University of Minnesota, Department of Medicine, Infectious Diseases and International Medicine, Minneapolis, MN, USA.
Diagn Microbiol Infect Dis. 2013 Jul;76(3):356-60. doi: 10.1016/j.diagmicrobio.2013.03.032. Epub 2013 May 6.
We report the prevalence of carbapenemase-positive Klebsiella pneumoniae among clinical isolates collected from US medical centers (n = 42) from 2007-2009 through the SENTRY Antimicrobial Surveillance Program. Isolates with imipenem or meropenem MIC ≥ 2 μg/mL were screened by PCR for various carbapenemase genes. Of 2049 K. pneumoniae isolates, 126 (6.1%) were non-susceptible to imipenem or meropenem. blaKPC was identified in 113 isolates (5.5%). No other carbapenemase genes were identified. For US regions combined, prevalence of K. pneumoniae carbapenemase (KPC)-positive isolates were 5.9% in 2007, 4.9% in 2008, and 5.7% in 2009. Rates were highest in the Mid-Atlantic region (28.6% overall), with fluctuation over time (29%, 23%, and 33% from 2007-2009), followed by the East North Central region (2.4% overall), with a slightly increasing trend (nil, 3.1%, 3.8% from 2007-2009). All KPC-positive organisms were carbapenem non-susceptible according to updated CLSI breakpoints, although all but one was similarly classified according to previous breakpoints.
我们报告了 2007-2009 年期间通过 SENTRY 抗菌监测计划收集的来自美国医疗中心的临床分离株中碳青霉烯酶阳性肺炎克雷伯菌的流行情况(n = 42)。用 PCR 对 2049 株肺炎克雷伯菌分离株中对亚胺培南或美罗培南 MIC≥2μg/ml 的分离株进行各种碳青霉烯酶基因筛查。在 2049 株肺炎克雷伯菌分离株中,有 126 株(6.1%)对亚胺培南或美罗培南不敏感。在 113 株分离株中鉴定出 blaKPC(5.5%)。未鉴定出其他碳青霉烯酶基因。对于美国各地区综合来看,2007 年、2008 年和 2009 年肺炎克雷伯菌碳青霉烯酶(KPC)阳性分离株的流行率分别为 5.9%、4.9%和 5.7%。在大西洋中部地区(总体 28.6%)的比率最高,且随着时间的推移呈波动趋势(2007-2009 年分别为 29%、23%和 33%),其次是东北中部地区(总体 2.4%),呈略微上升趋势(2007-2009 年分别为无、3.1%和 3.8%)。所有 KPC 阳性菌均根据更新的 CLSI 折点被归类为碳青霉烯类药物不敏感,尽管除一株外,所有菌均根据之前的折点被归类为碳青霉烯类药物不敏感。