定制和非定制菌体治疗在耐火/耐药细菌感染患者的临床应用:系统性审查和元分析
Yang Liu1, Shuhua Thong2, Wilfried Moreira3
1Division of Pharmacy, Singapore General Hospital, Singapore; PhD Clinical and Translational Sciences, Duke-NUS Medical School, National University of Singapore, Singapore.
International journal of antimicrobial agents
|July 9, 2025
概括
菌体治疗 (PT) 显示出治疗耐药细菌感染的前景,定制生产产生了最高的成功率. 需要进一步进行精心设计的试验,以解决证据缺口并优化实施.
科学领域:
- 微生物学 微生物学
- 传染性疾病 传染性疾病
- 治疗方法 治疗方法
背景情况:
- 耐火性细菌感染具有显著的死亡风险.
- 菌体治疗 (PT) 提供了一个潜在的解决方案,但临床数据是分散的.
- 本综述综合了关于PT有效性,安全性和实施策略的证据.
研究的目的:
- 对耐火/耐药细菌感染的细菌治疗 (PT) 的当前临床证据进行审查和综合.
- 根据定制策略分析PT的有效性和安全性:非定制,定制选择和定制生产.
- 识别证据缺口和未来研究领域.
主要方法:
- 从16,226篇文章中确定了130项临床研究 (1115名患者) 的系统综述和元分析.
- 使用随机效应模型的有效性 (临床改善,细菌根除) 和安全性结果.
- 偏差风险评估和子集敏感性分析,包括个人患者数据分析.
主要成果:
- 总体临床改善率为71%,细菌根除率为51%.
- 定制生产显示出最高的成功率 (79%和87%),但产生了成本和潜在的延误.
- 副作用一般为轻度至中度;菌体中和药物动力学影响需要进一步调查.
结论:
- 菌体治疗显示出对抗性感染的有希望的临床结果.
- 显著的证据缺口需要精心设计的临床试验来确认疗效和安全性.
- 基于实验室的菌体监测需要进行系统的调查以改善实施.
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