最近更新的治疗卡巴胺耐药性感染在患有血液性恶性瘤的患者
Abdullah Tarık Aslan1, Murat Akova2
1Faculty of Medicine, UQ Centre for Clinical Research, The University of Queensland, Brisbane, Queensland, Australia.
Expert review of anti-infective therapy
|September 23, 2024
概括
患有血液性恶性瘤的患者面临高危的卡巴因耐药生物体感染的风险. 新的疗法,如ceftazidime/avibactam提供了选择,但金属β-lactamase生产者仍然是一个挑战.
科学领域:
- 传染性疾病 传染性疾病
- 血液学 血液学 血液学
- 抗微生物药物管理委员会
背景情况:
- 患有血性恶性瘤 (PHM) 的患者极易感染抗卡巴胺生物体 (CRO) 感染.
- 在PHM中CRO感染导致显著的发病率,死亡率和增加的医疗保健成本.
研究的目的:
- 对PHM中CRO感染的现有和新兴治疗替代方案进行审查.
- 要突出处理特定CRO类型的挑战,例如金属β-乳糖酶生产者.
主要方法:
- 对CRO感染的抗微生物疗法的当前文献的综述.
- 关于各种抗生素剂的有效性和应用的专家意见.
主要成果:
- 对于KPC和OXA-48生产商来说,建议使用Ceftazidime/avibactam; imipenem/cilastatin/relebactam和meropenem/vaborbactam是可以选择的替代品.
- 塞法胺/阿维巴克坦加上阿兹特里或阿兹特里/阿维巴克坦对金属β-乳酸酶生产者来说是有前途的.
- 塞夫托洛赞/塔扎巴克坦是对抗卡巴因耐药性*Pseudomonas aeruginosa*的第一线选择.
结论:
- 对于PHM中CRO感染,存在几种治疗选择,根据耐药机制推使用特定的药物.
- 产生金属β-乳糖酶的生物体是一个持续的治疗挑战.
- 包括人工智能在内的新型风险分层工具可能有助于预测殖民患者感染风险.
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