在异种干细胞移植后,患有多药耐药细菌殖民的患者的抗生素降级策略
Roberto Bono1, Giuseppe Sapienza1, Stefania Tringali1
1BMT Unit, Azienda Ospedaliera Villa Sofia-Cervello, Palermo, Italy.
Frontiers in microbiology
|January 20, 2025
概括
复杂耐药 (MDR) 细菌的殖民化对接受异性干细胞移植 (allo-SCT) 的患者构成高死亡风险. 一种缓解升级的抗生素方法被发现是安全有效的,可以减少MDR细菌在这些脆弱患者中的暴露.
科学领域:
- 血液学 血液学 血液学
- 传染性疾病 传染性疾病
- 微生物学 微生物学
背景情况:
- 耐多药性 (MDR) 细菌的殖民,特别是耐卡巴胺的Klebsiella pneumoniae (KPC),是血液性恶性瘤患者接受密集化疗和全原干细胞移植 (allo-SCT) 的死亡的一个重要风险因素.
- 由MDR细菌引起的血流感染 (BSI) 在这种免疫受损患者群体中进一步提高了死亡率.
研究的目的:
- 分析在 allo-SCT 之前被 MDR 细菌殖民的患者的结局.
- 研究在接受allo-SCT的MDR殖民患者中抗微生物降级战略的可行性和安全性.
主要方法:
- 对接受alo-SCT的106名患者的回顾性分析,重点关注34名患者 (32%) 在手术前被MDR细菌殖民.
- 在移植前期评估经验性抗生素治疗 (EAT) 方法,包括MDR活性EAT和常规EAT.
- 评估MDR转移率,降级率和移植后30天和100天的死亡结果.
主要成果:
- 在研究的患者中,MDR转位率为零.
- 总体降级率达到了79%,其中75%的患者患有源不明发烧 (FUO),100%的患者患有MDR阳性直肠拭子前SCT.
- 30日和100日的所有原因死亡率分别为6%和12%,30日+感染相关死亡率为3%.
结论:
- 抗微生物降级方法已被证实对先前MDR定居的患者进行allo-SCT.安全.
- 实施降级策略可以显著减少患者接触实证抗生素,从而减轻选择性压力和进一步耐药性发展的风险.
相关概念视频
Antibiotic Selection
52.2K
Overview
52.2K
Combined Effects of Drugs: Synergism
3.7K
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...
3.7K
Defense Against Bacterial Pathogens
1.4K
The human immune system is a complex network of cells, tissues, and organs that work together to defend the body against bacterial infections. It consists of various immune cells, each playing a specific role in the defense mechanism.
Phagocytes
Phagocytes are the frontline soldiers of the immune system. They include neutrophils and macrophages. Neutrophils are the most abundant type of white blood cell and are quickly mobilized to the site of infection. Macrophages are larger cells that patrol...
Phagocytes
Phagocytes are the frontline soldiers of the immune system. They include neutrophils and macrophages. Neutrophils are the most abundant type of white blood cell and are quickly mobilized to the site of infection. Macrophages are larger cells that patrol...
1.4K
Pulmonary Tuberculosis V
170
Medical management of tuberculosis (TB) patients involves a comprehensive approach that includes diagnosis, treatment, and monitoring. The specific strategies can vary depending on the type of tuberculosis (latent or active), the patient's overall health status, and other considerations.
Latent tuberculosis infection occurs when TB bacteria are present in a person's body, but are not causing illness or symptoms. It is not contagious, and preventive treatment is crucial to avoid the...
Latent tuberculosis infection occurs when TB bacteria are present in a person's body, but are not causing illness or symptoms. It is not contagious, and preventive treatment is crucial to avoid the...
170
Treatment Resistant Cancers
3.2K
Cancer is the second leading cause of death in the United States. A cancer cell is genetically unstable and hence can mutate faster. They can also modify their microenvironment and escape immune surveillance. The difficulties in treating cancer are further compounded by the emergence of rapid resistance to anticancer drugs. The most common ways to attain resistance in cancer cells include alteration in drug transport and metabolism, modification of drug target, elevated DNA damage response, or...
3.2K


