Coronavirus Disease 2019, Superinfections, and Antimicrobial Development: What Can We Expect?
Coronavirus Disease 2019, Superinfections, and Antimicrobial Development: What Can We Expect?
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DOI：
10.1093/cid/ciaa524
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发表时间：
2020-11-15
影响因子：
11.8
通讯作者：
Nguyen, M. Hong
中科院分区：
文献类型：
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作者：
Clancy, Cornelius J.;Nguyen, M. Hong
2019年冠状病毒病（COVID-19）是在人们对抗菌素耐药性（AMR）非常担忧的时候出现的。没有研究专门评估COVID-19相关的重复感染或AMR。基于病例系列的有限数据，可以合理预期，相当少的重度COVID-19患者将发生双重感染，最常见的是由院内细菌和曲霉菌引起的肺炎。微生物学和AMR模式可能反映机构生态学。广谱抗菌药物的使用可能在住院患者中广泛，无论是作为定向治疗还是经验性治疗。管理将在限制不必要的抗菌药物使用和AMR方面发挥关键作用。国会COVID-19救济法案正在考虑抗菌药物报销改革和抗菌药物订阅模式，但目前还不清楚这些是否会被纳入最终立法。需要对COVID-19重叠感染进行前瞻性研究，从中获得的数据可以为合理的抗菌治疗和管理策略提供信息，并为市场改革和可持续药物开发提供模型。
Coronavirus disease 2019 (COVID-19) arose at a time of great concern about antimicrobial resistance (AMR). No studies have specifically assessed COVID-19-associated superinfections or AMR. Based on limited data from case series, it is reasonable to anticipate that an appreciable minority of patients with severe COVID-19 will develop superinfections, most commonly pneumonia due to nosocomial bacteria and Aspergillus. Microbiology and AMR patterns are likely to reflect institutional ecology. Broad-spectrum antimicrobial use is likely to be widespread among hospitalized patients, both as directed and empiric therapy. Stewardship will have a crucial role in limiting unnecessary antimicrobial use and AMR. Congressional COVID-19 relief bills are considering antimicrobial reimbursement reforms and antimicrobial subscription models, but it is unclear if these will be included in final legislation. Prospective studies on COVID-19 superinfections are needed, data from which can inform rational antimicrobial treatment and stewardship strategies, and models for market reform and sustainable drug development.