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意大利产碳青霉烯酶肺炎克雷伯菌定植和感染的特征及其临床意义。

Characteristics and Clinical Implications of Carbapenemase-Producing Klebsiella pneumoniae Colonization and Infection, Italy.

出版信息

Emerg Infect Dis. 2021 May;27(5):1416-1426. doi: 10.3201/eid2705.203662.

DOI:10.3201/eid2705.203662
PMID:33900910
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC8084501/
Abstract

carbapenemase–producing (KPC) has been endemic in Italy since 2013. In a multicenter cohort study, we investigated various aspects of KPC among patients, including 15-day mortality rates and delays in adequate therapy. Most (77%) KPC strains were sequence type (ST) ST512 or ST307. During 2017, KPC- prevalence was 3.26 cases/1,000 hospitalized patients. Cumulative incidence of KPC- acquired >48 hours after hospital admission was 0.68% but varied widely between centers. Among patients with mild infections and noninfected colonized patients, 15-day mortality rates were comparable, but rates were much higher among patients with severe infections. Delays of 4 days in receiving adequate therapy more frequently occurred among patients with mild infections than those with severe infections, and delays were less common for patients with known previous KPC colonization. Italy urgently needs a concerted surveillance system to control the spread of KPC-.

摘要

自 2013 年以来，意大利一直存在产碳青霉烯酶（KPC）的问题。在一项多中心队列研究中，我们研究了患者中 KPC 的各个方面，包括 15 天死亡率和适当治疗的延迟。大多数（77%）KPC 菌株为 ST512 或 ST307 序列型。2017 年，KPC 的患病率为每 1000 名住院患者中有 3.26 例。入院后超过 48 小时获得 KPC 的累积发病率为 0.68%，但各中心之间差异很大。在轻度感染和未感染定植患者中，15 天死亡率相当，但在严重感染患者中，死亡率要高得多。与严重感染患者相比，接受适当治疗的时间延迟 4 天的情况在轻度感染患者中更为常见，而对于已知先前存在 KPC 定植的患者，治疗延迟则不太常见。意大利迫切需要一个协调一致的监测系统来控制 KPC 的传播。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4dd6/8084501/d7529f3bd903/20-3662-F2.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4dd6/8084501/00e4b39fbc19/20-3662-F1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4dd6/8084501/d7529f3bd903/20-3662-F2.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4dd6/8084501/00e4b39fbc19/20-3662-F1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4dd6/8084501/d7529f3bd903/20-3662-F2.jpg

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