Antibiotic regimens and intestinal colonization with antibiotic-resistant gram-negative bacilli
Antibiotic regimens and intestinal colonization with antibiotic-resistant gram-negative bacilli
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DOI：
10.1086/504481
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发表时间：
2006-09-01
影响因子：
11.8
通讯作者：
Donskey, Curtis J.
中科院分区：
文献类型：
--
作者：
Donskey, Curtis J.
肠道是耐药革兰氏阴性杆菌的重要储存库，包括肠杆菌科细菌、铜绿假单胞菌和鲍曼不动杆菌。抗生素施加的选择压力在这些病原体的出现和传播中起着至关重要的作用。许多种类的抗生素可能会促进卫生保健相关的革兰氏阴性杆菌的肠道定植，因为这些细菌通常具有多重耐药性。抗生素可以抑制仍然敏感的革兰氏阴性病原体的定殖，但由于耐药性的出现，这种作用的益处通常是有限的。抗生素处方的改变和标准的感染控制措施已有效地控制了耐药性革兰氏阴性病原体的定植和感染的爆发。需要进行更多的研究，以澄清诸如选择性消化道去污和环境表面以及患者皮肤和伤口去污等策略的作用。
The intestinal tract provides an important reservoir for antibiotic-resistant gram-negative bacilli, including Enterobacteriaceae species, Pseudomonas aeruginosa, and Acinetobacter baumannii. Selective pressure exerted by antibiotics plays a crucial role in the emergence and dissemination of these pathogens. Many classes of antibiotics may promote intestinal colonization by health care-associated gram-negative bacilli, because the organisms are often multidrug resistant. Antibiotics may inhibit colonization by gram-negative pathogens that remain susceptible, but the benefits of this effect are often limited because of the emergence of resistance. Antibiotic formulary alterations and standard infection control measures have been effective in controlling outbreaks of colonization and infection with antibiotic-resistant gram-negative pathogens. Additional research is needed to clarify the role of strategies such as selective decontamination of the digestive tract and decontamination of environmental surfaces and of patients' skin and wounds.