Treatment of multidrug-resistant Gram-negative bloodstream infections in critically ill patients: an update.

IF 3.5 3区医学 Q1 CRITICAL CARE MEDICINE

Current Opinion in Critical Care Pub Date : 2024-10-01 Epub Date: 2024-07-08 DOI:10.1097/MCC.0000000000001190

Diego Viasus, Carlota Gudiol, Jordi Carratalà

{"title":"Treatment of multidrug-resistant Gram-negative bloodstream infections in critically ill patients: an update.","authors":"Diego Viasus, Carlota Gudiol, Jordi Carratalà","doi":"10.1097/MCC.0000000000001190","DOIUrl":null,"url":null,"abstract":"Purpose of review: This review describes the latest information in the management of bloodstream infections caused by multidrug-resistant Gram-negative bacilli (MDRGNB) in critically ill patients.Recent findings: The prevalence of bloodstream infections due to MDRGNB is high, and they pose a significant risk in critically ill patients. Recently, novel antimicrobial agents, including new β-lactam/β-lactamase inhibitor combinations and cefiderocol, have been introduced for treating these infections. Concurrently, updated guidelines have been issued to aid in treatment decisions. Prompt diagnosis and identification of resistance patterns are crucial for initiating effective antibiotic therapy. Current studies, especially with observational design, and with limited sample sizes and patients with bacteremia, suggest that the use of these new antibiotics is associated with improved outcomes in critically ill patients with MDRGNB bloodstream infections.Summary: For critically ill patients with bloodstream infections caused by MDRGNB, the use of newly developed antibiotics is recommended based on limited observational evidence. Further randomized clinical trials are necessary to determine the most effective antimicrobial therapies among the available options.","PeriodicalId":10851,"journal":{"name":"Current Opinion in Critical Care","volume":" ","pages":"448-455"},"PeriodicalIF":3.5000,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Current Opinion in Critical Care","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1097/MCC.0000000000001190","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2024/7/8 0:00:00","PubModel":"Epub","JCR":"Q1","JCRName":"CRITICAL CARE MEDICINE","Score":null,"Total":0}

引用次数: 0

Abstract

Purpose of review: This review describes the latest information in the management of bloodstream infections caused by multidrug-resistant Gram-negative bacilli (MDRGNB) in critically ill patients.

Recent findings: The prevalence of bloodstream infections due to MDRGNB is high, and they pose a significant risk in critically ill patients. Recently, novel antimicrobial agents, including new β-lactam/β-lactamase inhibitor combinations and cefiderocol, have been introduced for treating these infections. Concurrently, updated guidelines have been issued to aid in treatment decisions. Prompt diagnosis and identification of resistance patterns are crucial for initiating effective antibiotic therapy. Current studies, especially with observational design, and with limited sample sizes and patients with bacteremia, suggest that the use of these new antibiotics is associated with improved outcomes in critically ill patients with MDRGNB bloodstream infections.

Summary: For critically ill patients with bloodstream infections caused by MDRGNB, the use of newly developed antibiotics is recommended based on limited observational evidence. Further randomized clinical trials are necessary to determine the most effective antimicrobial therapies among the available options.

查看原文本刊更多论文

重症患者耐多药革兰氏阴性血流感染的治疗：最新进展。

综述的目的：本综述介绍了重症患者中由耐多药革兰氏阴性杆菌（MDRGNB）引起的血流感染管理方面的最新信息：耐多药革兰氏阴性杆菌引起的血流感染发病率很高，对危重病人构成重大风险。最近，新型抗菌药物，包括新的β-内酰胺/β-内酰胺酶抑制剂组合和头孢克肟，已被用于治疗这些感染。与此同时，还发布了最新指南，以帮助做出治疗决定。及时诊断和识别耐药模式对于启动有效的抗生素治疗至关重要。目前的研究，尤其是观察性研究，以及样本量和菌血症患者有限的研究表明，使用这些新型抗生素可改善 MDRGNB 血流感染重症患者的治疗效果：对于由 MDRGNB 引起血流感染的重症患者，基于有限的观察证据，建议使用新开发的抗生素。有必要进一步开展随机临床试验，以确定在现有选择中最有效的抗菌疗法。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

求助全文

约1分钟内获得全文求助全文

来源期刊

Current Opinion in Critical Care 医学-危重病医学

CiteScore

5.90

自引率

3.00%

发文量

172

审稿时长

6-12 weeks

期刊介绍： Current Opinion in Critical Care delivers a broad-based perspective on the most recent and most exciting developments in critical care from across the world. Published bimonthly and featuring thirteen key topics – including the respiratory system, neuroscience, trauma and infectious diseases – the journal’s renowned team of guest editors ensure a balanced, expert assessment of the recently published literature in each respective field with insightful editorials and on-the-mark invited reviews.