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从新的角度看碳青霉烯酶编码细菌的全球分布模式:关于种族作用的线索。

Global Distribution Patterns of Carbapenemase-Encoding Bacteria in a New Light: Clues on a Role for Ethnicity.

机构信息

Institute of Medical Microbiology, Immunology and Parasitology, University Hospital Bonn, Bonn, Germany.

ZEW-Leibniz Centre for European Economic Research, Mannheim, Germany.

出版信息

Front Cell Infect Microbiol. 2021 Jun 29;11:659753. doi: 10.3389/fcimb.2021.659753. eCollection 2021.

Abstract

Antibiotic resistance represents a major global concern. The rapid spread of opportunistically pathogenic carbapenemase-encoding bacteria (CEB) requires clinicians, researchers, and policy-makers to swiftly find solutions to reduce transmission rates and the associated health burden. Epidemiological data is key to planning control measures. Our study aims to contribute by providing an analysis of 397 unique CEB isolates detected in a tertiary hospital in Germany. We propose new findings on demographic variables to support preventive sanitary precautions in routine clinical practice. Data on detected CEB was combined with patient's demographic and clinical information for each isolate. Multiple regression techniques were applied to estimate the predictive quality of observed differences. Our findings confirm the role of age and gender in CEB colonization patterns and indicate a role for ethnicity and domicile. Also, carbapenemase-encoding was most frequently introduced to the hospital, while the risk of colonization with VIM-encoding rose with the length of hospital stay. remains an important complication of prolonged hospital stays. The strong link to hospital-wastewater may have implications for hospital-built environments. can be efficiently controlled from spreading at hospital admission. OXA-encoding CEB being harder to detect in routine screening, targeted preventive measures, such as culture media selective for carbapenem-resistant bacteria, would be opportune for patients from selected regions. The CEB differences linked to ethnicity found in our study may further be supporting the tailoring of diagnostic approaches, as well as health policies upon confirmation by other studies and a better understanding of their global distribution.

摘要

抗生素耐药性是一个全球性的主要关注点。机会性致病碳青霉烯酶编码细菌(CEB)的快速传播,要求临床医生、研究人员和政策制定者迅速找到解决方案,以降低传播率和相关的健康负担。流行病学数据是规划控制措施的关键。我们的研究旨在通过分析德国一家三级医院检测到的 397 个独特的 CEB 分离株做出贡献。我们提出了关于人口统计学变量的新发现,以支持常规临床实践中的预防性卫生措施。每个分离株的检测到的 CEB 数据与患者的人口统计学和临床信息相结合。应用多元回归技术来估计观察到的差异的预测质量。我们的研究结果证实了年龄和性别在 CEB 定植模式中的作用,并表明了种族和居住地的作用。此外,碳青霉烯酶编码基因最常被引入医院,而携带 VIM 编码基因的定植风险随着住院时间的延长而增加。产碳青霉烯酶的肠杆菌科细菌仍然是延长住院时间的一个重要并发症。与医院废水的强烈联系可能对医院建筑环境产生影响。在医院入院时,可以有效地控制 OXA 编码 CEB 的传播。由于在常规筛查中难以检测到产 OXA 编码的 CEB,因此对于来自特定地区的患者,有针对性的预防措施,如针对耐碳青霉烯菌的培养基,将是适时的。我们的研究中发现的与种族相关的 CEB 差异可能进一步支持根据其他研究和对其全球分布的更好理解来调整诊断方法和卫生政策。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7e59/8276097/b027ca087364/fcimb-11-659753-g001.jpg

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