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抗菌药物耐药性领导联盟在革兰氏阳性菌感染研究方面的优先事项和进展:叙事性综述。

Priorities and Progress in Gram-positive Bacterial Infection Research by the Antibacterial Resistance Leadership Group: A Narrative Review.

机构信息

Division of Infectious Diseases, Department of Medicine, University of California, SanFrancisco, California, USA.

Division of Infectious Diseases, Department of Medicine, Houston Methodist Hospital, Houston, Texas, USA.

出版信息

Clin Infect Dis. 2023 Oct 16;77(Suppl 4):S295-S304. doi: 10.1093/cid/ciad565.

Abstract

The Antibacterial Resistance Leadership Group (ARLG) has prioritized infections caused by gram-positive bacteria as one of its core areas of emphasis. The ARLG Gram-positive Committee has focused on studies responding to 3 main identified research priorities: (1) investigation of strategies or therapies for infections predominantly caused by gram-positive bacteria, (2) evaluation of the efficacy of novel agents for infections caused by methicillin-resistant Staphylococcus aureus (MRSA) and vancomycin-resistant enterococci, and (3) optimization of dosing and duration of antimicrobial agents for gram-positive infections. Herein, we summarize ARLG accomplishments in gram-positive bacterial infection research, including studies aiming to (1) inform optimal vancomycin dosing, (2) determine the role of dalbavancin in MRSA bloodstream infection, (3) characterize enterococcal bloodstream infections, (4) demonstrate the benefits of short-course therapy for pediatric community-acquired pneumonia, (5) develop quality of life measures for use in clinical trials, and (6) advance understanding of the microbiome. Future studies will incorporate innovative methodologies with a focus on interventional clinical trials that have the potential to change clinical practice for difficult-to-treat infections, such as MRSA bloodstream infections.

摘要

抗菌药物耐药性领导组织 (ARLG) 将革兰氏阳性菌引起的感染作为其重点关注领域之一。ARLG 革兰氏阳性菌委员会专注于针对 3 项主要确定的研究重点开展研究:(1) 研究主要由革兰氏阳性菌引起的感染的策略或治疗方法,(2) 评估新型药物治疗耐甲氧西林金黄色葡萄球菌 (MRSA) 和万古霉素耐药肠球菌引起的感染的疗效,以及 (3) 优化治疗革兰氏阳性菌感染的抗菌药物剂量和持续时间。在此,我们总结了 ARLG 在革兰氏阳性菌感染研究方面的成果,包括旨在 (1) 为万古霉素剂量提供信息,(2) 确定达巴万星在 MRSA 血流感染中的作用,(3) 描述肠球菌血流感染,(4) 证明短程治疗对儿童社区获得性肺炎的益处,(5) 开发临床试验中使用的生活质量衡量标准,以及 (6) 加深对微生物组的理解。未来的研究将采用创新方法,重点开展干预性临床试验,有可能改变治疗困难感染(如 MRSA 血流感染)的临床实践。

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