicine, Emory University School of Medicine, Atlanta, Georgia.
Mod Pathol. 2023 Sep;36(9):100249. doi: 10.1016/j.modpat.2023.100249. Epub 2023 Jun 21.
The burden of emerging antimicrobial resistance (AMR) in the United States is significant and even greater worldwide. Mitigation efforts have decreased the incidence and deaths from antimicrobial-resistant organisms in the United States. Yet more than 2.8 million antimicrobial-resistant infections occur every year and more than 35,000 patients die as a result. Infection prevention and control, data tracking, antimicrobial stewardship, vaccines, therapeutics, diagnostics, and sanitation are all required to decrease AMR threats. In 2019, in the second version of the Centers for Disease Control and Prevention (CDC) report on antibiotic-resistant threats, the agency categorized AMR threats as urgent, serious, concerning, or to be watched. This review will discuss the following aspects of each bacterium in the CDC report: estimated numbers of cases and deaths, identify the better known and impactful mechanisms of resistance, diagnostic testing and its limitations, and current and possible future therapies. This review also presents anatomical pathology case examples that highlight the altered morphology of antibiotic partially treated bacteria in tissues.
美国新出现的抗菌药物耐药性(AMR)负担巨大,在全球范围内甚至更为严重。缓解措施已经降低了美国由抗菌药物耐药菌引起的发病率和死亡率。然而,每年仍有超过 280 万例抗菌药物耐药性感染发生,超过 3.5 万人因此死亡。感染预防和控制、数据跟踪、抗菌药物管理、疫苗、治疗方法、诊断方法和卫生设施,所有这些都需要减少 AMR 的威胁。2019 年,在美国疾病控制与预防中心(CDC)发布的第二份关于抗菌药物耐药性威胁的报告中,该机构将 AMR 威胁分为紧急、严重、关注或需要监测。本综述将讨论该报告中每种细菌的以下方面:估计的病例数和死亡人数,确定更知名和更具影响力的耐药机制,诊断检测及其局限性,以及当前和可能的未来治疗方法。本综述还介绍了解剖病理学病例示例,这些示例突出了组织中部分经抗生素治疗的细菌形态的改变。