Carbapenem-resistant Gram-negative bacteria (CR-GNB) in ICUs: resistance genes, therapeutics, and prevention - a comprehensive review

被引:4
作者
Li, Qi [1 ,2 ]
Zhou, Xiaoshi [1 ,2 ]
Yang, Rou [1 ,2 ]
Shen, Xiaoyan [2 ,3 ]
Li, Guolin [1 ,4 ]
Zhang, Changji [1 ,4 ]
Li, Pengfei [2 ]
Li, Shiran [1 ,2 ]
Xie, Jingxian [1 ]
Yang, Yong [1 ,2 ]
机构
[1] Univ Elect Sci & Technol China, Sichuan Acad Med Sci & Sichuan Prov Peoples Hosp, Sch Med, Dept Pharm, Chengdu, Peoples R China
[2] Univ Elect Sci & Technol China, Sch Med, Personalized Drug Therapy Key Lab Sichuan Prov, Chengdu, Peoples R China
[3] Chengdu Qingbaijiang Dist Peoples Hosp, Dept Pharm, Chengdu, Peoples R China
[4] China Pharmaceut Univ, Sch Basic Med & Clin Pharm, Nanjing, Peoples R China
关键词
ICU; CR-GNB; mechanism; genes; infection control strategies; predictive model; BLOOD-STREAM INFECTION; INTENSIVE-CARE-UNIT; SPECTRUM BETA-LACTAMASES; CRITICALLY-ILL PATIENTS; IN-VITRO ACTIVITY; KLEBSIELLA-PNEUMONIAE; MULTIDRUG-RESISTANT; PSEUDOMONAS-AERUGINOSA; ANTIMICROBIAL RESISTANCE; CEFTAZIDIME-AVIBACTAM;
D O I
10.3389/fpubh.2024.1376513
中图分类号
R1 [预防医学、卫生学];
学科分类号
1004 ; 120402 ;
摘要
Intensive care units (ICUs) are specialized environments dedicated to the management of critically ill patients, who are particularly susceptible to drug-resistant bacteria. Among these, carbapenem-resistant Gram-negative bacteria (CR-GNB) pose a significant threat endangering the lives of ICU patients. Carbapenemase production is a key resistance mechanism in CR-GNB, with the transfer of resistance genes contributing to the extensive emergence of antimicrobial resistance (AMR). CR-GNB infections are widespread in ICUs, highlighting an urgent need for prevention and control measures to reduce mortality rates associated with CR-GNB transmission or infection. This review provides an overview of key aspects surrounding CR-GNB within ICUs. We examine the mechanisms of bacterial drug resistance, the resistance genes that frequently occur with CR-GNB infections in ICU, and the therapeutic options against carbapenemase genotypes. Additionally, we highlight crucial preventive measures to impede the transmission and spread of CR-GNB within ICUs, along with reviewing the advances made in the field of clinical predictive modeling research, which hold excellent potential for practical application.
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页数:13
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