Chiang Tom, Mariano Noriel, Urban Carl, Colon-Urban Rita, Grenner Louise, Eng Robert H K, Huang David, Dholakia Hema, Rahal James J
Veteran Affairs New Jersey Health Care System, East Orange, New Jersey, USA.
Microb Drug Resist. 2007 Winter;13(4):235-39. doi: 10.1089/mdr.2007.767.
Klebsiella pneumoniae isolates harboring KPC enzymes have been identified in many geographical areas since 2001. Numerous problems exist in the detection and treatment of patients with such isolates. The clinical characteristics and molecular epidemiology associated with 12 randomly chosen patients in whom these enzymes were detected by molecular methods are described. This is the first description of the identification of carbapenem-resistant K. pneumoniae isolates harboring KPC beta-lactamases at the Veterans Administration Hospital in New Jersey (VA NJHCS). Because recognition of carbapenem resistance in K. pneumoniae due to KPC enzymes can only be achieved by molecular methods, detection in the Clinical Microbiology Laboratory by routine methods will continue to be difficult, leading to dilemmas in treatment.
自2001年以来,在许多地理区域均已鉴定出携带KPC酶的肺炎克雷伯菌分离株。此类分离株患者的检测和治疗存在诸多问题。本文描述了通过分子方法检测出这些酶的12例随机选择患者的临床特征及分子流行病学情况。这是新泽西州退伍军人管理局医院(VA NJHCS)首次对携带KPCβ-内酰胺酶的耐碳青霉烯类肺炎克雷伯菌分离株进行鉴定的描述。由于只有通过分子方法才能识别由KPC酶导致的肺炎克雷伯菌对碳青霉烯类药物的耐药性,临床微生物实验室通过常规方法进行检测仍将困难重重,从而导致治疗困境。