Second Critical Care Department, Attikon University Hospital, Athens, Greece.
UQ Centre for Clinical Research, Faculty of Medicine, The University of Queensland, Brisbane, Australia.
Curr Opin Infect Dis. 2023 Dec 1;36(6):545-554. doi: 10.1097/QCO.0000000000000977. Epub 2023 Sep 26.
This article aims to review the epidemiology of nonfermenting Gram-negative bacilli (NFGNB) based on recent literature reports, particularly, of the less common, but with emerging clinical significance species.
The reported frequency of multidrug-resistant Acinetobacter baumannii and Pseudomonas aeruginosa is increasing, with very significant variability, however, between different countries. Apart from the major NFGNB, that is, A. baumannii and P. aeruginosa, already recognized as of critical importance healthcare risks, several other NFGNB genera have been increasingly associated with diverse severe infections, such as Stenotrophomonas maltophilia, Burkholderia spp., Elizabethkingia spp., Chryseobacterium spp., Achromobacter spp., Alcaligenes spp., Sphingomonas spp., Shewanella spp. and Ralstonia spp., among others.
The exploration of the epidemiology, as well as the pathogenic potential of the of the less frequent, but emerging and increasingly reported NFGNB, is crucial, not only for immunocompromised patients, but also for critically ill patients without overt immunosuppression. As we are heading fast towards a postantibiotic era, such information would contribute to the optimal antimicrobial management, that is, providing prompt, appropriate antimicrobial coverage when needed and, at the same time, avoiding overuse and/or inappropriate use of antimicrobial therapy. Also, it would help to better understand their transmission dynamics and to develop effective prevention strategies.
本文旨在根据最近的文献报道，综述非发酵革兰阴性杆菌（NFGNB）的流行病学，特别是较少见但具有新兴临床意义的物种。
耐多药鲍曼不动杆菌和铜绿假单胞菌的报告频率正在增加，但在不同国家之间存在很大差异。除了已经被认为是严重的医疗保健风险的主要 NFGNB，即鲍曼不动杆菌和铜绿假单胞菌外，其他一些 NFGNB 属也越来越多地与各种严重感染相关，如嗜麦芽窄食单胞菌、伯克霍尔德菌属、伊丽莎白菌属、黄杆菌属、不动杆菌属、产碱杆菌属、鞘氨醇单胞菌属、希瓦氏菌属和罗尔斯顿菌属等。
探索较少见但新兴且越来越多报道的 NFGNB 的流行病学和发病潜能至关重要，不仅对免疫功能低下的患者，而且对没有明显免疫抑制的重症患者也是如此。随着我们快速进入后抗生素时代，此类信息将有助于优化抗菌药物管理，即在需要时提供及时、适当的抗菌药物覆盖，同时避免过度使用和/或不适当使用抗菌药物治疗。此外，它还有助于更好地了解其传播动态并制定有效的预防策略。
