Treatment of sepsis: What is the antibiotic choice in bacteremia due to carbapenem resistant Enterob

来源 :World Journal of Clinical Cases | 被引量 : 0次 | 上传用户:zjx000a
下载到本地 , 更方便阅读
声明 : 本文档内容版权归属内容提供方 , 如果您对本文有版权争议 , 可与客服联系进行内容授权或下架
论文部分内容阅读
Sepsis is one of the major challenges of today. Although gram-positive bacteria related infections are more prevalent in hospital setting, the highest mortality rate is associated with gram-negative microorganisms especially Enterobacteriaceae. Enterobacteriaceae, including Escherichia coli, Klebsiella spp., Proteus spp., Enterobacter spp. and Serratia spp. Resistance to β-lactams in Enterobacteriaceae is primarily attributed to the production of B-lactamase enzymes with subsequent antibiotic hydrolysis and to a lesser extent by alteration of efflux pump or porins expression. Carbapenem resistant Enterobacteriaceae(CRE) and Acinetobacter baumannii are the most notorious pathogens due to the high incidence of morbidity and mortality especially in the immunocompromised patients in the intensive care unit. The most appropriate antimicrobial therapy to treat CRE is still controversial. Combination therapy is preferred over monotherapy due to its broad-spectrum coverage of micro-organisms, due to its synergetic effect and to prevent development of further resistance. Current suggested therapies for CRE resistance as well as promising antibiotics that are currently under investigation for winning the war against the emerging CRE resistance are reviewed and discussed. Sepsis is one of the major challenges of today. Of gram-positive bacteria related infections are more prevalent in hospital setting, the highest mortality rate is associated with gram-negative microorganisms especially Enterobacteriaceae. Enterobacteriaceae, including Escherichia coli, Klebsiella spp., Proteus spp Enterobacter spp. And Serratia spp. Resistance to β-lactams in Enterobacteriaceae is attributed to the production of B-lactamase enzymes with subsequent antibiotic hydrolysis and to a lesser extent by alteration of efflux pump or porins expression. Carbapenem resistant Enterobacteriaceae (CRE ) and Acinetobacter baumannii are the most notorious pathogens due to the high incidence of morbidity and mortality especially in the immunocompromised patients in the intensive care unit. The most appropriate antimicrobial therapy to treat CRE is still controversial. Combination therapy is preferred over monotherapy due to its broad-spectrum coverage of micro-organisms, due to its synergetic effect and to prevent development of further resistance. Current suggested therapies for CRE resistance as well as promising for antibiotics that are currently under investigation for winning the war against the emerging CRE resistance are reviewed and discussed.
其他文献
“时远交移,质文代变”.随着改革开放政策的实行,当代西方的各种文艺思潮,如潮水般拥入我国,马列文论研究面临时代的挑战,存在着一个如何发展的问题.怎样正确认识马克思主义
液泛提取法的分离效果王杰,宋锡瑾,任仲皎,袁誉洪,伍明(中南民族学院化学系)关键词液泛提取器;固-液萃取;传质1引言从天然产物中获得有效成分的传统提取方法主要有浸渍、渗漉、煎煮、回
The question whether epithelial-mesenchymal transition(EMT) occurs during liver fibrogenesis is a controversial issue. In vitro studies confirm that hepatocytes
<正> 自从人类开始从事物质生产以后,就伴随着物质生产活动而开始了他们的精神生产活动。如原始的绘画,舞蹈以及后来的神话、诗歌。从以形象思维方式生产的产品发展到以抽象思维方式生产的产品,随着人类文明的演进,其精神生产领域也在不断扩大,总的看来,人类所从事的精神生产大体上是在三个主要部门进行着,即艺术部门、社会科学部门,自然科学部门。人类的精神生产,最初是从艺术领域开始的,绘画、建筑、雕塑这些被黑格尔称之为象征性艺术是人类最早期的精神生产,而后又出现了古典型艺术和浪漫型艺术。随着人类对于自然和社
小鼠循环可溶性CD44的特点:CD44的水平受机体免疫状态和肿瘤生长情况的影响[英/KontohS…//JImmunol1994;153(8):3440]近年来,可溶性细胞因子受体和可溶性细胞粘附分子的研究,越来越受到人们的关注。CD44分子在许多生... Charact
介绍我们遇到的1例左大腿上段肌肉包虫切除术后15年原位复发巨大包虫病病例,结合文献,就其产生原因及防范措施进行讨论,以期引起对该病的重视。 Introduced one case we enc
本文采用RT-PCR技术从LPS刺激后的小鼠腹腔巨噬细胞,扩增小鼠IL-6cDNA,并克隆构建pGEM-3Zf(+)IL-6质粒,继将小鼠所得cDNA克隆到pVL1392载体上,利用杆状病毒AcNPV表达系统在Sf9中进行瞬间表达,用IL-6依赖细胞株MH60·BSF2检测其表达活性,结果表明,感染
期刊
AIM To use a national database of United States hospitals to evaluate the incidence and costs of hospital admissions associated with gastroparesis.METHODS We an