联合用药治疗产KPC肠杆菌科细菌感染研究进展

Progress of antibiotics combination on treatment of KPC-producing Enterobacteriaceae infection

目的产KPC肠杆菌科细菌是一种多药耐药的革兰氏阴性杆菌,其在世界范围内暴发流行造成了极高的病死率。目前临床可治疗此类感染的抗菌药物十分有限,且其单药疗效并不理想,耐药报道也不断增加。因此,不同抗菌药物联合使用成为临床医生的重要选择。本文简述了单药治疗产KPC肠杆菌科细菌的缺陷;介绍了近年来不同抗菌药物联合对其抗菌活性的体内外研究进展,提示联合用药疗效要优于单药应用,其中以多粘菌素、替加环素为基础的联合在临床最为常用、有效;最后总结了相关指南中的推荐治疗方案,以期为临床治疗此类感染提供一定参考依据。

KPC-producing Enterobacteriaceae is a species of multidrug-resistant gram-negative bacilli,it outbreaks and prevails worldwide,which results in extremely high mortality rate.At present,few antibiotics were available for clinical treatment of such infection,the efficacy of monotherapy is not satisfied,and the reports about the drug resistance are increased.Therefore,many clinicians embrace combination regimens as the preferred treatment strategy for the infection.In this review,we briefly discussed the disadvantages of antibiotics monotherapy on treatment of the KPC-producing Enterobacteriaceae and introduced the progress of study on in vitro antibacterial activities of different antibiotics combinations,it is suggested that the antibiotic combination therapy is superior to the monotherapy and that the combinations containing polymyxin and tigecycline are most commonly used and most effective,and the review concludes by recommending treatment schemes regarding relevant guidelines so as to provide certain guidance for clinical treatment of such infection.