利芬素作为单一治疗黄金葡萄球菌引起的感染:不适用"括号中的断点"的考虑因素
Sara E Boyd1,2,3, Mandy Wootton4, Robin A Howe4
1David Price Evans Global Health and Infectious Disease Research Group, University of Liverpool, Institute of Systems, Molecular & Integrative Biology, William Henry Duncan Building, Liverpool L7 8TX, UK.
The Journal of antimicrobial chemotherapy
|November 3, 2025
概括
利芬素单一治疗黄金葡萄球菌感染通常是无效的,因为耐药性. 然而,EUCAST断点仍然没有被支,因为耐药性并不等同于固有的单一疗法无效性.
科学领域:
- 临床微生物学和传染病.
- 抗微生物耐药性. 抗微生物耐药性.
- 药理学和治疗学. 药理学和治疗学.
背景情况:
- 欧洲抗生素敏感性测试委员会 (EUCAST) 使用"括号中的断点"来表示不推单独治疗的药物.
- 利芬素单一治疗很少用于黄金葡萄球菌感染,但其断点目前没有被EUCAST括号.
- 对利芬素的新兴耐药性在金黄色葡萄球菌中很常见.
研究的目的:
- 为了评估非支架式里法素中断点对于黄金葡萄球菌感染的适当性.
- 为了确定频繁出现的耐药性是否符合EUCAST对抗菌剂分类的标准.
主要方法:
- 审查EUCAST关于断点括号标准的指导方针.
- 对Staphylococcus aureus中新出现的利芬辛耐药性的临床影响的分析.
- 抗药性模式与EUCAST对固有单一疗法无效性的定义进行比较.
主要成果:
- 经常出现的对利芬素的耐药性往往限制了其作为 Staphylococcus aureus 的单一治疗方法的使用.
- 新出现的耐药性不符合EUCAST对括号的核心标准,该标准要求药物作为单一治疗本质上是无效的.
- 里芬素的临床效用受到耐药性的影响,但它在单一治疗中并非本质上无效.
结论:
- 目前的EUCAST关于瑞芬素与金黄色葡萄球菌感染的断点状态值得考虑.
- 虽然阻力是常见的,但它不符合欧盟国家气象局 (EUCAST) 关于支架断点的具体标准.
- 可能需要进一步评估,以使断点指导与临床耐药性模式保持一致.
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