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产新德里金属β-内酰胺酶肺炎克雷伯菌的人类临床分离株全球基因型分布:系统评价。

Global genotype distribution of human clinical isolates of New Delhi metallo-β-lactamase-producing Klebsiella pneumoniae; A systematic review.

机构信息

Department of Microbiology, School of Medicine, Alborz University of Medical Sciences, Karaj, Iran.

Department of Microbiology, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran.

出版信息

J Glob Antimicrob Resist. 2020 Dec;23:420-429. doi: 10.1016/j.jgar.2020.10.016. Epub 2020 Nov 4.

Abstract

BACKGROUND AND AIM

The global rise of antimicrobial resistance among bacterial strains is a rapidly growing challenge and is becoming a major public health concern. This study documents the worldwide spread and genotype distribution of human clinical isolates of New Delhi metallo-β-lactamase-producing Klebsiella pneumoniae (NPKP).

METHODS

Several international databases, including Web of Science, Embase and Medline were searched (2010 - 2019) to identify studies addressing the frequency of NPKP regionally or worldwide.

RESULTS

Of 4779 articles identified, 202 studies fulfilled the eligibility criteria and were included in our analysis. The frequency of NPKP in Asia, Europe, America, Africa and Oceania was 64.6%, 20.1%, 9.0%, 5.6% and 0.4%, respectively. The most prevalent sequence types (STs) among NPKP were ST11, ST290, ST147, ST340, ST15, ST278 and ST14 based on published studies.

CONCLUSION

The dissemination of bla variants in different STs among NPKP in the various region of world is a serious concern to public health. The prevalence of NPKP should be controlled by comprehensive infection control measures and optimization of antibiotic therapy.

摘要

背景与目的

细菌菌株对抗菌药物的耐药性在全球范围内迅速上升,已成为主要的公共卫生关注点。本研究记录了产新德里金属β-内酰胺酶肺炎克雷伯菌(NPKP)的人临床分离株在全球的传播和基因型分布。

方法

检索了包括 Web of Science、Embase 和 Medline 在内的多个国际数据库(2010-2019 年),以确定区域性或全球性研究 NPKP 频率的文章。

结果

在 4779 篇文章中,有 202 项研究符合纳入标准并纳入分析。亚洲、欧洲、美洲、非洲和大洋洲的 NPKP 频率分别为 64.6%、20.1%、9.0%、5.6%和 0.4%。根据已发表的研究,NPKP 中最常见的序列类型(ST)是 ST11、ST290、ST147、ST340、ST15、ST278 和 ST14。

结论

不同地区 NPKP 中 bla 变体在不同 ST 中的传播对公共卫生构成严重威胁。应通过综合感染控制措施和优化抗生素治疗来控制 NPKP 的流行。

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