a Department of Pediatric and Adolescent Medicine , Mayo Clinic , Rochester , MN , USA.
b Department of Pathology and Laboratory Medicine , University of California , Los Angeles , CA , USA.
Virulence. 2017 May 19;8(4):427-439. doi: 10.1080/21505594.2016.1185577. Epub 2016 May 11.
Carbapenem resistance among the Enterobacteriaceae has become a significant clinical and public health dilemma. Rapid administration of effective antimicrobials and implementation of supplemental infection control practices is required to both improve patient outcomes and limit the spread of these highly resistant organisms. However, carbapenem-resistant Enterobacteriaceae (CRE)-infected patients are predominantly identified by routine culture methods, which take days to perform. Rapid genomic and phenotypic methods are currently available to accelerate the identification of carbapenemase-producing CRE. Effective use of these technologies is reliant on close collaboration between clinical microbiology, infection prevention, antimicrobial stewardship and infectious diseases specialists. This review discusses the performance characteristics of these technologies to date, and describes strategies for their optimal implementation.
肠杆菌科的碳青霉烯类耐药性已成为一个重大的临床和公共卫生难题。为了改善患者的预后并限制这些高度耐药菌的传播，需要迅速给予有效的抗菌药物，并实施补充性感染控制措施。然而，碳青霉烯类耐药肠杆菌科（CRE）感染患者主要通过常规培养方法来确定，而这些方法需要数天才能完成。目前有快速的基因组和表型方法可用于加速产碳青霉烯酶 CRE 的鉴定。这些技术的有效使用依赖于临床微生物学、感染预防、抗菌药物管理和传染病专家之间的密切合作。本文回顾了迄今为止这些技术的性能特征，并描述了其最佳实施策略。
