儿童厌氧菌感染及其治疗概述。

IF 1.9 4区 医学 Q3 INFECTIOUS DISEASES Journal of Infection and Chemotherapy Pub Date : 2024-07-18 DOI:10.1016/j.jiac.2024.07.014
Itzhak Brook
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引用次数: 0

摘要

厌氧菌可引起多种儿童感染。由于厌氧菌在正常人的皮肤和粘膜细菌群中占主导地位,因此它们往往与源自这些部位的细菌感染有关。它们很难从感染部位分离出来,因此经常被漏诊。厌氧菌感染可发生在身体的所有部位,包括中枢神经系统、口腔、头颈部、胸部、腹部、骨盆、皮肤和软组织。厌氧菌会在新生儿出生后定植,并在几种类型的新生儿感染中被分离出来。这些感染包括胎儿监护部位的蜂窝织炎、新生儿吸入性肺炎、菌血症、结膜炎、鹅口疮和婴儿肉毒中毒。厌氧菌感染的治疗具有挑战性,因为这些细菌生长缓慢,具有多菌性,而且厌氧菌对抗菌素的耐药性不断增强。抗菌治疗可能是唯一需要的治疗方法,也可能是手术治疗的辅助方法。需氧-厌氧菌多菌感染一般需要使用对所有病原体都有效的抗菌疗法。对厌氧菌活性最强的抗生素包括碳青霉烯类、β-内酰胺/β-内酰胺酶抑制剂复方制剂、甲硝唑和氯霉素。厌氧菌对抗菌素的耐药性正在增加。据报道,对克林霉素、头孢霉素和莫西沙星的耐药性主要是针对脆弱拟杆菌属和相关菌株。不同地区和医疗机构的耐药性模式各不相同。
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Overview of anaerobic infections in children and their treatment

Anaerobic bacteria can cause many infections in children. Because they predominant in the normal human skin and mucous membranes bacterial flora, they are often associated with bacterial infections that originate from these sites. They are difficult to isolate from infectious sites, and are frequently missed. Anaerobic infections can occur in all body sites, including the central nervous system, oral cavity, head and neck, chest, abdomen, pelvis, skin, and soft tissues. Anaerobes colonize the newborn after birth and have been isolated in several types of neonatal infections. These include cellulitis of the site of fetal monitoring, neonatal aspiration pneumonia, bacteremia, conjunctivitis, omphalitis, and infant botulism. Management of anaerobic infection is challenging because of the slow growth of these bacteria, by their polymicrobial nature and by the growing antimicrobial resistance of anaerobic. Antimicrobial therapy may be the only treatment required, and may also be an adjunct to a surgical approach. Polymicrobial aerobic-anaerobic infection generally requires delivering antimicrobial therapy effective against all pathogens. The antibiotics with the greatest activity against anaerobes include carbapenems, beta-lactam/beta-lactamase inhibitor combinations, metronidazole, and chloramphenicol. Antimicrobial resistance is growing among anaerobic bacteria. The major increased in resistance have been reported with clindamycin, cephamycins, and moxifloxacin against Bacteroides fragilis group and related strains. Resistance patterns vary between different geographic areas and medical facilities.

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来源期刊
Journal of Infection and Chemotherapy
Journal of Infection and Chemotherapy INFECTIOUS DISEASES-PHARMACOLOGY & PHARMACY
CiteScore
4.10
自引率
4.50%
发文量
303
审稿时长
47 days
期刊介绍: The Journal of Infection and Chemotherapy (JIC) — official journal of the Japanese Society of Chemotherapy and The Japanese Association for Infectious Diseases — welcomes original papers, laboratory or clinical, as well as case reports, notes, committee reports, surveillance and guidelines from all parts of the world on all aspects of chemotherapy, covering the pathogenesis, diagnosis, treatment, and control of infection, including treatment with anticancer drugs. Experimental studies on animal models and pharmacokinetics, and reports on epidemiology and clinical trials are particularly welcome.
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