用抗生素治疗由AMPC产生肠道细菌引起的感染
Gianpiero Tebano1, Irene Zaghi2, Monica Cricca3,4
1Infectious Diseases Unit, Ravenna Hospital, AUSL Romagna, 48100 Ravenna, Italy.
Pharmacy (Basel, Switzerland)
|September 23, 2024
概括
产生AMpC的肠道细菌可能会对常见的抗生素,如头素和 piperacillin/tazobactam,产生耐药性. 本综述阐明了AMPC产生格拉姆阴性细菌的治疗策略,指导了临床实践.
科学领域:
- 微生物学 微生物学
- 传染性疾病 传染性疾病
- 抗微生物耐药性 抗微生物耐药性
背景情况:
- AmpC酶是由格拉姆阴性细菌产生的β-乳酸酶,特别是肠杆菌.
- 过度生产AmpC会导致对第三代头素 (3GCs) 和piperacillin/tazobactam的耐药性.
- AmpC基因可以是染色体或等离子体编码的,有些物种表现出可诱导的染色体AmpC.
研究的目的:
- 审查AmpC产生的肠杆菌的微生物特性.
- 概述AmpC生成的肠杆菌的治疗方法.
- 为日常临床实践提供有关这些耐药病原体的指导.
主要方法:
- 对产生AmpC的肠杆菌的微生物特性进行文献综述.
- 对产生AMpC的肠杆菌的治疗策略的分析.
- 综合当前的证据,以告知临床决策.
主要成果:
- 像Enterobacter cloacae这样的物种中的诱导性染色体AmpC可以在β-乳酸治疗期间导致耐药性.
- 对于高风险的AMPC产生的肠道细菌引起的感染,卡巴胺或塞菲皮姆通常是首选的.
- 关于特定的β-lactam风险,piperacillin/tazobactam与cefepime的作用以及严重感染或较低风险物种的最佳治疗,仍然存在不确定性.
结论:
- 由于诱导性耐药机制,产生AMpC的肠道细菌构成了重大挑战.
- 了解AmpC基因的位置和表达对于有效的抗微生物选择至关重要.
- 需要进一步的研究,以解决这些感染的管理中持续存在的临床不确定性.
关键词:
这是一种AmpC酶.在Citrobacter freundii中使用.杆菌cloacae复杂的杆菌.克莱布西拉 (Klebsiella aerogenes) 是一种有机植物.的 ampC 基因基因.抗生素耐药性 抗生素耐药性贝塔 - 乳糖酶酶的存在贝塔乳糖类药物 贝塔乳糖类药物更多相关视频
12:03Antimicrobial Synergy Testing by the Inkjet Printer-assisted Automated Checkerboard Array and the Manual Time-kill Method
Published on: April 18, 2019
26.1K
05:06Author Spotlight: Advancing Antibiotic Resistance Research Using an Efflux-Deficient Bacterial Strain and a Single-Copy Gene Expression System
Published on: January 5, 2024
549
相关概念视频
01:16Treating Helicobacter pylori in Peptic Ulcers: Antimicrobial Therapy
333
Helicobacter pylori, a resilient gram-negative bacterium, can thrive in the stomach's harsh, acidic environment. Infection with H. pylori leads to a cascade of events within the stomach lining. One of the critical disruptions caused by this bacterium is the interference with somatostatin production, a hormone responsible for regulating acid secretion. This interference tips the balance, escalating acid secretion and diminishing bicarbonate levels. This imbalance compromises the defensive...
333
01:23Antimicrobial Proteins
947
Antimicrobial proteins are important components of the immune system. They aid the body in combating pathogens by either killing them directly or hindering their replication processes. Four main types of antimicrobial substances are interferons, the complement system, iron-binding proteins, and antimicrobial proteins.
Interferons
Interferons (IFNs) are proteins produced by lymphocytes, macrophages, and fibroblasts infected with viruses. While IFNs cannot prevent viruses from entering and...
Interferons
Interferons (IFNs) are proteins produced by lymphocytes, macrophages, and fibroblasts infected with viruses. While IFNs cannot prevent viruses from entering and...
947
00:57Antibiotic Selection
52.4K
Overview
52.4K
01:27Combined Effects of Drugs: Synergism
3.8K
Synergism is a useful mechanism where combining two or more drugs is more effective than each constituent used alone. Such combinations are also called supra-additive interactions. The drugs collectively enhance the final therapeutic effect by acting on different targets. Another advantage is that the low dose of each constituent drug is sufficient to achieve the desired effect. This helps reduce the duration of therapy and lower the adverse effects of these drugs.
Such synergistic combinations...
Such synergistic combinations...
3.8K
01:18Drugs Affecting GI Tract Motility: Antimicrobials as Antidiarrheal Agents
110
Acute diarrhea, a common gastrointestinal disturbance, is characterized by the rapid evacuation of fluid stools, leading to an excessive weight in fluid. This condition typically arises from disorders affecting intestinal water and electrolyte transport. It can be triggered by an increased osmotic load within the intestine, excessive secretion of electrolytes and water, mucosal exudation of protein and fluid, or altered intestinal motility. The primary risks of acute diarrhea are dehydration...
110
01:28Pneumonia IV: Management
308
The treatment of pneumonia varies based on its severity and the causative pathogen. Here is a structured approach to managing pneumonia, integrating pharmaceutical and supportive care strategies.
Bacterial Pneumonia Treatment
For bacterial pneumonia, antibiotics serve as the cornerstone of therapy. Initial treatment often begins with empirical antibiotics, tailored to the anticipated causative organism and adjusted based on culture results. Key antibiotic choices include:
Bacterial Pneumonia Treatment
For bacterial pneumonia, antibiotics serve as the cornerstone of therapy. Initial treatment often begins with empirical antibiotics, tailored to the anticipated causative organism and adjusted based on culture results. Key antibiotic choices include:
308