The importance of understanding the infectious microenvironment.
The importance of understanding the infectious microenvironment.
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DOI：
10.1016/s1473-3099(21)00122-5
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发表时间：
2022-03
影响因子：
56.3
通讯作者：
Frimodt-Moller, Niels
中科院分区：
文献类型：
--
作者：
Bjarnsholt, Thomas;Whiteley, Marvin;Rumbaugh, Kendra P.;Stewart, Philip S.;Jensen, Peter O.;Frimodt-Moller, Niels
标准剂量的抗生素不能有效治疗软组织和骨骼的慢性感染。在这个个人观点中，我们主张通过考虑感染性微环境来改善这些感染的治疗。感染性微环境可能导致敏感细菌失去对标准实验室敏感性测试中有效的抗生素的敏感性。我们认为，细菌在标准实验室条件下的行为与实际感染中的行为有很大不同。感染性微环境可以改变生长和代谢活动，从而增加对抗生素的保护。因此，我们主张，当在类似于实际感染微环境的相关体外条件下根据药敏试验推荐抗生素时，可以改善慢性感染的抗生素治疗。我们建议建立知识的化学和物理组成的感染性微环境的相关条件。RNA测序、代谢组学和显微镜检查的最新进展使感染微环境的表征和验证体外条件与实际感染的临床相关性成为可能。
Standard doses of antibiotics do not efficiently treat chronic infections of the soft tissue and bone. In this Personal View, we advocate for improving treatment of these infections by taking the infectious microenvironment into account. The infectious microenvironment can cause sensitive bacteria to lose their susceptibility to antibiotics that are effective in standard laboratory susceptibility testing. We propose that bacteria behave substantially different in standard laboratory conditions than they do in actual infections. The infectious microenvironment could impose changes in growth and metabolic activity that result in increased protection against antibiotics. Therefore, we advocate that improved antibiotic treatment of chronic infection is achievable when antibiotics are recommended on the basis of susceptibility testing in relevant in vitro conditions that resemble actual infectious microenvironments. We recommend establishing knowledge of the relevant conditions of the chemical and physical composition of the infectious microenvironment. Recent advances in RNA sequencing, metabolomics, and microscopy have made it possible for the characterisation of the microenvironment of infections and to validate the clinical relevance of in vitro conditions to actual infections.
影响因子：
8.8
作者：
Roizin-Towle, L;Hall, E J
通讯作者：
Hall, E J