PDF(Pubmed)
Abstract：
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.
摘要：
重症监护病房（ICU）是专门管理危重病人的专门环境，对耐药细菌特别敏感。其中,耐碳青霉烯类革兰氏阴性菌(CR-GNB)对ICU患者的生命构成重大威胁。碳青霉烯酶的产生是CR-GNB的关键耐药机制，随着抗性基因的转移，抗生素耐药性（AMR）的广泛出现。CR-GNB感染在ICU中普遍存在，强调迫切需要预防和控制措施，以降低与CR-GNB传播或感染相关的死亡率。本综述概述了ICU中围绕CR-GNB的关键方面。我们研究了细菌耐药性的机制，ICU中CR-GNB感染常见的耐药基因，以及针对碳青霉烯酶基因型的治疗选择。此外,我们强调了重要的预防措施，以阻止CR-GNB在ICU中的传播和传播，在回顾临床预测建模研究领域取得的进展的同时，这对实际应用具有极好的潜力。
