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在儿童中治疗耐药格拉姆阴性细菌的治疗方法

Robert Cohen¹, Laurent Dortet², Marion Caseris³

¹Université Paris Est, IMRB-GRC GEMINI, 94000 Créteil, France; Centre Hospitalier Intercommunal de Créteil, France; ACTIV, Association Clinique et Thérapeutique Infantile du Val de Marne, Saint-Maur des Fossés, France; Pediatric Infectious Pathology Group of the French Pediatric Society, Créteil, France.

Infectious diseases now

|October 6, 2023

概括

格拉姆阴性细菌的抗生素耐药性是一个主要的公共卫生问题. 新药对抗耐药菌株提供了进展,但了解耐药机制是有效治疗的关键.

科学领域:

微生物学微生物学
传染性疾病传染性疾病
药理学药理学是指药理学的学科.

背景情况:

格拉姆阴性细菌,特别是肠杆菌,对β-乳酸菌抗生素表现出显著的耐药性.
关键的抵抗机制包括扩展谱β-乳糖酶 (ESBLs) 和卡巴酶.
一些耐卡巴胺菌株缺乏卡巴胺酶,但具有其他耐药性因素,如头酶的过度生产和外膜透性降低.

研究的目的:

为了突出格拉姆阴性细菌对β-乳糖抗生素耐药性的挑战.
讨论新的抗菌剂和β-乳糖抑制剂在打击多药耐药菌株中的作用.
强调了解抗性机制对于最佳治疗选择的重要性.

主要方法:

审查当前关于格拉姆阴性细菌抗生素耐药性机制的文献.
对新抗菌剂的活性谱和限制的分析.
讨论治疗耐药性感染所需的临床影响和协作方法.

主要成果:

扩展谱β-乳糖酶 (ESBL) 和卡巴酶是主要的抵抗机制.
耐卡巴胺的格拉姆阴性细菌的一个子集通过氨酸酶的过度生产和降低透性表现出耐药性.
新的β-乳抑制剂对某些耐药菌株的活性有所改善,标志着治疗进展.

结论:

对抗药性机制的深入了解对于选择有效的抗生素至关重要.
新的抗菌剂提供了更好的疗效,但并不涵盖所有耐药机制或细菌物种.
处方这些新型药物需要微生物学家,传染病专家和重症监护医生之间的合作,没有改变持续时间或组合治疗指示.

关键词:

碳烯的质量也很大.孩子孩子孩子孩子孩子孩子肠杆菌抗生素耐药性肠杆菌抗生素耐药性扩展光谱β-乳糖酶酶的存在

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