针对Acinetobacter NDM-1疫情的基于Cefiderocol的治疗方案
Giovanna Travi1, Francesco Peracchi1,2, Marco Merli1
1Division of Infectious Diseases, ASST Grande Ospedale Metropolitano Niguarda, 20162 Milan, Italy.
Antibiotics (Basel, Switzerland)
|August 29, 2024
概括
塞菲德罗科尔在治疗抗卡巴因的Acinetobacter baumannii (CRAB) 感染,特别是产生NDM的菌株方面表现有前途,其临床治愈率很高. 然而,整体死亡率仍然很高,这凸显了敏感性测试和感染控制的必要性.
科学领域:
- 传染性疾病 传染性疾病
- 抗微生物耐药性 抗微生物耐药性
- 临床微生物学 临床微生物学
背景情况:
- 耐卡巴胺的巴曼尼菌 (CRAB) 构成了严重的治疗挑战.
- 产生金属β-乳糖酶 (MBL) 的CRAB菌株特别难以治疗.
- 塞菲德罗科尔是一种新型抗生素,具有针对格拉姆阴性细菌的活性,包括一些耐药菌株.
研究的目的:
- 描述在NDM-CRAB感染爆发期间使用Cefiderocol治疗的结果.
- 为了在现实环境中评估 cefiderocol 的临床有效性.
- 评估 cefiderocol 与 NDM-CRAB 隔离物的体外活性.
主要方法:
- 追溯NDM-CRAB殖民和/或感染的患者病例系列.
- 对临床结果的分析,包括临床治愈和死亡率.
- 在实验室中对使用商业测试的临床分离物进行二醇的敏感性测试.
主要成果:
- 38名患者被NDM-CRAB殖民和/或感染.
- 13名患者出现了全身性感染 (VAP和BSI).
- 到第7天,10名 (83%) 患者实现了临床治愈.
- 实验室内 cefiderocol 活性与体内有效性没有一致的相关性.
- 总体死亡率仍然很高,特别是在重病患者中.
结论:
- 塞菲德罗科尔可能是NDM-CRAB感染的可行治疗选择,特别是当其他选择有限时.
- 观察到高临床治愈率,但整体死亡率需要谨慎使用.
- 实施醇敏感性测试和强有力的感染控制措施至关重要.
相关概念视频
01:28Acute Pyelonephritis II: Diagnostic Studies and Management
Introduction:For diagnosing acute pyelonephritis, a comprehensive patient history is collected to identify symptoms such as dysuria, frequent or urgent urination, flank pain, or costovertebral angle (CVA) tenderness that may suggest a kidney infection.Physical ExaminationDuring the physical examination, CVA tenderness is assessed. This involves gentle percussion over the costovertebral angle, where tenderness often indicates a kidney infection.Diagnostic TestsUrinalysis: Used to identify white...
01:28Antimicrobial Effectiveness
The effectiveness of antimicrobial agents depends on various factors influencing their ability to eliminate microbial populations. Larger microbial populations require more time for complete eradication, emphasizing the importance of population size analysis when evaluating antimicrobial efficacy.Microbial resistance to antimicrobial agents varies significantly. Highly resilient microorganisms include endospores, gram-negative bacteria, and non-enveloped viruses, while prions are exceptionally...