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拉丁美洲新生儿和儿童的碳青霉烯类耐药感染:文献综述

Carbapenem-Resistant Infections in Neonates and Children in Latin America: A Literature Review.

作者信息

Shanks Gabriella, Grandjean Louis

机构信息

Charité-Universitätsmedizin Berlin, Institute of Tropical Medicine and International Health, Berlin, Germany.

Institute of Child Health, University College London, London, United Kingdom.

出版信息

Am J Trop Med Hyg. 2024 Oct 29;112(1):26-29. doi: 10.4269/ajtmh.24-0422. Print 2025 Jan 8.

Abstract

Carbapenems are broad-spectrum beta-lactam antibiotics that are increasingly being used worldwide to treat multidrug-resistant infections, but since their introduction, carbapenem resistance has emerged. This phenomenon has been well documented in the adult population, but there is a paucity of evidence from the neonatal and pediatric populations. A literature search of carbapenem-resistant infections in Latin American neonates and children was conducted via PubMed/Medline and SCOPUS: 551 titles were screened, and 17 articles were included in the review. The most commonly reported predominant isolate was Klebsiella pneumoniae (11 of 17 studies). Genotypic data were available in 10 of 17 studies, and the KPC gene was the most commonly reported resistance gene. The mortality rate ranged from 13% to 52.6%. Carbapenem-resistant infections are prevalent in children and neonates in Latin America and are associated with high rates of mortality, highlighting the need for enhanced antimicrobial stewardship and surveillance within these populations.

摘要

碳青霉烯类是广谱β-内酰胺类抗生素,在全球范围内越来越多地用于治疗多重耐药感染,但自其问世以来,碳青霉烯耐药性已经出现。这种现象在成人中已有充分记录,但新生儿和儿科人群的相关证据较少。通过PubMed/Medline和SCOPUS对拉丁美洲新生儿和儿童的碳青霉烯耐药感染进行了文献检索:筛选了551篇标题,17篇文章纳入综述。最常报告的主要分离株是肺炎克雷伯菌(17项研究中的11项)。17项研究中的10项有基因型数据,最常报告的耐药基因是KPC基因。死亡率在13%至52.6%之间。碳青霉烯耐药感染在拉丁美洲的儿童和新生儿中很普遍,并且与高死亡率相关,这突出表明在这些人群中需要加强抗菌药物管理和监测。

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