Abstract:
:Introduction: Among the multidrug resistant pathogens, extended-spectrum beta-lactamase (ESBL-E) or carbapenemase-producing Enterobacteriaceae (CPE) are currently considered the main threat due to the scarcity of therapeutic options and their rapid spread around the globe. In addition to developing new antibiotics and stopping transmission, recent research has focused on 'decolonization' strategies to eradicate the carriage of ESBL-E/CPE before infection occurs. Areas covered: In this narrative review, we aim to describe the current evidence of decolonization strategies for ESBL-E or CPE intestinal carriage. We first define decolonization and highlight the issues related to the lack of standardized definitions, then we summarize the available data on the natural history of colonization. Finally, we review the strategies assessed over the past 10 years for ESBL and CPE decolonization: oral antibiotics, probiotics and more recently fecal microbiota transplantation. We conclude by presenting the risks and uncertainties associated with these strategies. Expert opinion: The evidence available today is too low to recommend decolonization strategies for ESBL-E or CPE in routine clinical practice. The potential increase of resistance and the impact of microbiome manipulation should not be underestimated. Some of these decolonization strategies may nevertheless be effective, at least in temporarily suppressing colonization, which could be useful for specific populations such as high-risk patients. Effectiveness and long-term effects must be properly assessed through well-designed randomized controlled trials.
journal_name
Expert Rev Anti Infect Therjournal_title
Expert review of anti-infective therapyauthors
Catho G,Huttner BDdoi
10.1080/14787210.2019.1645007subject
Has Abstractpub_date
2019-08-01 00:00:00pages
557-569issue
8eissn
1478-7210issn
1744-8336journal_volume
17pub_type
杂志文章,评审abstract::Meningococcal disease is a life-threatening condition and a major cause of bacterial meningitis and sepsis worldwide. In many fatal cases, meningococcal disease is rapidly progressive and death occurs within hours of the initial symptoms. The early identification of patients at high risk of death would be useful in or...
journal_title:Expert review of anti-infective therapy
pub_type: 杂志文章,meta分析,评审
doi:10.1586/14787210.2014.966079
更新日期:2014-11-01 00:00:00
abstract::Ceftobiprole is among the first of a new generation of cephalosporins with activity against aerobic Gram-negative bacilli, which extends to cefepime-sensitive Pseudomonas aeruginosa, and activity against Gram-positive organisms, which includes methicillin-resistant Staphylococcus aureus. Ceftobiprole is currently unde...
journal_title:Expert review of anti-infective therapy
pub_type: 杂志文章,评审
doi:10.1586/eri.09.54
更新日期:2009-09-01 00:00:00
abstract::This report, completed in November 2003, is intended to serve as a resource for physicians, public health officials and organizations involved in the evaluation and treatment of Lyme disease. ...
journal_title:Expert review of anti-infective therapy
pub_type: 指南,杂志文章,实务指引
doi:10.1586/14789072.2.1.s1
更新日期:2004-01-01 00:00:00
abstract::Evaluation of: Riedel S, Melendez JH, An AT, Rosenbaum JE, Zenilman JM. Procalcitonin as a marker for the detection of bacteremia and sepsis in the emergency department. Am. J. Clin. Pathol. 135(2), 182-189 (2011). In a recent report, Riedel et al. proposed a procalcitonin cutoff of 0.1 ng/ml to rule out bacteremia in...
journal_title:Expert review of anti-infective therapy
pub_type: 评论,杂志文章
doi:10.1586/eri.11.42
更新日期:2011-06-01 00:00:00
abstract::Cryptosporidiosis, the disease caused by protozoa of the genus Cryptosporidium, represents a major public health problem in both developing and developed countries. The infection can be severe and life threatening among immunocompromised individuals, particularly in AIDS patients and in those with primary immunodefici...
journal_title:Expert review of anti-infective therapy
pub_type: 杂志文章,评审
doi:10.1586/14787210.4.3.429
更新日期:2006-06-01 00:00:00
abstract:INTRODUCTION:Drug-resistant tuberculous meningitis has been reported worldwide. Isoniazid mono-resistance is the most frequent cause of drug-resistant tuberculous meningitis, a life-threatening disease. Extensive drug-resistant tuberculous meningitis has also been reported in some isolated case reports. Areas covered: ...
journal_title:Expert review of anti-infective therapy
pub_type: 杂志文章,评审
doi:10.1080/14787210.2018.1540930
更新日期:2018-11-01 00:00:00
abstract::Influenza has circulated among humans for centuries and kills more people than many newly emerging diseases. The present methods for control of influenza are not adequate, especially for dealing with a pandemic. In the face of a rapidly spreading outbreak, a race to isolate the virus and prepare a vaccine would probab...
journal_title:Expert review of anti-infective therapy
pub_type: 杂志文章,评审
doi:10.1586/14787210.1.4.627
更新日期:2003-12-01 00:00:00
abstract::Human cytomegalovirus (HCMV) infection is of particular concern in immunodeficient individuals notably transplant recipients, leading to increased morbidity and mortality. HCMV is predicted to encode multiple microRNAs (miRNAs) and several have been characterized in vitro. Furthermore, these miRNAs have been shown to ...
journal_title:Expert review of anti-infective therapy
pub_type: 杂志文章,评审
doi:10.1586/14787210.2015.1106939
更新日期:2015-01-01 00:00:00
abstract:INTRODUCTION:The pathogenic and highly transmissible etiological agent, SARS-CoV-2, has caused a serious threat COVID-19 pandemic. WHO has declared the epidemic a public health emergency of international concern owing to its high contagiosity, mortality rate, and morbidity. Till now, there is no approved vaccine or dru...
journal_title:Expert review of anti-infective therapy
pub_type: 杂志文章
doi:10.1080/14787210.2021.1864327
更新日期:2020-12-23 00:00:00
abstract::Carbapenem-resistant Klebsiella pneumoniae causes serious nosocomial infections and therapeutic options are limited. There is increasing evidence suggesting that combination antibiotic therapy is more effective than monotherapy and leads to better outcomes. However, questions remain about which regimen is optimal and ...
journal_title:Expert review of anti-infective therapy
pub_type: 社论
doi:10.1586/14787210.2015.1018825
更新日期:2015-04-01 00:00:00
abstract::As a consequence of antibiotic overuse and misuse, nosocomial infections caused by multidrug-resistant bacteria represent a physician's nightmare throughout the world. No newer antimicrobials active against Pseudomonas aeruginosa, the main multidrug-resistant nosocomial pathogen, are available or under investigation. ...
journal_title:Expert review of anti-infective therapy
pub_type: 杂志文章,评审
doi:10.1586/14787210.4.4.601
更新日期:2006-08-01 00:00:00
abstract::Lopinavir is a protease inhibitor (PI) for the treatment of HIV infection that was specifically designed to overcome the shortcomings of earlier agents in this class. It is the only PI coformulated with ritonavir, whose pharmacological boosting effect results in a highly potent, well-tolerated, clinically effective an...
journal_title:Expert review of anti-infective therapy
pub_type: 杂志文章,评审
doi:10.1586/14787210.5.1.13
更新日期:2007-02-01 00:00:00
abstract::Hepatitis E, caused by hepatitis E virus, is a disease of global significance, causing 20 million infections each year. Genotypes 1 and 2 have vastly different epidemiological patterns from genotypes 3 and 4. In genotype 1 and 2 endemic areas, most infections and illness occur in persons 15-30 years of age, with pregn...
journal_title:Expert review of anti-infective therapy
pub_type: 杂志文章,评审
doi:10.1586/14787210.2015.981158
更新日期:2015-01-01 00:00:00
abstract::Late presentation of HIV is common and is associated with several adverse outcomes including an increased risk of clinical progression, blunted immune recovery on highly active antiretroviral therapy and a greater risk of drug toxicity. Late presenters may have higher rates of poor adherence, exacerbated by the same f...
journal_title:Expert review of anti-infective therapy
pub_type: 杂志文章,评审
doi:10.1586/eri.11.106
更新日期:2011-10-01 00:00:00
abstract:INTRODUCTION:Although evidence indicates that use of procalcitonin to guide antibiotic decisions for the treatment of acute respiratory infections (ARI) decreases antibiotic consumption and improves clinical outcomes, algorithms used within studies had differences in PCT cut-off points and frequency of testing. We ther...
journal_title:Expert review of anti-infective therapy
pub_type: 杂志文章,评审
doi:10.1080/14787210.2018.1496331
更新日期:2018-07-01 00:00:00
abstract::The 49th Annual Spring Meeting of the British Society of Parasitology was held at Nottingham University, UK, on 11-14 April 2011. Although a meeting of a national parasitological society, the meeting attracted approximately 375 delegates from 30 countries worldwide. Of the various themes at this meeting, two were focu...
journal_title:Expert review of anti-infective therapy
pub_type:
doi:10.1586/eri.11.62
更新日期:2011-07-01 00:00:00
abstract:BACKGROUND:Neuraminidase inhibitors (NAIs) reduce influenza symptoms but clear evidence of relationships between viral titer reduction and symptom alleviation is lacking. This open-label, randomized study evaluated differences in viral dynamics between NAIs, and relationships between viral dynamics and influenza sympto...
journal_title:Expert review of anti-infective therapy
pub_type: 杂志文章,随机对照试验
doi:10.1080/14787210.2018.1421945
更新日期:2018-02-01 00:00:00
abstract::Human enteritis resulting from the consumption of poultry products contaminated with serovars of Salmonella enterica remains a major public-health concern. Reducing food contamination by preventing or controlling infection in the chicken during rearing is an attractive solution. An accurate understanding of the mechan...
journal_title:Expert review of anti-infective therapy
pub_type: 杂志文章,评审
doi:10.1586/14787210.5.5.873
更新日期:2007-10-01 00:00:00
abstract::The authors sought to study whether extended or continuous infusion of cephalosporins is associated with better clinical outcomes than short-term infusion. PubMed and Scopus databases were systematically searched. Studies reporting the clinical outcomes of patients receiving extended or continuous infusion (≥3 or 24 h...
journal_title:Expert review of anti-infective therapy
pub_type: 杂志文章,meta分析
doi:10.1586/eri.13.44
更新日期:2013-06-01 00:00:00
abstract::Despite the constantly increasing need for new antimicrobial agents, antibiotic drug discovery and development seem to have greatly decelerated in recent years. Presented with the significant problem of advancing antimicrobial resistance, the global scientific community has attempted to find alternative solutions; one...
journal_title:Expert review of anti-infective therapy
pub_type: 杂志文章,评审
doi:10.1586/14787210.6.5.593
更新日期:2008-10-01 00:00:00
abstract::Nosocomial infections are the most frequent complications observed in surgical patients. In colorectal surgery, the opening of the viscera causes the dissemination into the operative field of microorganisms originating from endogenous sources, increasing the chance of developing postoperative complications. It is repo...
journal_title:Expert review of anti-infective therapy
pub_type: 杂志文章,评审
doi:10.1586/14787210.3.5.787
更新日期:2005-10-01 00:00:00
abstract::Sertaconazole is an imidazole-type antifungal agent that has shown considerable in vitro activity against pathogenic fungi. Various studies carried out in animal models, clinical and toxicologic trials have confirmed the value of sertaconazole in the topical treatment of superficial mycoses in dermatology and gynecolo...
journal_title:Expert review of anti-infective therapy
pub_type: 杂志文章,评审
doi:10.1586/14787210.3.3.333
更新日期:2005-06-01 00:00:00
abstract::A current focus in HIV management is improving adherence by minimizing pill burden with convenient formulations, including fixed-dose combinations (FDCs). Darunavir, a HIV protease inhibitor, co-administered with low-dose ritonavir (800/100 mg once daily), is recommended in guidelines in combination with other antiret...
journal_title:Expert review of anti-infective therapy
pub_type: 杂志文章,评审
doi:10.1586/14787210.2015.1033400
更新日期:2015-06-01 00:00:00
abstract:INTRODUCTION:The emergence of carbapenem-resistant Enterobacteriaceae (CRE) has brought aminoglycosides to the frontline since an aminoglycoside may be the only antimicrobial to which CRE isolates show in vitro susceptibility. The appropriateness of aminoglycoside-based therapies for severe infections by CRE is discuss...
journal_title:Expert review of anti-infective therapy
pub_type: 杂志文章,评审
doi:10.1080/14787210.2017.1316193
更新日期:2017-06-01 00:00:00
abstract::New respiratory fluoroquinolones (FQs), such as levofloxacin, offer many improved qualities over older agents, such as ciprofloxacin. These include retaining excellent Gram-negative bacilli activity, with improved Gram-positive activity. New FQ-like levofloxacin possesses greater bioavailabilty and a longer serum half...
journal_title:Expert review of anti-infective therapy
pub_type: 杂志文章,评审
doi:10.1586/14787210.4.5.725
更新日期:2006-10-01 00:00:00
abstract:INTRODUCTION:The Middle East Respiratory Syndrome Coronavirus (MERS-CoV) is an important emerging respiratory pathogen. MERS-CoV resulted in multiple hospital outbreaks within and outside the Arabian Peninsula. The disease has a high case fatality rate, with the need for a therapeutic option. Areas covered: In this rev...
journal_title:Expert review of anti-infective therapy
pub_type: 杂志文章,评审
doi:10.1080/14787210.2017.1271712
更新日期:2017-03-01 00:00:00
abstract::The use of combination antiretroviral therapy for the prevention of mother to child transmission of HIV infection has achieved vertical HIV transmission rates of <1%. The use of these drugs is not without risk to the mother and infant. Pregnant women with HIV-infection are at high risk of preterm birth (PTB <37 weeks)...
journal_title:Expert review of anti-infective therapy
pub_type: 杂志文章,评审
doi:10.1586/14787210.2014.885837
更新日期:2014-03-01 00:00:00
abstract:INTRODUCTION:Monkeypox is a re-emerging viral zoonosis that occurs naturally in heavily forested regions of West and Central Africa. Inter-human transmission of monkeypox virus, although limited, drives outbreaks, particularly in household and health-care settings. But the available evidence suggests that without repea...
journal_title:Expert review of anti-infective therapy
pub_type: 杂志文章,评审
doi:10.1080/14787210.2019.1567330
更新日期:2019-02-01 00:00:00
abstract::Tuberculosis (TB) is mainly an intracellular infection of the lung alveolar macrophages, and any anti-TB agent must therefore be active at the macrophage. Among the available therapies, isoniazid and rifampicin are the most effective drugs against susceptible Mycobacterium tuberculosis, but they are ineffective agains...
journal_title:Expert review of anti-infective therapy
pub_type: 杂志文章,评审
doi:10.1586/eri.10.20
更新日期:2010-04-01 00:00:00
abstract:INTRODUCTION:Patients with C. difficile infection (CDI) experience intestinal microflora changes that can promote the overgrowth and subsequent translocation of gut resident pathogens into the blood. Consistently, CDI due to PCR-ribotype 027 strain, severe or relapsing CDI, and treatment with high-dosage vancomycin are...
journal_title:Expert review of anti-infective therapy
pub_type: 杂志文章,评审
doi:10.1080/14787210.2016.1197118
更新日期:2016-07-01 00:00:00