Treatment and diagnosis of severe KPC-producing Klebsiella pneumoniae infections: a perspective on what has changed over last decades.
Treatment and diagnosis of severe KPC-producing Klebsiella pneumoniae infections: a perspective on what has changed over last decades.
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DOI：
10.1080/07853890.2022.2152484
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发表时间：
2023-12
影响因子：
4.4
通讯作者：
中科院分区：
文献类型：
--
作者：
在过去的十年里，随着新型β-内酰胺/β-内酰胺酶抑制剂组合和新型β-内酰胺类抗生素在临床实践中的引入，对Kpc-KP严重感染的治疗已经见证了显著的演变，严重Kpc-KP感染的治疗是一个高度动态的过程，其中明智地使用新型抗菌药的同时，应根据不断发展的临床证据和实验室诊断不断完善抗菌素耐药性是一个全球健康威胁。在革兰氏阴性细菌中，对碳青霉烯类抗生素的耐药性通常是难治性耐药性的代表，因为耐碳青霉烯类抗生素的微生物通常对多种抗生素具有耐药性。碳青霉烯类抗生素是一种β-内酰胺类抗生素。肺炎克雷伯菌对碳青霉烯类抗生素的耐药性主要是由于碳青霉烯类酶的产生，而肺炎克雷伯菌碳青霉烯酶(KPC)类酶是肺炎克雷伯菌中最常见的碳青霉烯类酶。在过去的十年中，人类由产KPC肺炎克雷伯菌(KPC-KP)引起的严重感染的管理给世界各地的临床医生提出了许多特殊的挑战。从这个角度来看，我们讨论了过去几十年来，在临床研究积累的证据的指导下，严重的KPC-KP感染的治疗是如何演变的，以及最近的诊断学进步如何允许在感染患者中预测KPC-KP的识别。
In the last decade, the management of severe infections due to KPC-Kp has presented many peculiar challenges to clinicians worldwide Following the introduction in clinical practice of novel β-lactam/β-lactamase inhibitor combinations and novel β-lactams active against KPC-producing bacteria, the management of severe KPC-Kp infections has witnessed a remarkable evolution Treatment of severe KPC-Kp infections is a highly dynamic process, in which the wise use of novel antimicrobials should be accompanied by a continuous refinement based on evolving clinical evidence and laboratory diagnostics Antimicrobial resistance is a global health threat. Among Gram-negative bacteria, resistance to carbapenems, a class of β-lactam antibiotics, is usually a proxy for difficult-to-treat resistance, since carbapenem-resistant organisms are often resistant to many classes of antibiotics. Carbapenem resistance in the Gram-negative pathogen Klebsiella pneumoniae is mostly due to the production of carbapenemases, enzymes able to hydrolyze carbapenems, and K. pneumoniae carbapenemase (KPC)-type enzymes are overall the most prevalent carbapenemases in K. pneumoniae. In the last decade, the management of severe infections due to KPC-producing K. pneumoniae (KPC-Kp) in humans has presented many peculiar challenges to clinicians worldwide. In this perspective, we discuss how the treatment of severe KPC-Kp infections has evolved over the last decades, guided by the accumulating evidence from clinical studies, and how recent advances in diagnostics have allowed to anticipate identification of KPC-Kp in infected patients.
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DOI：
10.1093/cid/ciy516
发表时间：
2018-11-28
期刊：
Clinical infectious diseases : an official publication of the Infectious Diseases Society of America
影响因子：
--
作者：
de Kraker MEA;Sommer H;de Velde F;Gravestock I;Weiss E;McAleenan A;Nikolakopoulos S;Amit O;Ashton T;Beyersmann J;Held L;Lovering AM;MacGowan AP;Mouton JW;Timsit JF;Wilson D;Wolkewitz M;Bettiol E;Dane A;Harbarth S;COMBACTE-NET Consortium
通讯作者：
COMBACTE-NET Consortium
影响因子：
4.9
作者：
Daikos, George L.;Tsaousi, Sophia;Skoutelis, Athanasios
通讯作者：
Skoutelis, Athanasios
影响因子：
4.9
作者：
Giordano, Liliana;Fiori, Barbara;Spanua, Teresa
通讯作者：
Spanua, Teresa
影响因子：
5.2
作者：
Del Bono, Valerio;Giacobbe, Daniele Roberto;Mattioli, Francesca
通讯作者：
Mattioli, Francesca
DOI：
10.1007/s10096-021-04377-1
发表时间：
2022-03
期刊：
European journal of clinical microbiology & infectious diseases : official publication of the European Society of Clinical Microbiology
影响因子：
--
作者：
Tiseo G;Yahav D;Paul M;Tinelli M;Gavazzi G;Mussini C;Prendki V;Falcone M
通讯作者：
Falcone M