由多药耐药格拉姆阴性病原体引起的医院获得和呼吸机相关的肺炎:了解COVID-19的流行病学,耐药性模式和影响
Dalal Hammoudi Halat1, Carole Ayoub Moubareck2
1Academic Quality Department, QU Health, Qatar University, Doha, Qatar.
抗菌素耐药性复杂化了医院获得的肺炎 (HAP) 和呼吸机相关的肺炎 (VAP) 的治疗. 本综述考察了多抗药性格拉姆阴性病原体,在HAP/VAP中至关重要,特别是在COVID-19后.
科学领域:
- 传染性疾病 传染性疾病
- 微生物学 微生物学
- 关键护理医学 关键护理医学
背景情况:
- 抗菌素耐药性 (AMR) 在治疗细菌性医院获得性肺炎 (HAP) 和呼吸机相关性肺炎 (VAP) 中构成重大挑战.
- 多种耐药性 (MDR) 格拉姆阴性病原体,包括*大肠杆菌*, *肺炎菌*, *Enterobacter* spp., *Pseudomonas aeruginosa* 和 *Acinetobacter* spp.,是主要的致病原体.
- 随着COVID-19的流行,了解和对抗这些耐药细菌肺部感染变得更加紧迫.
研究的目的:
- 审查HAP和VAP的流行病学.
- 阐明关键的MDR格兰氏阴性病原体在这些感染中所扮演的角色和抗菌素耐药性模式.
- 在COVID-19流行病的背景下,提供有关MDR阴性细菌引起的HAP/VAP的见解.
主要方法:
- 文献综述,重点关注流行病学和抗菌素耐药性模式.
- 在HAP和VAP中分析有关MDR格拉姆阴性病原体的数据.
- 综合了与耐卡巴胺*Acinetobacter baumannii* (CRAB),耐卡巴胺*Pseudomonas aeruginosa* (CRPA),耐卡巴胺的肠杆菌 (CRE),耐胺的格拉姆阴性病原体和扩展谱β-乳糖酶 (ESBL) 产生肠杆菌相关的发现.
主要成果:
- 在HAP和VAP中,MDR格拉姆阴性病原体普遍存在,导致治疗选择有限,结果差.
- 特定的MDR病原体,如CRAB,CRPA,CRE,抗胆固醇菌株和ESBL生产者,存在重大治疗挑战.
- 该审查突出了MDR阴性感染和COVID-19患者的HAP/VAP之间的关键相互作用.
结论:
- 了解HAP/VAP病原体的耐药性决定因素至关重要,特别是考虑到MDR菌株的兴起.
- 需要有效的策略来应对MDR格兰氏阴性细菌在肺炎中日益增长的流行和影响.
- 这些发现强调了需要修订的方法来管理在后疫情时代的细菌性肺炎.
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