耐碳青霉烯类肠杆科细菌感染治疗策略研究进展

Research Progress of Treatment Strategy of Carbapenem-Resistant Enterobacteriaceae Infection

目的探讨耐碳青霉烯类肠杆科细菌(CRE)感染的有效治疗方案。方法检索PubMed,Embase,Medline等数据库近10年全球范围内报道CRE新型治疗药物研发的相关文献,收集相关药代动力学、药物效应学数据,分析CRE感染的诊断标准、流行趋势、耐药机制、治疗方案(含传统方案和探索方案)。结果与结论CRE在全球的危险等级高,在我国呈急速高发趋势,并会造成社区流行。传统的治疗药物包括多黏菌素、替加环素及碳青霉烯类,并探索出了多种单药或联合用药的新方案,但CRE存在耐药性,有效的治疗药物还处在不断地探索和研究中,仍需大规模临床试验数据权衡利弊,筛选出更加合理的治疗方案。

Objective To investigate the effective treatment plan of carbapenem-resistant Enterobacteriaceae(CRE)infection.Methods The relevant literature related the development of new therapeutic drugs for CRE infection in the world in recent 10 years were searched from PubMed,Embase,Medline and other databases,the relevant pharmacokinetic and pharmacodynamics data were collected,and the diagnostic criteria,epidemic trend,drug resistance mechanism and treatment plan(including traditional plan and exploration plan)of CRE infection were analyzed.Results and Conclusion CRE has a high risk in the world,shows a rapid and high incidence trend in China,and will cause community epidemic.Traditional therapeutic drugs include polymyxin,tigecycline and carbapenems,and a variety of new schemes of single drug use or combined drug use have been explored,but CRE has drug resistance,and effective therapeutic drugs are still in the process of exploration and research,so large-scale clinical experimental data are still needed to weigh the advantages and disadvantages and screen out more reasonable treatment plans.