Section of Infection Disease, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel.
Clinical Microbiology Laboratory, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel.
Expert Rev Anti Infect Ther. 2023 Jul-Dec;21(7):749-758. doi: 10.1080/14787210.2023.2216455. Epub 2023 May 23.
The goal of this review is to provide a plausible explanation for the dissemination of NDM-producing Enterobacterales (NDME) and (NDMAb) across the ME.
We described and analyzed (1) the initial reports of NDME and NDMAb in ME countries; (2) the most contemporary data regarding the epidemiology of NDME and NDMAb in ME countries; and (3) the molecular features of NDME and NDMAb in ME countries.
NDMAb first appeared in the Eastern Mediterranean and the Gulf States in 2009-2010. Although no connection to the Indian subcontinent could be traced, evidence for transmission within the region was found. The spread of NDMAb was mainly by clonal transmission, and it remained limited to less than 10% of the total CRAb population.NDME most likely had evolved from NDMAb and appeared later in the ME. Subsequently, the spread of NDME was mainly via the transmission of the bla gene into several and successful clones that had served before as recipient to various blagenes. The most recent epidemiological situation varied widely, from 20.7% of carbapenem-resistant Enterobacterales (CRE) in Saudi Arabia to 80.5% in Egypt.
本综述旨在为肠杆菌科中产生 NDM 的细菌（NDME）和 NDM 抗体（NDMAb）在中东地区的传播提供一个合理的解释。
我们描述和分析了（1）中东国家中首次报告的 NDME 和 NDMAb；（2）关于中东国家中 NDME 和 NDMAb 流行病学的最新数据；以及（3）中东国家中 NDME 和 NDMAb 的分子特征。
NDMAb 于 2009-2010 年首次出现在东地中海和海湾国家。虽然无法追踪到与印度次大陆的联系，但在该地区发现了传播的证据。NDMAb 的传播主要通过克隆传播，并且仍然局限于不到总 CRAb 人群的 10%。NDME 很可能是从 NDMAb 进化而来，并在中东地区出现得更晚。随后，NDME 的传播主要是通过 bla 基因传播到几个 和 成功的克隆中，这些克隆之前曾作为各种 blagenes 的受体。最近的流行病学情况差异很大，从沙特阿拉伯的 20.7%碳青霉烯类耐药肠杆菌科（CRE）到埃及的 80.5%。
