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重症监护病房中[具体病菌名称未给出]的毒力、耐药性及流行病学风险的十年回顾。

A Decade-Long Review of the Virulence, Resistance, and Epidemiological Risks of in ICUs.

作者信息

Chen Tao-An, Chuang Ya-Ting, Lin Chieh-Hui

机构信息

Division of Respiratory Therapy, Department of Chest Medicine, Show Chwan Memorial Hospital, Changhua 500, Taiwan.

Surgical Intensive Care Unit, Show Chwan Memorial Hospital, Changhua 500, Taiwan.

出版信息

Microorganisms. 2024 Dec 11;12(12):2548. doi: 10.3390/microorganisms12122548.

Abstract

, a major opportunistic pathogen, causes severe infections in both community and healthcare settings, especially in intensive care units (ICUs), where multidrug-resistant (MDR) strains, such as carbapenem-resistant (CRKP), pose significant treatment challenges. The rise in hypervirulent (hvKP) with enhanced virulence factors complicates management further. The ST11 clone, prevalent in China, exhibits both resistance and virulence traits, contributing to hospital outbreaks. ICU patients, particularly those with comorbidities or prior antibiotic exposure, are at higher risk. Treatment is complicated by limited antibiotic options and the increasing prevalence of polymicrobial infections, which involve resistant pathogens like and . Combination therapies offer some promise, but mortality rates remain high, and resistance to last-resort antibiotics is growing. Infection control measures and personalized treatment plans are critical, alongside the urgent need for vaccine development to combat the rising threat of , particularly in vulnerable populations. Effective management requires improved diagnostic tools, antimicrobial stewardship, and innovative treatment strategies to reduce the burden of this pathogen, especially in resource-limited settings. This review aims to provide a comprehensive analysis of the virulence, resistance, and epidemiological risks of in ICUs over the past decade, highlighting the ongoing challenges and the need for continued efforts to combat this growing threat.

摘要

作为一种主要的机会性病原体,在社区和医疗机构环境中都会引发严重感染,尤其是在重症监护病房(ICU),在那里耐多药(MDR)菌株,如耐碳青霉烯类肺炎克雷伯菌(CRKP),带来了重大的治疗挑战。具有增强毒力因子的高毒力肺炎克雷伯菌(hvKP)的出现使管理进一步复杂化。在中国流行的ST11克隆株兼具耐药性和毒力特征,导致医院内暴发。ICU患者,尤其是那些患有合并症或先前有抗生素暴露史的患者,面临更高的风险。由于抗生素选择有限以及多重微生物感染的患病率不断上升,治疗变得复杂,多重微生物感染涉及如[未提及的病原体1]和[未提及的病原体2]等耐药病原体。联合治疗带来了一些希望,但死亡率仍然很高,并且对最后手段抗生素的耐药性正在增加。感染控制措施和个性化治疗计划至关重要,同时迫切需要开发疫苗来对抗[病原体名称]日益增长的威胁,特别是在弱势群体中。有效的管理需要改进诊断工具、抗菌药物管理和创新治疗策略,以减轻这种病原体的负担,特别是在资源有限的环境中。本综述旨在对过去十年ICU中[病原体名称]的毒力、耐药性和流行病学风险进行全面分析,突出持续存在的挑战以及应对这一日益严重威胁的持续努力的必要性。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b367/11678397/38e7b8741e87/microorganisms-12-02548-g001.jpg

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