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2024, Número 4

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Acta Pediatr Mex 2024; 45 (4)


Mecanismos moleculares y epidemiología de la resistencia a ceftazidima-avibactam: un análisis integral

Acosta MHE, Merida VJ, Aparicio OG, Urzua AMM, Aquino AA

Idioma: Español
Referencias bibliográficas: 93
Paginas: 326-342
Archivo PDF: 539.71 Kb.


RESUMEN

En 2015, se aprobó el uso de ceftazidima/avibactam (CZA) para el tratamiento de infecciones complicadas: urinarias, intrabdominales y neumonías adquiridas en hospitales, causadas por bacilos Gramnegativos multidrogorresistentes. Su aprobación para uso pediátrico fue en 2019. A pesar de su efectividad inicial, la resistencia a CZA ha ido en aumento, alcanzando un 10% a nivel global. Este artículo ofrece una revisión exhaustiva de los mecanismos de acción de la CZA. Se detallan las principales formas de adquisición de resistencia a este antimicrobiano, como las mutaciones en la carbapenemasa KPC y betalactamasas de espectro extendido (BLEE), sobreexpresión en bombas de eflujo y modificación de porinas. También se revisan investigaciones experimentales para entender las causas de este fenómeno y se destaca la emergencia de resistencia durante el tratamiento con CZA, subrayando la importancia de la epidemiología de esta resistencia para determinar los casos en los que CZA es la mejor opción terapéutica.


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