Berger Fabian K, Schmartz Georges P, Fritz Tobias, Veith Nils, Alhussein Farah, Roth Sophie, Schneitler Sophie, Gilcher Thomas, Gärtner Barbara C, Pirpilashvili Vakhtang, Pohlemann Tim, Keller Andreas, Rehner Jacqueline, Becker Sören L
Institute of Medical Microbiology and Hygiene, Saarland University, Homburg/Saar, Germany.
Chair for Clinical Bioinformatics, Saarland University, Saarbrücken, Germany.
Int J Infect Dis. 2023 Jul;132:89-92. doi: 10.1016/j.ijid.2023.04.394. Epub 2023 Apr 16.
We analyzed consecutive clinical cases of infections due to carbapenemase-producing gram-negative bacteria detected in war-wounded patients from Ukraine who were treated at one university medical center in southwest Germany between June and December 2022. The isolates of multiresistant gram-negative bacteria were subjected to a thorough microbiological characterization and whole genome sequencing (WGS). We identified five war-wounded Ukrainian patients who developed infections with New Delhi metallo-β-lactamase 1-positive Klebsiella pneumoniae. Two isolates also carried OXA-48 carbapenemases. The bacteria were resistant to novel antibiotics, such as ceftazidime/avibactam and cefiderocol. The used treatment strategies included combinations of ceftazidime/avibactam + aztreonam, colistin, or tigecycline. WGS suggested transmission during primary care in Ukraine. We conclude that there is an urgent need for thorough surveillance of multiresistant pathogens in patients from war zones.
我们分析了2022年6月至12月期间在德国西南部一家大学医学中心接受治疗的乌克兰战争伤员中检测到的产碳青霉烯酶革兰氏阴性菌感染的连续临床病例。对多重耐药革兰氏阴性菌分离株进行了全面的微生物学鉴定和全基因组测序（WGS）。我们确定了5名乌克兰战争伤员感染了新德里金属β-内酰胺酶1阳性肺炎克雷伯菌。两个分离株还携带OXA-48碳青霉烯酶。这些细菌对新型抗生素耐药，如头孢他啶/阿维巴坦和头孢地尔。使用的治疗策略包括头孢他啶/阿维巴坦+氨曲南、黏菌素或替加环素的联合使用。WGS提示在乌克兰初级医疗期间发生了传播。我们得出结论，迫切需要对来自战区的患者中的多重耐药病原体进行全面监测。
