Outcome of infections due to pandrug-resistant (PDR) Gram-negative bacteria.
Outcome of infections due to pandrug-resistant (PDR) Gram-negative bacteria.
复制标题
DOI：
10.1186/1471-2334-5-24
复制
发表时间：
2005-04-08
影响因子：
3.7
通讯作者：
Michalopoulos A
中科院分区：
文献类型：
--
作者：
Falagas ME;Bliziotis IA;Kasiakou SK;Samonis G;Athanassopoulou P;Michalopoulos A
由于耐多药的革兰氏阴性细菌引起的感染问题日益严重，导致多粘菌素在几个国家重新使用。然而，已经有临床分离的革兰氏阴性细菌对所有可用的抗生素产生抗药性，包括多粘菌素。我们介绍了一系列患者，由于病原体对所有测试的抗菌剂，包括多粘菌素耐药而引起的感染。对青霉素类、头孢菌素类、碳青霉烯类、单环菌素类、喹诺酮类、氨基糖苷类和多粘菌素等7种抗假单胞菌药物均耐药的菌株称为熊猫耐药株(PDR)。联合应用粘菌素和β-内酰胺类抗生素，6例患者中有4例临床治愈了耐甲氧西林革兰阴性杆菌(PDR)感染。粘菌素与β-内酰胺类抗生素联合使用，可能是治疗耐药革兰氏阴性细菌感染的有效药物。重复使用多粘菌素是一种古老的抗生素，应谨慎使用，以试图延缓耐药革兰氏阴性细菌感染的发展速度。
The increasing problem of infections due to multidrug-resistant Gram-negative bacteria has led to re-use of polymyxins in several countries. However, there are already clinical isolates of Gram-negative bacteria that are resistant to all available antibiotics, including polymyxins. We present a case series of patients with infections due to pathogens resistant to all antimicrobial agents tested, including polymyxins. An isolate was defined as pandrug-resistant (PDR) if it exhibited resistance to all 7 anti-pseudomonal antimicrobial agents, i.e. antipseudomonal penicillins, cephalosporins, carbapenems, monobactams, quinolones, aminoglycosides, and polymyxins. Clinical cure of the infection due to pandrug-resistant (PDR) Gram-negative bacteria, namely Pseudomonas aeruginosa or Klebsiella pneumoniae was observed in 4 out of 6 patients with combination of colistin and beta lactam antibiotics. Colistin, in combination with beta lactam antibiotics, may be a useful agent for the management of pandrug-resistant Gram-negative bacterial infections. The re-use of polymyxins, an old class of antibiotics, should be done with caution in an attempt to delay the rate of development of pandrug-resistant Gram-negative bacterial infections.