Bacterial toxins in musculoskeletal infections.
Bacterial toxins in musculoskeletal infections.
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DOI：
10.1002/jor.24683
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发表时间：
2021-03
期刊：
影响因子：
--
通讯作者：
Schwarz EM
中科院分区：
文献类型：
--
作者：
Saeed K;Sendi P;Arnold WV;Bauer TW;Coraça-Huber DC;Chen AF;Choe H;Daiss JL;Ghert M;Hickok NJ;Nishitani K;Springer BD;Stoodley P;Sculco TP;Brause BD;Parvizi J;McLaren AC;Schwarz EM
肌肉骨骼感染(MSKI)仍然是骨科的主要健康负担。细菌毒素是MSKI发病机制的基础，但护理MSKI患者的提供者社区对此知之甚少，导致一个由微生物学家、传染病专家、矫形外科医生和生物膜科学家组成的国际小组回顾了这一领域的文献，以确定关键主题并汇编关于毒素在MSKI中作用的当前知识，目的是阐明对生物膜形成和扩散的潜在影响以及治疗策略。该小组的结论是，需要进一步研究，以最大限度地了解毒素对MSKI的影响，包括：(I)进一步研究，以确定细菌毒素在MSKI中的作用，(Ii)建立对环境和宿主因素的重要性以及毒素在感染过程中在体内表达的理解，(Iii)建立MSKI中抗毒素作为抗菌剂的药物能力的原则，(Iv)制定明确的抗毒素作为抗感染药物的成功指标，(V)设计一种针对特定病原体的抗毒素鸡尾酒，以(A)抑制生物膜的形成和(B)抑制毒素的释放。在抗生素耐药性上升的时代，抗毒素作为潜在的抗菌剂的适用性可以满足临床医生的日常需求。
Musculoskeletal infections (MSKIs) remain a major health burden in orthopaedics. Bacterial toxins are foundational to pathogenesis in MSKI, but poorly understood by the community of providers that care for patients with MSKI, inducing an international group of microbiologists, infectious diseases specialists, orthopaedic surgeons and biofilm scientists to review the literature in this field to identify key topics and compile the current knowledge on the role of toxins in MSKI, with the goal of illuminating potential impact on biofilm formation and dispersal as well as therapeutic strategies. The group concluded that further research is needed to maximize our understanding of the effect of toxins on MSKIs, including: (i) further research to identify the roles of bacterial toxins in MSKIs, (ii) establish the understanding of the importance of environmental and host factors and in vivo expression of toxins throughout the course of an infection, (iii) establish the principles of drug-ability of anti-toxins as antimicrobial agents in MSKIs, (iv) have well-defined metrics of success for anti-toxins as anti-infective drugs, (v) design a cocktail of anti-toxins against specific pathogens to (a) inhibit biofilm formation and (b) inhibit toxin release. The applicability of anti-toxins as potential antimicrobials in the era of rising antibiotic resistance could meet the needs of day-to-day clinicians.
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