碳青霉烯耐药肠杆菌定植的血液肿瘤患者的选择性消化净化。

IF 1 4区 医学 Q3 MEDICINE, GENERAL & INTERNAL
Acta medica portuguesa Pub Date : 2025-09-01 Epub Date: 2025-08-12 DOI:10.20344/amp.23139
Sara De Abreu Luís, Carla Mimoso Santos
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引用次数: 0

摘要

包括耐碳青霉烯肠杆菌在内的多重耐药革兰氏阴性菌引起的感染是一种全球性威胁,其逐渐增加令人震惊。由于治疗选择有限和病死率高,它们对公共卫生构成重大挑战。血液肿瘤患者是这些类型感染的高风险亚群,更具体地说,在以前碳青霉烯耐药肠杆菌定植的患者中,不仅由于疾病本身,而且由于强化化疗或同种异体造血干细胞移植等治疗,严重的免疫抑制。选择性消化净化是一种预防性干预措施,目的是减少或消除病原体的肠道定植,保留有益的内源性菌群,但由于研究之间存在很大的异质性,其应用仍存在争议。然而,在这篇综述中,我们打算研究选择性消化净化在高危患者(如血液肿瘤碳青霉烯耐药肠杆菌携带者)中的作用,这些患者将接受高度免疫抑制治疗,因为它似乎是预防难治性感染的一种有吸引力的短期策略。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Selective Digestive Decontamination in Hemato-Oncological Patients Colonized with Carbapenem-Resistant Enterobacterales.

Infections caused by multidrug-resistant Gram-negative bacteria, including carbapenem-resistant Enterobacterales, are a global threat and their gradual increase is alarming. They represent a major challenge to public health because of limited therapeutic options and high case-fatality rates. Hemato-oncological patients represent a high-risk subpopulation for these types of infections, more specifically in previous carbapenem-resistant Enterobacterales colonized patients, because of severe immunosuppression not only due to the disease itself but also due to treatment like intensive chemotherapy or allogeneic hematopoietic stem cell transplant. Selective digestive decontamination is a prophylactic intervention with the purpose of reducing or eliminating gut colonization by pathogenic agents, preserving beneficial endogenous flora but its application remains controversial due to great heterogeneity amongst studies. However, in this review we intend to examine the role of selective digestive decontamination in context of high-risk patients such as hemato-oncological carbapenem-resistant Enterobacterales carriers who will receive highly immunosuppressive treatments, as it appears to be an appealing short-term strategy for the prevention of difficult-to-treat infections.

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来源期刊
Acta medica portuguesa
Acta medica portuguesa MEDICINE, GENERAL & INTERNAL-
CiteScore
1.90
自引率
16.70%
发文量
256
审稿时长
6-12 weeks
期刊介绍: The aim of Acta Médica Portuguesa is to publish original research and review articles in biomedical areas of the highest standard, covering several domains of medical knowledge, with the purpose to help doctors improve medical care. In order to accomplish these aims, Acta Médica Portuguesa publishes original articles, review articles, case reports and editorials, among others, with a focus on clinical, scientific, social, political and economic factors affecting health. Acta Médica Portuguesa will be happy to consider manuscripts for publication from authors anywhere in the world.
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