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产碳青霉烯酶肺炎克雷伯菌(KPC)肺炎克雷伯菌:流行病学和临床方面的综述。

Klebsiella pneumoniae carbapenemase (KPC)-producing Klebsiella pneumoniae: a review of epidemiological and clinical aspects.

机构信息

University of Southern Santa Catarina, Unisul, Master Programme in Health Sciences, Av José Acácio Moreira, Tubarão 88704-900, Brazil.

出版信息

Expert Opin Biol Ther. 2012 Jun;12(6):663-71. doi: 10.1517/14712598.2012.681369. Epub 2012 Apr 16.

Abstract

INTRODUCTION

The indiscriminate use of antibiotics associated with other situations has revealed a considerable increase in outbreaks caused by microorganisms resistant to antimicrobial drugs. Among these is the Klebsiella pneumoniae carbapenemase (KPC)-producing Klebsiella pneumoniae.

AREAS COVERED

This review provides an overview of the KPC-producing K. pneumoniae with emphasis on the epidemiological and clinical aspects.

EXPERT OPINION

The KPC-producing K. pneumoniae was first described in the US. Most cases were reported between 2007 and 2009. It is widespread in almost all continents. The presence of severe comorbidities, previous use of fluoroquinolones and broad-spectrum cephalosporin are independent factors for this type of infection. Besides the increasing number of resistant strains that greatly complicates the therapeutic management of patients, the clinical characteristics of infection make the diagnosis difficult, resulting in high morbidity and mortality rates. The spread of KPC-producing K. pneumoniae shows how we are prone to pandemics. Transport systems, the exchange of healthcare professionals, the transfer of patients between hospitals and, mainly, the lack of preventive measures such as hand washing are related to the spread of KPC-producing Klebsiella pneumoniae in virtually all continents.

摘要

简介

抗生素的滥用与其他情况一起,导致了对抗微生物药物耐药的微生物引起的爆发显著增加。其中包括产碳青霉烯酶肺炎克雷伯菌(KPC)的肺炎克雷伯菌。

涵盖领域

本文综述了产 KPC 的肺炎克雷伯菌,重点介绍了其流行病学和临床方面。

专家意见

产 KPC 的肺炎克雷伯菌最初在美国被描述。大多数病例报告发生在 2007 年至 2009 年之间。它几乎在所有大陆广泛存在。严重合并症、氟喹诺酮类和广谱头孢菌素的先前使用是这种感染的独立因素。除了增加的耐药菌株大大增加了患者治疗管理的复杂性外,感染的临床特征使诊断变得困难,导致高发病率和死亡率。产 KPC 的肺炎克雷伯菌的传播表明我们容易发生大流行。运输系统、医护人员的交流、医院之间的患者转移,以及主要是缺乏预防措施,如洗手,与几乎所有大陆产 KPC 的肺炎克雷伯菌的传播有关。

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