دانلود رایگان مقاله لاتین مقاومت به آنتی بیوتیک در عفونت باکتریال گرم منفی در بیماران سرطانی از سایت الزویر
عنوان فارسی مقاله:
مقاومت به آنتی بیوتیک در عفونت باکتریال گرم منفی در بیماران مبتلا به سرطان
عنوان انگلیسی مقاله:
Antibiotic-Resistant Gram-Negative Bacterial Infections in Patients With Cancer
سال انتشار : 2014
بخشی از مقاله انگلیسی:
ACINETOBACTER BAUMANNII
Our understanding of the genetic diversity and the population structure of Acinetobacter has given rise to the concept of MDR clonal lineages. The predominant clone type has shifted from clonal cluster 3 (CC3 in the Pasteur scheme, or CC110 in the Oxford scheme) to clonal cluster 2 (CC2 or CC92), associated with carbapenem resistance mediated by the β-lactamase OXA-23 (oxacillinase) [27]. In Pittsburgh, where CC2 is prevalent, the mortality rate of patients with cancer and MDR Acinetobacter baumannii infection reached 55% [28]. Interestingly, a multivariate analysis revealed that the risk factors for acquisition of MDR A. baumannii were related to healthcare exposure, such as need for dialysis and length of previous intensive care, rather than to the underlying cancer [28]. In patients undergoing hematopoietic stem cell transplant, pneumonia (occurring after engraftment) was the main source of MDR A. baumannii bloodstream infections, with overwhelming mortality (95%) [29]. STENOTROPHOMONAS MALTOPHILIA The hallmark of Stenotrophomonas maltophilia is intrinsic antibiotic resistance. Its chromosome harbors 2 β-lactamases: L1, a metallo-β-lactamase with carbapenemase activity that does not hydrolyze aztreonam; and L2, a serine cephalosporinase that is inhibited by clavulanic acid. Additionally, S. maltophilia possesses a relatively impermeable membrane, and like P. aeruginosa, expresses efflux pumps and acquires additional resistance determinants in class 1 integrons. Trimethoprim-sulfamethoxazole (TMP-SMX) remains the main reliable antibiotic option to treat infections caused by S. maltophilia, although resistance to TMPSMX has emerged; tigecycline, minocycline, moxifloxacin, and, inparticular,colistinmayofferactivity [30].Bloodstreaminfection with S. maltophilia is associated commonly with central lines, and strong consideration should be given to catheter removal [31]. Patients with hematologic malignancy may develop fulminant hemorrhagic pneumonia caused by S. maltophilia [32].
کلمات کلیدی:
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