产碳青霉烯酶肠杆菌科骨髓炎的病例系列：感受它在你的骨头里。

Case series of carbapenemase-producing Enterobacteriaceae osteomyelitis: Feel it in your bones.

机构信息

Service des Maladies Infectieuses, Centre Hospitalier Universitaire Raymond Poincaré, AP-HP, Garches, France.

Laboratoire de Microbiologie, Centre Hospitalier Universitaire Raymond Poincaré, AP-HP, Garches, France.

出版信息

J Glob Antimicrob Resist. 2020 Dec;23:74-78. doi: 10.1016/j.jgar.2020.08.007. Epub 2020 Sep 1.

DOI:10.1016/j.jgar.2020.08.007

PMID:32882450

Abstract

OBJECTIVES

Limited data have been reported regarding osteomyelitis due to carbapenemase-producing Enterobacteriaceae (CPE), including co-infections with extended-spectrum β-lactamase (ESBL)-producing micro-organisms.

METHODS

We conducted a retrospective study in a reference centre for bone and joint infections from 2011 to 2019 among patients infected with CPE.

RESULTS

Nine patients (mean age 46.8 ± 16.6 years), including three with infected implants, were identified. Infections were mostly polymicrobial (n = 8/9), including Staphylococcus aureus (n = 6/9). CPE were mainly OXA-48-type, associated with ESBL-producing Enterobacteriaceae (n = 8/9), of which 5/9 isolates were Klebsiella pneumoniae. Control of the infection was achieved in seven cases.

CONCLUSIONS

CPE osteomyelitides are essentially polymicrobial and fluoroquinolone-resistant infections, highlighting the need for efficient surgery with implant removal.

摘要

目的

产碳青霉烯酶肠杆菌科细菌（CPE）引起的骨髓炎相关数据有限，包括与产超广谱β-内酰胺酶（ESBL）微生物的合并感染。

方法

我们对 2011 年至 2019 年间在一家骨与关节感染参考中心感染 CPE 的患者进行了回顾性研究。

结果

共确定了 9 例患者（平均年龄 46.8 ± 16.6 岁），其中 3 例有感染性植入物。感染主要为混合感染（n=8/9），包括 6/9 例金黄色葡萄球菌。CPE 主要为 OXA-48 型，与产 ESBL 的肠杆菌科细菌相关（n=8/9），其中 5/9 株为肺炎克雷伯菌。7 例患者的感染得到了控制。