产碳青霉烯酶肠杆菌科的全球流行病学。
The global epidemiology of carbapenemase-producing Enterobacteriaceae.
机构信息
a Division of Infectious Diseases , University of North Carolina , Chapel Hill , NC , USA.
b Division of Infectious Diseases , University of Pittsburgh School of Medicine , Pittsburgh , PA , USA.
出版信息
Virulence. 2017 May 19;8(4):460-469. doi: 10.1080/21505594.2016.1222343. Epub 2016 Aug 11.
Abstract
Carbapenemase-producing Enterobacteriaceae (CPE) are an important and increasing threat to global health. Both clonal spread and plasmid-mediated transmission contribute to the ongoing rise in incidence of these bacteria. Among the 4 classes of β-lactamases defined by the Ambler classification system, the carbapenemases that confer carbapenem resistance in Enterobacteriaceae belong to 3 of them: Class A (K. pneumoniae carbapenemases, KPC), Class B (metallo-β-lactamases, MBL including New Delhi metallo-β-lactamases, NDM) and Class D (OXA-48-like carbapenemases). KPC-producing CPE are the most commonly occurring CPE in the United States. MBL-producing CPE have been most commonly associated with the Indian Subcontinent as well as with specific countries in Europe, including Romania, Denmark, Spain, and Hungary. The epicenter of OXA-48-like-producing is in Turkey and surrounding countries. Detailed knowledge of the epidemiology and molecular characteristics of CPE is essential to stem the spread of these pathogens.
摘要
产碳青霉烯酶肠杆菌科细菌（CPE）对全球健康构成了重要且日益严重的威胁。克隆传播和质粒介导的传播都导致了这些细菌发病率的持续上升。在 Ambler 分类系统定义的 4 类β-内酰胺酶中，赋予肠杆菌科细菌碳青霉烯耐药性的碳青霉烯酶属于其中 3 类：A 类（肺炎克雷伯菌碳青霉烯酶，KPC）、B 类（金属β-内酰胺酶，MBL 包括新德里金属β-内酰胺酶，NDM）和 D 类（OXA-48 样碳青霉烯酶）。在美国，产 KPC 的 CPE 最为常见。产 MBL 的 CPE 最常与印度次大陆以及欧洲的特定国家相关，包括罗马尼亚、丹麦、西班牙和匈牙利。产 OXA-48 样碳青霉烯酶的中心在土耳其及其周边国家。详细了解 CPE 的流行病学和分子特征对于阻止这些病原体的传播至关重要。
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