对抗多种药物耐药的格拉姆阴性微生物的治疗指南
1Rafael Cantón. Servicio de Microbiología, Hospital Universitario Ramón. 28034-Madrid, Spain. rafael.canton@salud.madrid.org.
概括
新的抗微生物药物可以对抗抗微生物药物耐药性的增加,但治疗指南各不相同. 未来的指导方针需要纳入针对抗药性细菌引起的具有挑战性的感染的新疗法.
科学领域:
- 传染性疾病 传染性疾病
- 药理学 药理学是指药理学的学科.
- 微生物学 微生物学
背景情况:
- 抗菌素耐药性增加需要新的治疗选择.
- 已经引入了几种新的抗微生物药物,包括β-lactam/β-lactamase抑制剂组合和cefiderocol.
- 专业协会 (ESCMID,IDSA,SEIMC) 的现有治疗指南涉及耐药病原体,但在建议方面有所不同.
研究的目的:
- 审查目前针对多药耐药微生物引起的感染的治疗指南.
- 突出主要专业协会之间建议的差异.
- 确定需要更新的指导方针,包括新型抗微生物药物和管理策略.
主要方法:
- 对ESCMID,IDSA和SEIMC的治疗指南进行比较分析.
- 每个指南所涵盖的病原体和耐药性机制的识别.
- 评估针对特定具有挑战性的病原体的建议,如耐卡巴尼姆的肠杆菌,阿辛托巴克特宝曼尼, Pseudomonas aeruginosa 和 Stenotrophomonas maltophilia.
主要成果:
- 这些指导方针针对的是扩展光谱β-乳糖酶的生产者,耐卡巴胺的肠杆菌,Acinetobacter baumannii和Pseudomonas aeruginosa.
- IDSA的指导方针独特地包括了针对AmpC生产商的建议.
- IDSA 和 SEIMC 提供了对 Stenotrophomonas maltophilia 治疗的建议.
结论:
- 目前的指导方针为治疗耐药细菌引起的感染提供了不同的方法.
- 需要未来的指导方针来整合新可用的抗微生物药物和创新的治疗选择.
- 协调和更新对于有效管理具有挑战性的感染至关重要.
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