Unit of Infectious Diseases, Department of Clinical and Experimental Medicine, University of Catania, ARNAS Garibaldi Hospital, 95122 Catania, Italy.
Department of Biomedical and Biotechnological Science, Section of Pharmacology, University of Catania, 95123 Catania, Italy.
Int J Mol Sci. 2024 Jun 21;25(13):6814. doi: 10.3390/ijms25136814.
represents a significant concern in nosocomial settings, particularly in critically ill patients who are forced to remain in hospital for extended periods. The challenge of managing and preventing this organism is further compounded by its increasing ability to develop resistance due to its extraordinary genomic plasticity, particularly in response to adverse environmental conditions. Its recognition as a significant public health risk has provided a significant impetus for the identification of new therapeutic approaches and infection control strategies. Indeed, currently used antimicrobial agents are gradually losing their efficacy, neutralized by newer and newer mechanisms of bacterial resistance, especially to carbapenem antibiotics. A deep understanding of the underlying molecular mechanisms is urgently needed to shed light on the properties that allow enormous resilience against standard therapies. Among the most promising alternatives under investigation are the combination sulbactam/durlobactam, cefepime/zidebactam, imipenem/funobactam, xeruborbactam, and the newest molecules such as novel polymyxins or zosurabalpin. Furthermore, the potential of phage therapy, as well as deep learning and artificial intelligence, offer a complementary approach that could be particularly useful in cases where traditional strategies fail. The fight against is not confined to the microcosm of microbiological research or hospital wards; instead, it is a broader public health dilemma that demands a coordinated, global response.
代表了医院环境中的一个重大问题,特别是在需要长时间住院的重症患者中。由于其非凡的基因组可塑性,特别是对不利环境条件的反应,该生物体的管理和预防变得更加复杂,其对药物产生耐药性的能力不断增强。由于其被认为是一个重大的公共卫生风险,因此为确定新的治疗方法和感染控制策略提供了重要动力。事实上,目前使用的抗生素由于细菌产生的新的耐药机制而逐渐失去疗效,尤其是对碳青霉烯类抗生素的耐药性。急需深入了解潜在的分子机制,以阐明使该生物体具有对抗标准疗法的巨大弹性的特性。正在研究的最有前途的替代方案包括舒巴坦/多尼培南、头孢吡肟/齐多夫定、亚胺培南/法硼巴坦、西鲁巴坦和最新的分子,如新型多粘菌素或佐他巴坦。此外,噬菌体治疗以及深度学习和人工智能提供了一种补充方法,在传统策略失败的情况下可能特别有用。与 的斗争不仅局限于微生物学研究或医院病房的微观世界;相反,这是一个更广泛的公共卫生难题,需要协调一致的全球应对。