Russo Alessandro, Serapide Francesca
Infectious and Tropical Disease Unit, Department of Medical and Surgical Sciences, 'Magna Graecia' University of Catanzaro, Viale Europa, 88100 Grosseto, Italy.
Microorganisms. 2025 Apr 5;13(4):829. doi: 10.3390/microorganisms13040829.
Carbapenem-resistant (CRAB) is an emerging and important major cause of nosocomial infections, posing a significant challenge to clinicians worldwide. The intrinsic and acquired resistance mechanisms exhibited by CRAB, associated with its ability to persist in healthcare environments, have transformed it into a critical public health concern. The clinical implications of CRAB infections include severe manifestations, like ventilator-associated pneumonia and bloodstream infections. These infections are often associated with increased morbidity and mortality, particularly in critically ill patients, such as those in intensive care units, immunocompromised, and those undergoing invasive procedures. Considering these characteristics, the therapeutic armamentarium for the treatment of CRAB infections is increasingly limited, as these strains exhibit resistance to a broad range of antibiotics, including carbapenems and the new β-lactam inhibitors, which are considered last-line agents for many bacterial infections. An important role is represented by cefiderocol and data from real-world evidence. The aim of this narrative review is to discuss the main topics of CRAB infection and strategies for prevention, management, and therapy.
耐碳青霉烯类鲍曼不动杆菌(CRAB)是医院感染新出现的一个重要主要病因,给全球临床医生带来了重大挑战。CRAB表现出的固有和获得性耐药机制,与其在医疗环境中持续存在的能力相关,已使其成为一个关键的公共卫生问题。CRAB感染的临床影响包括严重表现,如呼吸机相关性肺炎和血流感染。这些感染通常与发病率和死亡率增加相关,尤其是在重症患者中,如重症监护病房的患者、免疫功能低下者以及接受侵入性操作的患者。考虑到这些特征,治疗CRAB感染的可用治疗手段越来越有限,因为这些菌株对包括碳青霉烯类和新型β-内酰胺酶抑制剂在内的多种抗生素耐药,而这些抗生素被认为是许多细菌感染的一线药物。头孢地尔和来自真实世界证据的数据发挥了重要作用。本叙述性综述的目的是讨论CRAB感染的主要话题以及预防、管理和治疗策略。