The Lancet Infectious Diseases, Journal Year: 2024, Volume and Issue: unknown
Published: Oct. 1, 2024
Language: Английский
Clinical Infectious Diseases, Journal Year: 2024, Volume and Issue: unknown
Published: Aug. 7, 2024
Abstract The Infectious Diseases Society of America (IDSA) is committed to providing up-to-date guidance on the treatment antimicrobial-resistant (AMR) infections. This document focuses infections caused by extended-spectrum β-lactamase-producing Enterobacterales (ESBL-E), AmpC (AmpC-E), carbapenem-resistant (CRE), Pseudomonas aeruginosa with difficult-to-treat resistance (DTR P. aeruginosa), Acinetobacter baumannii (CRAB), and Stenotrophomonas maltophilia. updated replaces previous versions document. A panel 6 infectious diseases specialists expertise in managing formulated questions about ESBL-E, AmpC-E, CRE, DTR aeruginosa, CRAB, S. Because differences epidemiology AMR availability specific anti-infectives internationally, this United States. Preferred alternative suggested approaches are provided accompanying rationales, assuming causative organism has been identified antibiotic susceptibility results known. Approaches empiric treatment, transitioning oral therapy, duration other management considerations discussed briefly. Suggested apply for both adult pediatric populations, although dosages only adults. field highly dynamic. Consultation an specialist recommended current as December 31, 2023 will be periodically. most version document, including date publication, available at www.idsociety.org/practice-guideline/amr-guidance/.
Language: Английский
Citations
187
Antibiotics, Journal Year: 2025, Volume and Issue: 14(3), P. 221 - 221
Published: Feb. 21, 2025
Background/Objectives: Antimicrobial resistance poses a major public health challenge. The World Health Organization has identified 15 priority pathogens that require prompt development of new antibiotics. This review systematically evaluates the antibacterial most significant bacterial pathogens, currently available treatment options, as well complementary approaches for management infections caused by challenging multidrug-resistant (MDR) bacteria. For carbapenem-resistant Gram-negative bacteria, options include combinations beta-lactam antibiotics and beta-lactamase inhibitors, novel siderophore cephalosporin, known cefiderocol, older like polymixins tigecycline. Treatment Gram-positive bacteria are vancomycin, daptomycin, linezolid, etc. Although stagnated, various agents with properties in clinical preclinical trials. Non-antibiotic strategies encompass antibiotic potentiators, bacteriophage therapy, antivirulence therapeutics, antimicrobial peptides, nanomaterials, host-directed vaccines, antibodies, plant-based products, repurposed drugs, their combinations, including those used alongside Significant challenges exist developing antimicrobials, particularly related to scientific technical issues, along policy economic factors. Currently, alternative not part routine protocols. Conclusions Future Directions: There is an urgent need expedite treating MDR requires multidisciplinary approach involves collaboration across research, healthcare, regulatory bodies. Suggested crucial addressing this challenge should be backed rational use, enhanced infection control practices, improved surveillance systems emerging pathogens.
Language: Английский
Citations
1
Clinical Infectious Diseases, Journal Year: 2024, Volume and Issue: unknown
Published: April 25, 2024
Abstract We report identification of 5 patients with infections caused by NDM-5-producing Escherichia coli harboring PBP3 mutations that showed reduced susceptibility to aztreonam-avibactam and cefiderocol. Durlobactam, a novel diazabicyclooctane β-lactamase inhibitor, demonstrated minimum inhibitory concentrations ranging from 0.5 2 µg/mL supporting future investigations into potential role in clinical management.
Language: Английский
Citations
5
Current Opinion in Infectious Diseases, Journal Year: 2025, Volume and Issue: unknown
Published: Jan. 16, 2025
Purpose of review To discuss the new available options for treatment acute bacterial skin and structure infections (ABSSSIs) how to implement in clinical practice innovative approaches their management. Recent findings The availability long-acting antibiotics, including dalbavancin oritavancin, changed approach patients with ABSSSI. Direct discharge from emergency department early hospital should be considered Despite limited data about different bactericidal properties, choice between oritavacin is usually based on patients’ characteristics comorbidities. Delafloxacin omadacycline are other have advantage both intravenous oral formulations, allowing a sequential therapy switch clinically stable patients. Further studies elucidate profile who may beneficiate these drugs. Summary Early ABSSSI at high risk methicillin-resistant Staphylococcus aureus vulnerable which hospitalization detrimental consequences. In elderly individuals, diabetes mellitus, oncological people need continuing healthcare pathway, this reduce complications costs related hospitalization.
Language: Английский
Citations
0
Infection, Journal Year: 2025, Volume and Issue: unknown
Published: March 7, 2025
Language: Английский
Citations
0
Drugs, Journal Year: 2024, Volume and Issue: unknown
Published: Oct. 28, 2024
Gram-negative multidrug-resistant (MDR) bacteria, including Enterobacterales, Acinetobacter baumannii, and Pseudomonas aeruginosa, pose a significant challenge in clinical practice. Infections caused by metallo-β-lactamase (MBL)–producing organisms, particular, require careful consideration due to their complexity varied prevalence, given that the microbiological diagnosis of these pathogens is intricate compounded challenges assessing efficacy anti-MBL antimicrobials. We discuss both established new approaches treatment MBL–producing infections, focusing on 3 strategies: colistin; recently approved combination aztreonam with avibactam (or ceftazidime/avibactam); cefiderocol. Despite its activity against various pathogens, colistin limited resistance mechanisms, while nephrotoxicity acute renal injury call for dosing monitoring Aztreonam combined avibactam/ceftazidime if plus not available) exhibits potent pathogens. Cefiderocol monotherapy effective wide range MBL producers, favorable outcomes have been observed trials case series. After examining scientific evidence management infections we developed comprehensive algorithm guide therapeutic decision making. recommend reserving as last-resort option MDR infections. aztreonam/avibactam represent options In P. aeruginosa enzymes difficult-to-treat resistance, cefiderocol preferred option. Further research needed optimize strategies minimize resistance.
Language: Английский
Citations
2
Published: June 11, 2024
Blood stream infections (BSI) due to carbapenem-resistant gram-negative bacilli (CR-GNB), especially Klebsiella pneumoniae carbapenemase (KPC) and New-Delhi metallo-β-lactamase (NDM) producers, are a major concern of public health, as they associated with high morbidity mortality. We conducted single-center, retrospective, observational study at tertiary-care, teaching Greek hospital, determine the incidence, 30-day overall, in-hospital, crude mortality, risk factors efficacy best available treatment options in patients BSIs from KPC- or NDM-producing GR-GNB. During one-year period, 1st January 31st December 2023, we recorded 133 episodes 118 unique patients; 79 were KPC-producing 54 CR-GNB. Our showed relatively incidence by both CR-GNB (0.49 0.31 per 1000 patient-days respectively). found mortality rates for producing (26.4 %), (37%), while P. aeruginosa had highest (47.1%) overall (70.6%) Beta-lactam/beta-lactamase inhibitors monotherapy combination other active agents used treat improved survival (p=0.009).
Language: Английский
Citations
1
Infectious Diseases and Therapy, Journal Year: 2024, Volume and Issue: 13(11), P. 2423 - 2447
Published: Oct. 1, 2024
Language: Английский
Citations
1
Antibiotics, Journal Year: 2024, Volume and Issue: 13(12), P. 1139 - 1139
Published: Nov. 27, 2024
The COVID-19 pandemic has exacerbated the global antimicrobial resistance (AMR) crisis. Consequently, it is more urgent than ever to prioritize AMR containment and support countries in improving detection, characterization, rapid response emerging threats. We conducted a prospective, multicenter study assess prevalence of carbapenemase-producing Enterobacterales infectious processes Argentina during post-COVID-19 period explore therapeutic alternatives for their treatment (RECAPT-AR study). Methods: A total 182 hospitals participated by submitting clinical isolates National Reference Laboratory (NRL) first three weeks November 2021. Inclusion criteria were defined as an ertapenem MIC ≥ 0.5 mg/L, zone diameter ≤ 22 mm. Carbapenemase genes those coding major extended-spectrum β-lactamases molecularly characterized using multiplex PCR at NRL. Antibiotic susceptibility testing followed international standards (CLSI EUCAST). Results: NRL analyzed 821 isolates. Metallo-β-lactamase (MBL, 42.0%) KPC (39.8%) accounted 81.8% carbapenemases, OXA-163 (7.4%), variant OXA-48 with additional activity against cephalosporins, enzyme combinations (8.3%). These included NDM plus (3.4%), (2.4%), (2.1%). Klebsiella pneumoniae was main species recovered, representing 76% According carbapenemase classes or combinations, tigecycline exhibited range 33–83%, fosfomycin 59–81%, colistin 27–78%, amikacin 17–81%. Ceftazidime-avibactam (CZA) imipenem-relebactam (IMR) showed 92% 98% serine respectively. Meanwhile, aztreonam-avibactam (AZA) 96–98% all classes. Conclusions: new epidemiological landscape emerged, equivalent circulation KPC. K. remains primary responsible dissemination. co-production particularly NDM, confirmed, mainly pneumoniae. High observed AZA MBLs CZA IMR carbapenemases.
Language: Английский
Citations
1
Infection, Journal Year: 2024, Volume and Issue: unknown
Published: Dec. 6, 2024
Language: Английский
Citations
1