Desafios da resistência antimicrobiana no manejo de doenças infecciosas em adultos
##plugins.themes.bootstrap3.article.sidebar##
##plugins.themes.bootstrap3.article.main##
Resumo
Objetivo: Identificar os desafios da resistência antimicrobiana no manejo de doenças infecciosas e elencar estratégias para o controle dessa resistência. Métodos: Trata-se de uma revisão integrativa realizada através das buscas nas bases de dados PubMED, Periódico CAPES e BVS, utilizando os descritores: “Bactérias”; “Doenças transmissíveis”; “Farmacorresistência Bacteriana”; “Infecções Bacterianas”; “Resultado do tratamento” e obtendo o truncamento de pesquisa: ("Drug Resistance, Microbial" OR "Bacteria") AND ("Infectious diseases" OR "Bacterial Infections") AND (Treatment Outcome). Foram incluídos 18 artigos publicados nos últimos 2 anos e disponíveis na íntegra, sendo excluídos aqueles que não respondiam ao objetivo da pesquisa. Resultados: Os principais desafios na resistência antimicrobiana em doenças infecciosas são: a necessidade de novas pesquisas e antimicrobianos eficazes, a prescrição inadequada e a proliferação de bactérias resistentes em hospitais. O desenvolvimento de novos tratamentos enfrenta obstáculos econômicos e falta de padronização, enquanto a prescrição médica inadequada exacerba o problema. Além disso, a transmissão de bactérias resistentes é intensificada por práticas inadequadas de higiene e uso de EPIs, além da dificuldade em isolar pacientes infectados. Considerações finais: Pode-se considerar que, apesar dos avanços, desafios persistem no manejo da resistência antimicrobiana, exigindo pesquisas focadas em novos antibióticos, prescrição criteriosa, e educação sobre o uso correto de antimicrobianos.
##plugins.themes.bootstrap3.article.details##
Copyright © | Todos os direitos reservados.
A revista detém os direitos autorais exclusivos de publicação deste artigo nos termos da lei 9610/98.
Reprodução parcial
É livre o uso de partes do texto, figuras e questionário do artigo, sendo obrigatória a citação dos autores e revista.
Reprodução total
É expressamente proibida, devendo ser autorizada pela revista.
Referências
2. ARNS B, et al. A randomized, open-label, non-inferiority clinical trial assessing 7 versus 14 days of antimicrobial therapy for severe multidrug-resistant gram-negative bacterial infections: The OPTIMISE trial protocol. Infectious diseases and therapy, 2024; 13(1): 237–250.
3. BADGER-EMEKA L, et al. Incidence of drug-resistant hospital-associated gram-negative bacterial infections, the accompanying risk factors, and clinical outcomes with treatment. Antibiotics (Basel, Switzerland), 2023; 12(9).
4. CORCIONE S, et al. Cefiderocol use in Gram negative infections with limited therapeutic options: Is combination therapy the key? Journal of infection and public health, 2022; 15(9): 975–979.
5. DING H, et al. Incidence of drug-resistant pathogens in community-acquired pneumonia at a safety net hospital. Microbiology spectrum, 2024; 0079224.
6. DUNNE MW, et al. Impact of empirical antibiotic therapy on outcomes of outpatient urinary tract infection due to nonsusceptible Enterobacterales. Microbiology spectrum, 2022; 10(1): 0235921.
7. GORANOVA M, et al. Evolutionary optimisation of antibiotic dosing regimens for bacteria with different levels of resistance. Artificial intelligence in medicine, 2022; 133(102405): 102405.
8. GRANATA G e CICALINI S. The evolving challenge of appropriate antibiotics use in hospitalized COVID-19 patients: A systematic literature review. Antibiotics (Basel, Switzerland), 2024; 13(6): 545.
9. KANJ SS, et al. Clinical data from studies involving novel antibiotics to treat multidrug-resistant Gram-negative bacterial infections. International journal of antimicrobial agents, 2022; 60(3): 106633.
10. LI K, et al. Ceftazidime-avibactam combination therapy versus monotherapy for the treatment of carbapenem-resistant gram-negative bacterial infections: A retrospective observational study. Infection and drug resistance, 2024; 17: 1281–1289.
11. MAEDA M, et al. Efficacy of carbapenems versus alternative antimicrobials for treating complicated urinary tract infections caused by antimicrobial-resistant Gram-negative bacteria: protocol for a systematic review and meta-analysis. BMJ open, 2023; 13(4): 69166.
12. MO Y et al. Implications of reducing antibiotic treatment duration for antimicrobial resistance in hospital settings: A modelling study and meta-analysis. PLoS medicine, 2023; 20(6): 1004013.
13. ONALLAH H, et al. Compassionate use of bacteriophages for failed persistent infections during the first 5 years of the Israeli Phage Therapy Center. Open forum infectious diseases, 2023; 10(5): 221.
14. PARK KH, et al. Impact of multidrug resistance on outcomes in hematologic cancer patients with bacterial bloodstream infections. Scientific reports, 2024; 14(1): 15622.
15. PAUL M, et al. European Society of Clinical Microbiology and Infectious Diseases (ESCMID) guidelines for the treatment of infections caused by multidrug-resistant Gram-negative bacilli (endorsed by European society of intensive care medicine). Clinical microbiology and infection: the official publication of the European Society of Clinical Microbiology and Infectious Diseases, 2022; 28(4): 521–547.
16. PINA-VAZ C, et al. A multisite validation of a two hours antibiotic susceptibility flow cytometry assay directly from positive blood cultures. BMC microbiology, 2024; 24(1).
17. RAHMAN MN, et al. The use of probiotics and prebiotics in decolonizing pathogenic bacteria from the gut; a systematic review and meta-analysis of clinical outcomes. Gut microbes, 2024; 16(1): 2356279.
18. SUBAGDJA MFM, et al. Antibiotic resistance in COVID-19 with bacterial infection: Laboratory-based surveillance study at single tertiary hospital in Indonesia. Infection and drug resistance, 2022; 15: 5849–5856.
19. TANG PC, et al. Within-species variability of antibiotic interactions in Gram-negative bacteria. mBio, 2024; 15(3).
20. TANTALO LC, et al. Antimicrobial susceptibility of Treponema pallidum subspecies pallidum: an in-vitro study. The Lancet. Microbe, 2023; 4(12): 994–1004.
21. TAYLOR SL, et al. Preventing empirical antibiotic treatment failure in migrant populations: screening by infection risk, not ethnic background. International journal of infectious diseases: IJID: official publication of the International Society for Infectious Diseases, 2023; 134: 168–171.
22. VALLICELLI C, et al. Sepsis team organizational model to decrease mortality for intra-abdominal infections: Is antibiotic stewardship enough? Antibiotics (Basel, Switzerland), 2022; 11(11): 1460.
23. VAN DUIJN PJ, et al. The effects of antibiotic cycling and mixing on acquisition of antibiotic resistant bacteria in the ICU: A post-hoc individual patient analysis of a prospective cluster-randomized crossover study. PloS one, 2022; 17(5): 0265720.
24. WITZANY C, et al. Assessing the relative importance of bacterial resistance, persistence and hyper-mutation for antibiotic treatment failure, Proceedings. Biological sciences, 2022; 289(1986): 20221300.
25. ZHANG F, et al. Clinical outcomes and risk factors for mortality in recipients with carbapenem-resistant gram-negative bacilli infections after kidney transplantation treated with ceftazidime-avibactam: a retrospective study. Frontiers in cellular and infection microbiology, 2024; 14.
26. ZHOU Y, et al. Efficacy and safety of different polymyxin-containing regimens for the treatment of pneumonia caused by multidrug-resistant gram-negative bacteria: a systematic review and network meta-analysis. Critical care (London, England), 2024; 28(1).