应对造血细胞移植中耐药肠杆菌感染激增的问题。

IF 6.9 2区 医学 Q1 HEMATOLOGY Blood Reviews Pub Date : 2024-08-20 DOI:10.1016/j.blre.2024.101229
Mobil Akhmedov, J Luis Espinoza
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引用次数: 0

摘要

接受造血细胞移植(HCT)的患者发生严重感染的风险会增加。近年来,由革兰氏阴性菌引起的血流感染在 HCT 受者中的报道越来越多,其中许多感染是由肠杆菌科细菌菌株引起的。在这些病原体中,尤其令人担忧的是多重耐药肠杆菌(MDRE),如产扩展谱β-内酰胺酶肠杆菌和耐碳青霉烯类肠杆菌,因为这些病原体引起的感染因抗菌药物选择有限而难以治疗,并与较差的移植预后相关。我们总结了发表在 PubMed 和 Scopus 上有关 HCT 受者 MDRE 感染负担的研究证据,并讨论了管理和预防这些感染的策略,包括严格遵守推荐的感染控制规范和多学科抗菌药物管理、使用益生菌和粪便微生物群移植。
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Addressing the surge of infections by multidrug-resistant Enterobacterales in hematopoietic cell transplantation.

Patients undergoing hematopoietic cell transplantation (HCT) have an increased risk of developing severe infections. In recent years, bloodstream infections caused by Gram-negative bacteria have been increasingly reported among HCT recipients, and many of these infections are caused by bacterial strains of the Enterobacterales order. Among these pathogens, particularly concerning are the multidrug-resistant Enterobacterales (MDRE), such as Extended Spectrum β-lactamase-producing Enterobacterales and Carbapenem-resistant Enterobacterales, since infections caused by these pathogens are difficult to treat due to the limited antimicrobial options and are associated with worse transplant outcomes. We summarized the evidence from studies published in PubMed and Scopus on the burden of MDRE infections in HCT recipients, and strategies for the management and prevention of these infections, including strict adherence to recommended infection control practices and multidisciplinary antimicrobial stewardship, the use of probiotics, and fecal microbiota transplantation, are also discussed.

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来源期刊
Blood Reviews
Blood Reviews 医学-血液学
CiteScore
13.80
自引率
1.40%
发文量
78
期刊介绍: Blood Reviews, a highly regarded international journal, serves as a vital information hub, offering comprehensive evaluations of clinical practices and research insights from esteemed experts. Specially commissioned, peer-reviewed articles authored by leading researchers and practitioners ensure extensive global coverage across all sub-specialties of hematology.
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