Aztreonam and Avibactam Combination Therapy for Metallo-β-Lactamase-Producing Gram-Negative Bacteria: A Comprehensive Review.

IF 10.9 1区医学 Q1 INFECTIOUS DISEASES Clinical Microbiology and Infection Pub Date : 2024-11-09 DOI:10.1016/j.cmi.2024.11.006

Giuseppe Sangiorgio, Maddalena Calvo, Stefania Stefani

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Abstract

Background: Carbapenem-resistant Gram-negative bacteria represent a challenging healthcare threat, accounting for metallo-β-lactamases (MBL) production increase across the world. MBL-producing Enterobacterales and P. aeruginosa represent the main target for ultimate antibiotics combinations due to the difficulty to include carbapenems within the antimicrobial treatment.

Objectives: To provide a comprehensive review of the current knowledge about the aztreonam/avibactam (ATM-AVI) combination, which has emerged as a promising option for treating MBL-producing bacteria. Sources Relevant in vitro and in vivo studies on ATM-AVI effectiveness.

Content: The review summarizes ATM-AVI characteristics and targets, examining how avibactam restores aztreonam effectiveness against MBLs while protecting it from other β-lactamases. Key in vitro and in vivo studies on ATM-AVI efficacy are presented.

Implications: This review provides insights into the potential clinical management implications of ATM-AVI for treating carbapenem-resistant Gram-negative infections, particularly those caused by MBL-producing organisms.

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针对产生金属β-乳酰胺酶的革兰氏阴性菌的阿兹曲南和阿维菌素联合疗法：全面回顾。

背景：耐碳青霉烯类革兰氏阴性菌是一种具有挑战性的医疗保健威胁，导致全球金属-β-内酰胺酶（MBL）产量增加。由于很难将碳青霉烯类纳入抗菌治疗范围，产 MBL 的肠杆菌科细菌和铜绿假单胞菌是最终抗生素组合的主要目标：目的：全面回顾目前有关阿曲南钠/阿维巴坦（ATM-AVI）组合的知识，该组合已成为治疗产生 MBL 细菌的一种有前途的选择。资料来源关于 ATM-AVI 效力的相关体外和体内研究：综述总结了 ATM-AVI 的特点和靶点，探讨了阿维菌素如何恢复阿曲南抗 MBL 的效力，同时保护阿曲南不受其他 β-内酰胺酶的影响。文中介绍了有关 ATM-AVI 药效的主要体外和体内研究：本综述深入探讨了 ATM-AVI 在治疗耐碳青霉烯类革兰氏阴性菌感染（尤其是由产生 MBL 的微生物引起的感染）方面的潜在临床管理意义。

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来源期刊

Clinical Microbiology and Infection 医学-传染病学

CiteScore

25.30

自引率

2.10%

发文量

441

审稿时长

2-4 weeks

期刊介绍： Clinical Microbiology and Infection (CMI) is a monthly journal published by the European Society of Clinical Microbiology and Infectious Diseases. It focuses on peer-reviewed papers covering basic and applied research in microbiology, infectious diseases, virology, parasitology, immunology, and epidemiology as they relate to therapy and diagnostics.