Infectious Diseases Society of America Guidance on the Treatment of Extended-Spectrum β-lactamase Producing Enterobacterales (ESBL-E), Carbapenem-Resistant Enterobacterales (CRE), and Pseudomonas aeruginosa with Difficult-to-Treat Resistance (DTR-P. aeruginosa)
Infectious Diseases Society of America Guidance on the Treatment of Extended-Spectrum β-lactamase Producing Enterobacterales (ESBL-E), Carbapenem-Resistant Enterobacterales (CRE), and Pseudomonas aeruginosa with Difficult-to-Treat Resistance (DTR-P. aeruginosa)
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DOI：
10.1093/cid/ciaa1478
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发表时间：
2021-04-01
影响因子：
11.8
通讯作者：
Clancy, Cornelius J.
中科院分区：
文献类型：
--
作者：
Tamma, Pranita D.;Aitken, Samuel L.;Clancy, Cornelius J.
背景。抗微生物药物耐药性感染在美国医院中很常见，并导致显著的发病率和死亡率。本指导文件提供了治疗由广谱β -内酰胺酶产生肠杆菌（ESBL-E）、耐碳青霉烯肠杆菌（CRE）和难以治疗耐药铜绿假单胞菌（DTR-P）引起的感染的建议。绿脓杆菌).Methods。一个由6名具有抗微生物药物耐药性感染管理专业知识的传染病专家组成的小组制定了有关ESBL-E、CRE和DTR-P治疗的常见问题。绿脓杆菌感染。在回顾已发表的文献和临床经验的基础上，专家组提出建议和每项建议的相关理由。由于全球在耐药分子流行病学和特异性抗感染药物的可用性方面存在显著差异，本文重点介绍了美国耐药感染的治疗情况。方法的经验治疗选择，治疗的持续时间，和其他管理方面的考虑进行了简要的讨论。大多数指南侧重于对抗微生物药物耐药性感染的首选和替代治疗建议，假设病原生物已被确定并且抗生素敏感性试验结果已知。治疗建议适用于成人和儿童。抗微生物药物耐药性领域是动态和快速发展的，抗微生物药物耐药性感染的治疗将继续挑战临床医生。本指导文件截止到2020年9月17日。随着新数据的出现，本指导文件将定期更新。此外，该小组将扩大建议，在未来的版本中包括其他有问题的革兰氏阴性病原体。该指南的最新版本（包括出版日期）可在www.idsociety.org/practice-guideline/amr-guidance/上找到。
Background. Antimicrobial-resistant infections are commonly encountered in US hospitals and result in significant morbidity and mortality. This guidance document provides recommendations for the treatment of infections caused by extended-spectrum beta-lactamase-producing Enterobacterales (ESBL-E), carbapenem-resistant Enterobacterales (CRE), and Pseudomonas aeruginosa with difficult-to-treat resistance (DTR-P. aeruginosa).Methods. A panel of 6 infectious diseases specialists with expertise in managing antimicrobial-resistant infections formulated common questions regarding the treatment of ESBL-E, CRE, and DTR-P. aeruginosa infections. Based on review of the published literature and clinical experience, the panel provide recommendations and associated rationale for each recommendation. Because of significant differences in the molecular epidemiology of resistance and the availability of specific anti-infective agents globally, this document focuses on treatment of antimicrobial-resistant infections in the United States.Results. Approaches to empiric treatment selection, duration of therapy, and other management considerations are briefly discussed. The majority of guidance focuses on preferred and alternative treatment recommendations for antimicrobial-resistant infections, assuming that the causative organism has been identified and antibiotic susceptibility testing results are known. Treatment recommendations apply to both adults and children.Conclusions. The field of antimicrobial resistance is dynamic and rapidly evolving, and the treatment of antimicrobial-resistant infections will continue to challenge clinicians. This guidance document is current as of 17 September 2020. Updates to this guidance document will occur periodically as new data emerge. Furthermore, the panel will expand recommendations to include other problematic gram-negative pathogens in future versions. The most current version of the guidance including the date of publication can be found at www.idsociety.org/practice-guideline/amr-guidance/.