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我们对贝达基林耐药性的准备不足:呼吁临床和程序准备
Gail Brenda Cross1,2,3,4, Harry N Walker5,6,7, Tasnim Hasan8,9
1Burnet Institute, Victoria, Australia.
概括
贝达基林耐药性威胁着对抗多药耐药结核病的进展. 需要新的策略来保护贝达奎林.
科学领域:
- 传染性疾病 传染性疾病
- 微生物学 微生物学
- 药理学 药理学是指药理学的学科.
背景情况:
- 贝达基林彻底改变了多抗药结核病 (MDR-TB) 的治疗方法.
- 新兴的贝达基林耐药性对这些进展构成重大威胁.
- 贝达基林耐药结核病与糟糕的结局,高死亡率和传播有关.
研究的目的:
- 检查驱动MDR-TB中贝达基林耐药性的因素.
- 确定当前药物敏感性测试 (DST) 方法的局限性.
- 提出维护贝达基林疗效和打击耐药性的策略.
主要方法:
- 审查关于贝达基林耐药性的新出现的监测数据.
- 对贝达基林的药理动力学特性进行分析.
- 评估目前用于贝达基林耐药性的表型和基因型DST方法.
主要成果:
- 抗药性在基线和治疗开始后都在出现.
- 目前的DST方法存在关键差距,包括延迟检测和诊断灰色区域.
- 异质抗性使得及时的临床决策变得复杂.
结论:
- 迫切需要评估贝达基林节约疗法.
- 加强抗药性监测和制定复合DST标准至关重要.
- 建议采用快速分子工具,如下一代测序.
- 公平获得伴随药物和强大的患者支持是必不可少的.
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