Auteur: LAHMIDI Dounia.
Rapporteur: professeur SEKHSOKH Yassine
Mots clés: Carbapénèmases, Carbapénème, Dépistage, Recommandations, Résistance
L’émergence des bactéries productrices de carbapénèmases représente un véritable risque de santé publique et un problème clinique car les carbapénèmases confèrent une résistance à la plupart des β-lactames, ces derniers présentent fréquemment de multiples mécanismes de résistances qui peuvent conduire à une impasse thérapeutique. Une détection précoce des mécanismes de résistance émergents peut permettre d’envisager de limiter leur diffusion en milieu nosocomial et d’optimiser l’antibiothérapie. ces souches nécessitent d’être rapidement et efficacement détectées afin de prendre au plus vite les mesures préventives et thérapeutiques appropriées vis à vis des patients qui les hébergent. Cependant, afin de prévenir le développement de poussées nosocomiales, l'identification des producteurs de carbapénèmases doit réellement être suivie d'une adaptation rapide de l'antibiothérapie et de l'isolement des patients colonisés. Plusieurs études, rétrospectives pour la plupart, ont montré que les monothérapies sont associées à une mortalité et une sélection de résistance élevées, démontrant l’importance d’utiliser des associations de molécules actives in vitro pour le traitement des infections à entérobactéries productrices de carbapénèmases.
ABSTRACT
Title: Resistance to carbapenems in bacteria.
Author: LAHMIDI Dounia.
Raporter: Pr. SEKHSOKH Yassine
Key words: Carbapenemases, Carbapenem, Screening, Recommendations, Resistance.
The emergence of carbapenemase-producing bacteria represents a real public health risk and a clinical problem because carbapenemases confer resistance to most β-lactams, which frequently exhibit multiple resistance mechanisms which can lead to a therapeutic impasse. Early detection of emerging resistance mechanisms can make it possible to consider limiting their diffusion in a nosocomial environment and optimizing antibiotic therapy. these strains need to be quickly and efficiently detected in order to take the appropriate preventive and therapeutic measures as quickly as possible for the patients who harbor them. However, in order to prevent the development of nosocomial outbreaks, the identification of producers of carbapenemases must really be followed by a rapid adaptation of antibiotic therapy and the isolation of colonized patients. Several studies, mostly retrospective, have shown that monotherapies are associated with high mortality and resistance selection, demonstrating the importance of using combinations of active molecules in vitro for the treatment of carbapenemase-producing enterobacterial infections.
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