ABSTRACT

Introduction

Patients admitted to hospitals are at risk of developing nosocomial infections. These types of infections typically occur in immune-compromised patients. Furthermore, nosocomial infections are frequently caused by resistant organisms, including nonfermenting gram-negative bacilli such as Pseudomonas aeruginosa.

Areas covered

P. aeruginosa is a hazardous pathogen. It can resist numerous antibiotics, due to several resistance mechanisms. It is associated with serious illnesses, particularly hospital-acquired infections including ventilator-associated pneumonia. In the past, only a limited number of anti-pseudomonal drugs were available. However, several therapeutic advancements have been made, in recent years, to target P. aeruginosa, including the development of the new cephalosporin: ceftolozane-tazobactam.

Expert opinion

Ceftolozane-tazobactam is a combination of a novel semi-synthetic fifth-generation cephalosporin with a well-established beta-lactamase inhibitor. From a structural perspective, ceftolozane-tazobactam has attested increased stability to AmpC β-lactamases. Additionally, ceftolozane-tazobactam is less affected by changes in efflux pumps and porin permeability due to an enhanced affinity to certain penicillin-binding proteins (PBPs). This enables the molecule to overcome the most common anti-drug resistant mechanisms of bacteria. According to previous clinical trials conducted, ceftolozane-tazobactam must be considered when treating patients with confirmed or suspected P. aeruginosa respiratory tract infections, either nosocomial pneumonia or ventilator-associated pneumonia.

中文翻译：

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头孢洛赞和他唑巴坦用于治疗医院获得性肺炎。

摘要

介绍

入院的患者有发生医院感染的风险。这些类型的感染通常发生在免疫功能低下的患者中。此外，医院感染通常由耐药菌引起，包括非发酵革兰氏阴性杆菌，如铜绿假单胞菌。

覆盖区域

铜绿假单胞菌是有害的病原体。由于多种耐药机制，它可以抵抗多种抗生素。它与严重疾病有关，尤其是医院获得性感染，包括呼吸机相关性肺炎。过去，仅可获得有限数量的抗假性伪狂药。然而，近年来，针对铜绿假单胞菌已经取得了一些治疗进展，包括开发了新的头孢菌素：头孢噻嗪-他唑巴坦。

专家意见

头孢唑烷-他唑巴坦是新型半合成的第五代头孢菌素与成熟的β-内酰胺酶抑制剂的组合。从结构的角度来看，头孢唑烷-他唑巴坦已证明对AmpCβ-内酰胺酶具有更高的稳定性。另外，由于对某些青霉素结合蛋白（PBPs）的亲和力增强，所以头孢洛氮-他唑巴坦受流出泵和孔蛋白渗透性变化的影响较小。这使分子能够克服最常见的细菌抗药性机制。根据先前进行的临床试验，在治疗已确诊或怀疑有铜绿假单胞菌呼吸道感染（医院内肺炎或呼吸机相关性肺炎）的患者时，必须考虑使用头孢洛氮他唑巴坦。