脆弱宿主的新发感染:嗜麦芽窄养单胞菌和按蚊伊丽莎白。

IF 3.6 3区 医学 Q2 INFECTIOUS DISEASES Current Opinion in Infectious Diseases Pub Date : 2023-12-01 Epub Date: 2023-08-02 DOI:10.1097/QCO.0000000000000953
Yu-Lin Lee, Po-Ren Hsueh
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引用次数: 0

摘要

综述目的:本系统综述旨在探讨两种新出现的机会致病菌,嗜麦芽窄食单胞菌和伊丽莎白金氏按蚊的流行病学、危险因素和抗菌药物敏感性的最新趋势。最新发现:自2020年以来,全球范围内已报告了多起嗜麦芽S.和嗜麦芽E.的爆发。这些疫情大多与医疗机构有关,尽管法国有一次由大肠杆菌引起的疫情被认为是社区相关感染。在抗菌药物敏感性方面,甲氧苄啶/磺胺甲恶唑(TMP-SMZ)、左氧氟沙星和米诺环素对嗜麦芽链球菌表现出良好的疗效。此外,头孢iderocol和氨曲南和阿维巴坦的组合在体外药敏试验中显示出有希望的结果。对于大肠杆菌,目前还没有就最佳治疗达成共识。尽管一些研究报告了利福平、TMP-SMZ、哌拉西林/他唑巴坦和头孢哌酮/舒巴坦的良好疗效,但米诺环素的体外药敏率最有利。头孢地罗可作为一种替代品,因为其对大肠杆菌的最低抑制浓度(MIC)较低。万古霉素在治疗中的作用仍然不确定,尽管已经报道了几例万古霉素治疗的成功病例,即使MIC值很高。摘要:免疫受损的患者特别容易受到嗜麦芽糖链球菌和嗜按蚊引起的感染,但最佳治疗策略仍不确定。有必要进行进一步的研究,以确定常规和新型抗菌剂在对抗这些耐多药病原体方面的最有效用途。
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Emerging infections in vulnerable hosts: Stenotrophomonas maltophilia and Elizabethkingia anophelis.

Purpose of review: This systematic review aimed to explore the recent trends in the epidemiology, risk factors, and antimicrobial susceptibility of two emerging opportunistic pathogens, Stenotrophomonas maltophilia and Elizabethkingia anophelis .

Recent findings: Since 2020, numerous outbreaks of S. maltophilia and E. anophelis have been reported worldwide. Most of these outbreaks have been associated with healthcare facilities, although one outbreak caused by E. anophelis in France was considered a community-associated infection. In terms of antimicrobial susceptibility, trimethoprim/sulfamethoxazole (TMP-SMZ), levofloxacin, and minocycline have exhibited good efficacy against S. maltophilia . Additionally, cefiderocol and a combination of aztreonam and avibactam have shown promising results in in vitro susceptibility testing. For E. anophelis , there is currently no consensus on the optimal treatment. Although some studies have reported good efficacy with rifampin, TMP-SMZ, piperacillin/tazobactam, and cefoperazone/sulbactam, minocycline had the most favourable in vitro susceptibility rates. Cefiderocol may serve as an alternative due to its low minimum inhibitory concentration (MIC) against E. anophelis . The role of vancomycin in treatment is still uncertain, although several successful cases with vancomycin treatment, even with high MIC values, have been reported.

Summary: Immunocompromised patients are particularly vulnerable to infections caused by S. maltophilia and E. anophelis , but the optimal treatment strategy remains inconclusive. Further research is necessary to determine the most effective use of conventional and novel antimicrobial agents in combatting these multidrug-resistant pathogens.

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来源期刊
CiteScore
6.70
自引率
2.60%
发文量
121
审稿时长
6-12 weeks
期刊介绍: This reader-friendly, bimonthly resource provides a powerful, broad-based perspective on the most important advances from throughout the world literature. Featuring renowned guest editors and focusing exclusively on two topics, every issue of Current Opinion in Infectious Disease delivers unvarnished, expert assessments of developments from the previous year. Insightful editorials and on-the-mark invited reviews cover key subjects such as HIV infection and AIDS; skin and soft tissue infections; respiratory infections; paediatric and neonatal infections; gastrointestinal infections; tropical and travel-associated diseases; and antimicrobial agents.
期刊最新文献
Effective strategies for managing trimethoprim-sulfamethoxazole and levofloxacin-resistant Stenotrophomonas maltophilia infections: bridging the gap between scientific evidence and clinical practice. The many faces of brucellosis: diagnostic and management approach. New antibiotics in clinical pipeline for treating infections caused by metallo-β-lactamases producing Gram-negative bacteria. When antimicrobial stewardship begins with microbiological test requests: the case of asymptomatic bacteriuria. Interpreting and managing preservation fluids positive for Gram-negative bacteria.
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