Ficik Jozef, Andrezál Michal, Drahovská Hana, Böhmer Miroslav, Szemes Tomáš, Liptáková Adriána, Slobodníková Lívia
Institute of Clinical Microbiology, Central Military Hospital, 034 26 Ružomberok, Slovakia.
Institute of Microbiology, Faculty of Medicine, Comenius University and the University Hospital in Bratislava, 811 08 Bratislava, Slovakia.
Antibiotics (Basel). 2023 Aug 4;12(8):1285. doi: 10.3390/antibiotics12081285.
The COVID-19 era brought about new medical challenges, which, together with nosocomial bacterial infections, resulted in an enormous burden for the healthcare system. One of the most alarming nosocomial threats was carbapenem-resistant (CRKP). Monitoring CRKP incidence and antimicrobial resistance globally and locally is vitally important. In a retrospective study, the incidence of CRKP in the pre-COVID-19 period (2017-2019) and the COVID-19 pandemic (2020-2022) was investigated in the Central Military Hospital in Ružomberok, Slovak Republic. The relative incidence of CRKP significantly increased during the COVID-19 period-by 4.8 times, from 0.18 to 0.76%. At the same time, 47% of CRKP-positive patients also had COVID-19. Twenty-six KPC and sixty-nine NDM-producing isolates were identified. CRKPs isolated in the year 2022 were submitted to whole genome sequencing, and their susceptibility was tested to cefiderocol, ceftazidime-avibactam, imipenem-relebactam and meropenem-vaborbactam, with excellent results. KPC-producing isolates were also highly susceptible to colistin (92%). The NDM isolates revealed lower susceptibility rates, including only 57% colistin susceptibility. ST-307 prevailed in KPC and ST-11 in NDM isolates. Despite the excellent activity of new antimicrobials, rational antibiotic policy must be thoroughly followed, supported by complementary treatments and strict anti-epidemic precautions.
新冠疫情时代带来了新的医学挑战，这些挑战与医院内细菌感染一起，给医疗系统造成了巨大负担。最令人担忧的医院内威胁之一是耐碳青霉烯类肺炎克雷伯菌（CRKP）。在全球和本地监测CRKP的发病率及抗菌药物耐药性至关重要。在一项回顾性研究中，对斯洛伐克共和国鲁佐姆贝罗克中央军事医院在新冠疫情前时期（2017 - 2019年）和新冠疫情期间（2020 - 2022年）CRKP的发病率进行了调查。在新冠疫情期间，CRKP的相对发病率显著增加——增加了4.8倍，从0.18%升至0.76%。同时，47%的CRKP阳性患者也感染了新冠病毒。共鉴定出26株产KPC酶和69株产NDM酶的菌株。对2022年分离出的CRKP进行了全基因组测序，并测试了它们对头孢地尔、头孢他啶 - 阿维巴坦、亚胺培南 - 瑞来巴坦和美罗培南 - 瓦博巴坦的敏感性，结果良好。产KPC酶的菌株对黏菌素也高度敏感（92%）。产NDM酶的菌株显示出较低的敏感性，包括仅57%对黏菌素敏感。KPC菌株中ST - 307占主导，NDM菌株中ST - 11占主导。尽管新型抗菌药物活性良好，但必须严格遵循合理的抗生素政策，并辅以补充治疗和严格的防疫措施。
