Duhaniuc Alexandru, Păduraru Diana, Nastase Eduard-Vasile, Trofin Felicia, Iancu Luminița-Smaranda, Sima Cristina-Mihaela, Dorneanu Olivia-Simona
Department of Preventive Medicine and Interdisciplinarity-Microbiology, University of Medicine and Pharmacy "Grigore T. Popa", 700115 Iasi, Romania.
National Institute of Public Health-Regional Center of Public Health, 700465 Iasi, Romania.
Pharmaceuticals (Basel). 2024 Aug 30;17(9):1151. doi: 10.3390/ph17091151.
The increasing incidence of antibiotic resistance in bacteria is a major problem in terms of therapeutic options, especially in immunocompromised patients, such as patients from intensive care units (ICUs), HIV-positive patients, patients with malignancies or transplant patients. Commensal bacteria, especially anaerobes, serve to maintain microbial stability by preventing overpopulation with pathogenic bacteria. In immunocompromised patients, microbiota imbalance caused by antibiotic therapy and decreased host immunity favors intestinal overpopulation with pathogenic species, leading to increased bacterial translocation and susceptibility to systemic infections. Infections with multidrug-resistant (MDR) bacteria pose major challenges to the establishment of appropriate treatment and lead to increased mortality. Asymptomatic colonization with MDR bacteria usually precedes infection and tends to persist for long periods of time, and in immunocompromised patients, colonization with MDR bacteria is a risk factor for systemic infections. This review aims to assess the relation between colonization and infection with MDR bacteria in immunocompromised patients such as ICU patients, HIV-positive patients and cancer patients and to identify the prevalence and patterns of MDR bacterial colonization and infection in this category of patients.
细菌对抗生素耐药性的日益增加在治疗选择方面是一个主要问题，尤其是在免疫功能低下的患者中，如重症监护病房（ICU）的患者、HIV阳性患者、恶性肿瘤患者或移植患者。共生细菌，尤其是厌氧菌，通过防止病原菌过度繁殖来维持微生物稳定性。在免疫功能低下的患者中，抗生素治疗和宿主免疫力下降导致的微生物群失衡有利于病原菌在肠道内过度繁殖，导致细菌易位增加和全身感染易感性增加。多重耐药（MDR）细菌感染对建立适当治疗构成重大挑战，并导致死亡率增加。MDR细菌的无症状定植通常先于感染，并倾向于长期持续存在，在免疫功能低下的患者中，MDR细菌定植是全身感染的一个危险因素。本综述旨在评估ICU患者、HIV阳性患者和癌症患者等免疫功能低下患者中MDR细菌定植与感染之间的关系，并确定此类患者中MDR细菌定植和感染的患病率及模式。
