Treatment for carbapenem-resistant Enterobacterales infections: recent advances and future directions.

Treatment for carbapenem-resistant Enterobacterales infections: recent advances and future directions.
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DOI:
10.1007/s10096-021-04296-1
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发表时间:
2021-10
期刊:
European journal of clinical microbiology & infectious diseases : official publication of the European Society of Clinical Microbiology
影响因子:
--
通讯作者:
van Duin D
van Duin D
中科院分区:
其他
文献类型:
--
作者:
Tompkins K;van Duin D

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耐碳青霉烯类肠杆菌(CRE)对全世界人类健康构成越来越大的威胁。与碳青霉烯类敏感菌株相比,CRE 通常携带多种耐药基因,这些基因限制了治疗选择,需要更长的治疗时间,治疗成本更高,并且需要毒性更大的治疗。在这里,我们概述了 CRE 的耐药机制、全球 CRE 感染的流行病学以及 CRE 的可用治疗方案。我们回顾了最近批准的治疗 CRE 的药物,包括头孢他啶-阿维巴坦、美罗培南-伐硼巴坦、亚胺培南-瑞莱巴坦、头孢地罗以及新型氨基糖苷类和四环素类药物。我们还讨论了噬菌体疗法和目前正在开发的针对 CRE 的抗生素的最新进展。对这些疗法产生耐药性的可能性仍然很高,因此必须加强抗菌药物管理,以减少 CRE 在全球范围内的传播并确保持续获得有效的治疗方案。
Carbapenem-resistant Enterobacterales (CRE) are a growing threat to human health worldwide. CRE often carry multiple resistance genes that limit treatment options and require longer durations of therapy, are more costly to treat, and necessitate therapies with increased toxicities when compared to carbapenem-susceptible strains. Here, we provide an overview of the mechanisms of resistance in CRE, the epidemiology of CRE infections worldwide, and available treatment options for CRE. We review recentlyapproved agents for the treatment of CRE, including ceftazidime-avibactam, meropenem-vaborbactam, imipenem-relebactam, cefiderocol, and novel aminoglycosides and tetracyclines. We also discuss recent advances in phage therapy and antibiotics that are currently in development targeted to CRE. The potential for the development of resistance to these therapies remains high, and enhanced antimicrobial stewardship is imperative both to reduce the spread of CRE worldwide and to ensure continued access to efficacious treatment options.
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