Aaron Simoni, Laura Schwartz, Guillermo Yepes Junquera, Christina B. Ching, John David Spencer
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引用次数: 0
Abstract
Rising rates of antibiotic resistance in uropathogenic bacteria compromise patient outcomes and prolong hospital stays. Consequently, new strategies are needed to prevent and control the spread of antibiotic resistance in uropathogenic bacteria. Over the past two decades, sizeable clinical efforts and research advances have changed urinary tract infection (UTI) treatment and prevention strategies to conserve antibiotic use. The emergence of antimicrobial stewardship, policies from national societies, and the development of new antimicrobials have shaped modern UTI practices. Future UTI management practices could be driven by the evolution of antimicrobial stewardship, improved and readily available diagnostics, and an improved understanding of how the microbiome affects UTI. Forthcoming UTI treatment and prevention strategies could employ novel bactericidal compounds, combinations of new and classic antimicrobials that enhance bacterial killing, medications that prevent bacterial attachment to uroepithelial cells, repurposing drugs, and vaccines to curtail the rising rates of antibiotic resistance in uropathogenic bacteria and improve outcomes in people with UTI. Antibiotic-resistant uropathogenic bacteria are becoming increasingly prevalent. In this Review, strategies for clinicians and researchers to address this challenge are delineated, including implementation of policies, stewardship practices, and the exploration of emerging therapeutic targets aimed at mitigating antibiotic resistance.
泌尿道致病菌的抗生素耐药率不断上升,损害了患者的治疗效果,延长了住院时间。因此,需要采取新的策略来预防和控制尿路病原菌抗生素耐药性的扩散。在过去的二十年里,大量的临床工作和研究进展改变了尿路感染(UTI)的治疗和预防策略,以节约抗生素的使用。抗菌药物管理的出现、国家协会制定的政策以及新型抗菌药物的开发塑造了现代UTI治疗方法。抗菌药物管理的发展、诊断技术的改进和普及,以及对微生物组如何影响 UTI 的进一步了解,都将推动未来 UTI 的治疗方法。未来的UTI治疗和预防策略可以采用新型杀菌化合物、新型和传统抗菌药的组合(以增强对细菌的杀伤力)、防止细菌附着于尿路上皮细胞的药物、再利用药物和疫苗,以遏制尿路致病菌抗生素耐药率的上升并改善UTI患者的治疗效果。
期刊介绍:
Nature Reviews Urology is part of the Nature Reviews portfolio of journals.Nature Reviews' basic, translational and clinical content is written by internationally renowned basic and clinical academics and researchers. This journal targeted readers in the biological and medical sciences, from the postgraduate level upwards, aiming to be accessible to professionals in any biological or medical discipline.
The journal features authoritative In-depth Reviews providing up-to-date information on topics within a field's history and development. Perspectives, News & Views articles, and the Research Highlights section offer topical discussions and opinions, filtering primary research from various medical journals.
Covering a wide range of subjects, including andrology, urologic oncology, and imaging, Nature Reviews provides valuable insights for practitioners, researchers, and academics within urology and related fields.