在骨和关节感染中针对多药性耐药性格拉姆阴性病原体的抗菌治疗选择
Maria Tsilika1, Fotinie Ntziora2, Efthymia Giannitsioti2
11st Department of Internal Medicine, Medical School, National and Kapodistrian University of Athens, Laiko General Hospital, 11527 Athens, Greece.
Pathogens (Basel, Switzerland)
|February 26, 2025
概括
耐多药性格拉姆阴性细菌 (GNB) 是骨和关节感染中日益严重的威胁. 治疗需要除菌,移除植入物和联合抗生素治疗,包括用于广泛抗药性的新药.
科学领域:
- 传染性疾病 传染性疾病
- 整形外科 整形外科 整形外科
- 药理学 药理学是指药理学的学科.
背景情况:
- 多抗药性 (MDR) 和广泛抗药性 (XDR) 格拉姆阴性细菌 (GNB) 构成了全球卫生挑战.
- 虽然格拉姆阳性细菌通常会导致骨和关节感染,但MDR GNB越来越多地涉及,特别是在先前接触过抗生素的住院患者中.
研究的目的:
- 审查流行病学,当前数据和难以治疗 (DTR) GNB在骨和关节感染中的治疗选择.
- 突出除菌,植入物切除和抗菌策略的作用.
主要方法:
- 对流行病学趋势,实验数据和临床经验进行叙述性审查.
- 对DTR GNB骨和关节感染的可用治疗方案的分析.
主要成果:
- 激进的脱bridement和植入物去除是关键的. 迅速,长时间的联合抗生素治疗是必不可少的.
- 诺基诺对于DTR GNB.显示出良好的骨穿透. 碳烯是MDR GNB的一个选择.
- 对于XDR GNB,建议使用胆固醇素,胺素,tigecycline和新型β-乳糖/β-乳糖酶抑制剂的联合治疗,以及局部抗生素化.
结论:
- 为了有效地治疗DTR GNB骨和关节感染,需要采用多模式的方法.
- 新型抗生素和组合疗法显示出前景,但进一步的大规模研究至关重要.
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