https://scholars.lib.ntu.edu.tw/handle/123456789/528429
標題: | Changing bacteriology of abdominal and surgical sepsis | 作者: | Chen Y.-H. PO-REN HSUEH |
公開日期: | 2012 | 卷: | 25 | 期: | 5 | 起(迄)頁: | 590-595 | 來源出版物: | Current Opinion in Infectious Diseases | 摘要: | Purpose of Review: This review focuses on recent changes in epidemiological aspects of bacteria-induced intra-abdominal infections (IAIs), including the dominant pathogens, antimicrobial susceptibility profiles, and emerging resistance phenotypes. Recent Findings: Enterobacteriaceae species, including Escherichia coli and Klebsiella pneumoniae, remain the major pathogens contributing to abdominal sepsis, although Pseudomonas aeruginosa and Acinetobacter baumannii have recently become common causes of hospital-acquired IAIs. The prevalence of multidrug-resistant Gram-negative bacilli, especially those that produce extended-spectrum β-lactamases (ESBLs), has increased worldwide, although the distribution of those organisms varies from region to region. Furthermore, recent changes in interpretive breakpoints for antimicrobial susceptibility testing recommended by the Clinical Laboratory Standards Institute (CLSI) and the European Committee on Antimicrobial Susceptibility Testing (EUCAST) have resulted in a marked increase in the reported rates of resistance among Gram-negative bacilli to carbapenems, extended-spectrum cephalosporins, and fluoroquinolones. Besides, routine detection and reporting of ESBL phenotypes for clinical isolates have not been recommended after following new interpretive breakpoints. More studies are needed to investigate the impacts of these changes on therapeutic strategies and epidemiological surveillance. In addition, pathogens carrying New Delhi metallo-β-lactamases (NDMs), K. pneumoniae carbapenemases (KPCs), and other carbapenemases show extended resistance to currently available antibiotics and rapid transfer between species and countries. Although some of these pathogens are still susceptible to tigecycline and colistin, rates of resistance to these two agents are rising. Summary: Abdominal sepsis due to multidrug-resistant bacteria, especially ESBL producers, and international and interspecies spreading of metallo-β-lactamase raise key therapeutic problems. ? 2012 Wolters Kluwer Health | Lippincott Williams & Wilkins. |
URI: | https://scholars.lib.ntu.edu.tw/handle/123456789/528429 | ISSN: | 0951-7375 | DOI: | 10.1097/QCO.0b013e32835635cb | SDG/關鍵字: | carbapenem derivative; carbapenemase; cefepime; cefotaxime; cephalosporin derivative; doripenem; ertapenem; extended spectrum beta lactamase; imipenem; imipenemase; meropenem; metallo beta lactamase; quinoline derived antiinfective agent; tigecycline; unclassified drug; Acinetobacter baumannii; antibiotic resistance; antibiotic sensitivity; antibiotic therapy; antimicrobial activity; bacterial peritonitis; bacteriology; bacterium detection; bacterium isolate; biliary tract infection; clinical laboratory; Enterobacteriaceae; Escherichia coli; extended spectrum beta lactamase producing Enterobacteriaceae; Gram negative bacterium; hospital infection; human; Klebsiella pneumoniae; minimum inhibitory concentration; multidrug resistance; nonhuman; phenotype; prevalence; Pseudomonas aeruginosa; review; sepsis; standard; surgical infection; treatment outcome; Anti-Bacterial Agents; Drug Resistance, Multiple, Bacterial; Enterobacteriaceae; Enterobacteriaceae Infections; Humans; Intraabdominal Infections; Sepsis; Surgical Procedures, Operative |
顯示於: | 醫學院附設醫院 (臺大醫院) |
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