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一家三级医院中耐碳青霉烯类雷特格普罗威登斯菌的暴发。

Outbreak of carbapenem-resistant Providencia rettgeri in a tertiary hospital.

作者信息

Tshisevhe V S, Lekalakala M R, Tshuma N, Janse van Rensburg S, Mbelle N

机构信息

Department of Medical Microbiology, Tshwane Academic Division, National Health Laboratory Service, Pretoria; and Department of Medical Microbiology, Faculty of Health Sciences, University of Pretoria, South Africa.

出版信息

S Afr Med J. 2016 Dec 21;107(1):31-33. doi: 10.7196/SAMJ.2016.v107.i1.12002.

Abstract

The emergence of resistance to multiple antimicrobial agents in pathogenic bacteria is a significant public health threat, as there are limited effective antimicrobial agents for infections caused by multidrug-resistant (MDR) bacteria. Several MDR bacteria are now frequently detected. Carbapenem resistance in Enterobacteriaceae is often plasmid mediated, necessitating stringent infection control practices. Wedescribe an outbreak of carbapenem-resistant Providencia rettgeri involving 4 patients admitted to intensive care and high-care units at a tertiary hospital. Clinical and demographic characteristics of 4 patients with carbapenem-resistant P. rettgeri were documented. All P. rettgeri isolated in these cases had a carbapenem-resistant antibiogram, with resistance to imipenem, ertapenem and meropenem. These cases could be epidemiologically linked. A multiprong approach, simultaneously targeting antibiotic stewardship, universal precautions and appropriate transmission-based precaution practices, is integral to prevention and control of nosocomial infections.

摘要

病原菌对多种抗菌药物产生耐药性的出现是一个重大的公共卫生威胁,因为对于耐多药(MDR)细菌引起的感染,有效的抗菌药物有限。现在经常检测到几种耐多药细菌。肠杆菌科对碳青霉烯类的耐药性通常由质粒介导,这就需要严格的感染控制措施。我们描述了一起耐碳青霉烯类雷特格普罗威登斯菌暴发事件,涉及一家三级医院重症监护病房和高护理病房收治的4名患者。记录了4例耐碳青霉烯类雷特格普罗威登斯菌患者的临床和人口统计学特征。在这些病例中分离出的所有雷特格普罗威登斯菌都有耐碳青霉烯类抗菌谱,对亚胺培南、厄他培南和美罗培南耐药。这些病例在流行病学上可能存在关联。一种多管齐下的方法,同时针对抗生素管理、普遍预防措施和基于传播的适当预防措施,对于预防和控制医院感染至关重要。

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