如何应对多重耐药菌医院感染的严峻挑战

How to deal with severe challenge of healthcare-associated infection due to multidrug-resistant organisms

摘要:

近年来，随着广谱抗菌药物的广泛应用，多重耐药菌（MDRO）随之出现并越来越多，如耐甲氧西林金黄色葡萄球菌（MRSA）和耐碳青霉烯类肠杆菌（CRE），给临床抗感染治疗及医院感染防控带来严峻挑战。新抗菌药物的研发上市与细菌耐药性的发展此消彼长，目前，细菌耐药性发展似有压倒抗菌药物研发的趋势。抗菌药物耐药性（AMR）现已被公认为是影响全球人类健康的重大威胁之一。美国疾病控制与预防中心（CDC）提出了四项核心计划，以应对MDRO的挑战，即监测、抗菌药物管理、改进药物和诊断、预防和控制传播。在应对MDRO感染的严峻威胁时，只有坚持以预防感染为中心，抗菌药物管理和医院感染管理两手抓两手硬，围绕感染源、感染途径与易感者三个环节，采取有效措施，关注多个细节并不断创新，才能取得最后的胜利。

Abstract:

In recent years, with the widespread use of broad-spectrum antimicrobial agents, multidrug-resistant organisms (MDROs) have emerged and become more and more common, such as methicillin-resistant Staphylococcus aureus(MRSA) and carbapenem-resistant Enterobacteriaceae(CRE), which pose severe challenge to clinical anti-infective treatment and prevention and control of healthcare-associated infection. The new antimicrobial agents and bacterial resistance have developed at the same time, development of bacterial resistance seems to have a tendency to overwhelm the development of antimicrobial agents. Antimicrobial resistance(AMR) is now recognized as one of the major threat to human health worldwide. The Center for Disease Control and Prevention (CDC) of America has proposed four core plans to address the challenge of MDROs:surveillance, antimicrobial management, improvement of antimicrobial agents and diagnosis, as well as prevention and control of transmission. In response to the severe threat of MDRO infection, prevention of infection should be focused on, antimicrobial management and HAI management should be grasped at the same time and attached sufficient importance, effective measures should be taken based on the source, route, and susceptible people of infection, multiple details and constant innovation should be paid attention to, the final victory can be achieved.