Antimicrobial management strategies for Gram-positive bacterial resistance in the intensive care unit
Antimicrobial management strategies for Gram-positive bacterial resistance in the intensive care unit
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DOI：
10.1097/00003246-200104001-00009
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发表时间：
2001-04-01
影响因子：
8.8
通讯作者：
Schentag, JJ
中科院分区：
文献类型：
--
作者：
Schentag, JJ
本文总结了革兰氏阳性菌感染的现状，包括与重症监护室相关的两个主要后果——无法治愈和耐药。过去几年，一些中心的屎肠球菌对万古霉素的耐药性从 10% 增加到接近 60%。现在万古霉素失败的情况如此频繁，以至于无法再安全使用。这导致了两种新抗生素的使用，奎努普丁/达福普汀 (Synercid) 于 1999 年 9 月在美国首次上市，利奈唑胺 (Zyvox) 于 2000 年 5 月进入美国市场。这两种药物均用于治疗经培养证明对万古霉素耐药的屎肠球菌。万古霉素的抑制曲线下面积 (AUIC) 值甚至当其最低抑菌浓度（MIC）为4.0μg/mL时，显示几乎所有耐万古霉素的大肠杆菌、屎肠球菌均具有AUIC
This article summarizes the current situation with Gram-positive infections, including the two primary consequences-failure to cure and resistance-relevant to the intensive care unit. The past few years have seen Enterococcus faecium resistance to vancomycin increase from 10% of strains to approaching 60% of strains in some centers. Failure is now so frequent that vancomycin can no longer be safely used. This has lead to use of two new antibiotics, quinupristin/dalfopristin (Synercid), first marketed in the United States in September 1999, and linezolid (Zyvox), which reached the U.S. market in May 2000, Both of these agents are being used to treat culture-proven vancomycin-resistant E. faecium.The calculated areas under the inhibitory curve (AUIC) values of vancomycin, even when its minimal inhibitory concentration (MIC) is 4.0 mug/mL, show almost all vancomycin-resistant E, faecium have AUICs