Hansen Glen T
Department of Pathology and Laboratory Medicine, Hennepin County Medical Center, Minneapolis, MN, USA.
Department of Pathology and Laboratory Medicine, University of Minnesota, School of Medicine, Minneapolis, MN, USA.
Infect Dis Ther. 2021 Mar;10(1):75-92. doi: 10.1007/s40121-020-00395-2. Epub 2021 Jan 25.
The global emergence of carbapenemase-producing bacteria capable of hydrolyzing the once effective carbapenem antibiotics is considered a contemporary public health concern. Carbapenemase enzymes, once constrained to isolates of Klebsiella pneumoniae, are now routinely reported in different bacteria within the Enterobacterales order of bacteria, creating the acronym CRE which now defines Carbapenem-Resistant Enterobacterales. CRE harboring different types of enzymes, including the most prevalent types KPC, VIM, IMP, NDM, and OXA-48, are now routinely reported and more importantly, are now frequently present in many infections world-wide. Defining and updating the contemporary epidemiology of both the US and global burden of carbapenem-resistant infections is now more important than ever. This review describes the global distribution and continued evolution of carbapenemases which continue to spread at alarming rates. Informed understanding of the current epidemiology of CRE, coupled with advances in antibiotic options, and the use rapid diagnostics offers the potential for rapid identification and management of carbapenem-resistant infections.
能够水解曾经有效的碳青霉烯类抗生素的产碳青霉烯酶细菌在全球范围内的出现被视为当代公共卫生问题。碳青霉烯酶曾局限于肺炎克雷伯菌分离株，现在在肠杆菌目细菌中的不同细菌中经常被报道，创造了首字母缩写词CRE，现在它定义了耐碳青霉烯类肠杆菌。携带不同类型酶（包括最常见的KPC、VIM、IMP、NDM和OXA - 48型）的CRE现在经常被报道，更重要的是，现在在全球许多感染中经常出现。定义并更新美国和全球碳青霉烯类耐药感染负担的当代流行病学现在比以往任何时候都更加重要。这篇综述描述了碳青霉烯酶的全球分布和持续演变，其仍在以惊人的速度传播。对CRE当前流行病学的深入了解，加上抗生素选择的进展以及快速诊断的应用，为快速识别和管理碳青霉烯类耐药感染提供了可能。
