耐碳青霉烯类肠杆菌科细菌的流行病学：一种全球威胁的影响与演变
The Epidemiology of Carbapenem-Resistant Enterobacteriaceae: The Impact and Evolution of a Global Menace.
作者信息
Logan Latania K, Weinstein Robert A
机构信息
Section of Pediatric Infectious Diseases, Department of Pediatrics.
Cook County Health and Hospitals System, Chicago, Illinois.
出版信息
J Infect Dis. 2017 Feb 15;215(suppl_1):S28-S36. doi: 10.1093/infdis/jiw282.
Abstract
Carbapenem-resistant Enterobacteriaceae (CRE) are a serious public health threat. Infections due to these organisms are associated with significant morbidity and mortality. Mechanisms of drug resistance in gram-negative bacteria (GNB) are numerous; β-lactamase genes carried on mobile genetic elements are a key mechanism for the rapid spread of antibiotic-resistant GNB worldwide. Transmissible carbapenem-resistance in Enterobacteriaceae has been recognized for the last 2 decades, but global dissemination of carbapenemase-producing Enterobacteriaceae (CPE) is a more recent problem that, once initiated, has been occurring at an alarming pace. In this article, we discuss the evolution of CRE, with a focus on the epidemiology of the CPE pandemic; review risk factors for colonization and infection with the most common transmissible CPE worldwide, Klebsiella pneumoniae carbapenemase-producing K. pneumoniae; and present strategies used to halt the striking spread of these deadly pathogens.
摘要
耐碳青霉烯类肠杆菌科细菌（CRE）是对公共卫生的严重威胁。这些微生物引起的感染与显著的发病率和死亡率相关。革兰氏阴性菌（GNB）的耐药机制众多；移动遗传元件携带的β-内酰胺酶基因是耐药GNB在全球迅速传播的关键机制。肠杆菌科细菌中可传播的碳青霉烯耐药性在过去20年中已得到确认，但产碳青霉烯酶肠杆菌科细菌（CPE）的全球传播是一个较新出现的问题，一旦开始传播，其速度惊人。在本文中，我们讨论CRE的演变，重点关注CPE大流行的流行病学；回顾全球最常见的可传播CPE——产肺炎克雷伯菌碳青霉烯酶的肺炎克雷伯菌的定植和感染风险因素；并介绍用于阻止这些致命病原体惊人传播的策略。
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