Carbapenem-resistant Enterobacteriaceae: a review of treatment and outcomes

被引:264
|
作者
van Duin, David [1 ,2 ]
Kaye, Keith S. [3 ]
Neuner, Elizabeth A. [4 ]
Bonomo, Robert A. [5 ,6 ,7 ,8 ,9 ]
机构
[1] Cleveland Clin, Dept Infect Dis, Cleveland, OH 44106 USA
[2] Cleveland Clin, Transplant Ctr, Cleveland, OH 44106 USA
[3] Wayne State Univ, Detroit Med Ctr, Div Infect Dis, Detroit, MI USA
[4] Cleveland Clin, Dept Pharm, Cleveland, OH 44106 USA
[5] Louis Stokes Cleveland Dept Vet Affairs Med Ctr, Res Serv, Cleveland, OH USA
[6] Case Western Reserve Univ, Sch Med, Dept Med, Cleveland, OH 44106 USA
[7] Case Western Reserve Univ, Sch Med, Dept Pharmacol, Cleveland, OH 44106 USA
[8] Case Western Reserve Univ, Sch Med, Dept Mol Biol & Microbiol, Cleveland, OH 44106 USA
[9] Louis Stokes Cleveland Dept Vet Affairs Med Ctr, Med Serv, Cleveland, OH USA
基金
美国国家卫生研究院;
关键词
Enterobacteriaceae; Carbapenem resistance; Multidrug resistance; Mortality; Bacteremia; URINARY-TRACT-INFECTIONS; CRITICALLY-ILL PATIENTS; KLEBSIELLA-PNEUMONIAE; RISK-FACTORS; POLYMYXIN-B; COLISTIN METHANESULFONATE; BETA-LACTAMASE; ANTIMICROBIAL RESISTANCE; ACINETOBACTER-BAUMANNII; K.-PNEUMONIAE;
D O I
10.1016/j.diagmicrobio.2012.11.009
中图分类号
R51 [传染病];
学科分类号
100401 ;
摘要
The emergence of carbapenem resistance in Enterobacteriaceae is an important threat to global health. Reported outcomes of infections with carbapenem-resistant Enterobacteriaceae (CRE) are poor. Very few options remain for the treatment of these virulent organisms. Antibiotics which are currently in use to treat CRE infections include aminoglycosides, polymyxins, tigecycline, fosfomycin, and temocillin. In addition, the role of combination therapy, including carbapenem containing regimens, remains to be defined. There are several important concerns regarding all of these treatment options such as limited efficacy, increasing reports of resistance, and specific toxicities. Data from retrospective studies favor combination therapy over single-agent therapy for the treatment of CRE bloodstream infections. In summary, new antibiotics are greatly needed, as is additional prospective research. (C) 2013 Elsevier Inc. All rights reserved.
引用
收藏
页码:115 / 120
页数:6
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