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去殖民化和病原体减少方法预防抗菌药物耐药和与医疗保健相关感染。

Decolonization and Pathogen Reduction Approaches to Prevent Antimicrobial Resistance and Healthcare-Associated Infections.

出版信息

Emerg Infect Dis. 2024 Jun;30(6):1069-1076. doi: 10.3201/eid3006.231338.

Abstract

Antimicrobial resistance in healthcare-associated bacterial pathogens and the infections they cause are major public health threats affecting nearly all healthcare facilities. Antimicrobial-resistant bacterial infections can occur when colonizing pathogenic bacteria that normally make up a small fraction of the human microbiota increase in number in response to clinical perturbations. Such infections are especially likely when pathogens are resistant to the collateral effects of antimicrobial agents that disrupt the human microbiome, resulting in loss of colonization resistance, a key host defense. Pathogen reduction is an emerging strategy to prevent transmission of, and infection with, antimicrobial-resistant healthcare-associated pathogens. We describe the basis for pathogen reduction as an overall prevention strategy, the evidence for its effectiveness, and the role of the human microbiome in colonization resistance that also reduces the risk for infection once colonized. In addition, we explore ideal attributes of current and future pathogen-reducing approaches.

摘要

医疗机构相关细菌病原体的耐药性及其引发的感染是影响几乎所有医疗机构的主要公共卫生威胁。当正常构成人类微生物组一小部分的定植性病原菌因临床干扰而数量增加时,就会发生对抗生素耐药的细菌感染。当病原体对破坏人类微生物组的抗生素的附带作用具有耐药性时,更有可能发生这种感染,从而导致定植抵抗力丧失,这是宿主防御的关键。病原体减少是预防传播和感染抗生素耐药医疗机构相关病原体的新兴策略。我们描述了将病原体减少作为一种整体预防策略的基础,以及其有效性的证据,以及人类微生物组在定植抵抗力中的作用,定植抵抗力也降低了定植后的感染风险。此外,我们还探讨了当前和未来病原体减少方法的理想属性。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/86a4/11138981/d4a3dd1fb4a2/23-1338-F.jpg

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