Koumaki Vasiliki, Voudanta Eleni, Michelaki Aikaterini, Orfanidou Maria, Vagiakou Eleni, Vrioni Georgia, Tsakris Athanassios
Department of Microbiology, Medical School, National and Kapodistrian University of Athens, 115 27 Athens, Greece.
Department of Microbiology, General Hospital G. Gennimatas, 115 27 Athens, Greece.
Antibiotics (Basel). 2025 Feb 26;14(3):239. doi: 10.3390/antibiotics14030239.
Carbapenemase-producing Enterobacterales (CPEs) represent a significant global health threat, particularly in the context of nosocomial infections. The current study constitutes a retrospective epidemiological survey that aimed to provide updated data on the prevalence and characteristics of carbapenemases among carbapenem-resistant Enterobacterales (CREs) in a Greek tertiary hospital in Athens during and after the COVID-19 pandemic. : A total of 2021 non-duplicate CPE clinical isolates were detected. A significant increase in the number of carbapenemase-positive Enterobacterales was revealed during the study period ( < 0.05). KPC remained the predominant carbapenemase type through all four years of the survey, representing 40.7%, 39.9%, 53.5%, and 45.7% of the CPE isolates, respectively. However, a rapid transition from VIM to NDM metal-β-lactamase types was revealed, changing the epidemiological image of carbapenemases in the hospital setting. Notably, among the CPEs, antimicrobial resistance rates were significantly raised in the post-COVID-19 period (2022 and 2023) compared to the first study year (2020) for almost all the tested antibiotics, including those characterized as last-resort antibiotics. : CREs were identified and subjected to screening for the five most prevalent carbapenemase genes [ carbapenemase (KPC), Verona integron-borne metallo-β-lactamase (VIM), New Delhi metallo-β-lactamase (NDM), imipenemase (IMP), and oxacillin-hydrolyzing (OXA-48)] using a lateral flow immunoassay, and the CREs recovered from blood cultures were analyzed using a FilmArray system. Their clinical and epidemiological characteristics, as well as their antimicrobial susceptibility profiles, were also subjected to analysis : Given this alarming situation, which is exacerbated by the limited treatment options, the development of new, effective antimicrobial agents is needed. The continued monitoring of the changing epidemiology of carbapenemases is also imperative in order to undertake rational public health interventions.
产碳青霉烯酶肠杆菌目细菌（CPEs）对全球健康构成重大威胁，尤其是在医院感染方面。本研究是一项回顾性流行病学调查，旨在提供雅典一家希腊三级医院在新冠疫情期间及之后耐碳青霉烯类肠杆菌目细菌（CREs）中碳青霉烯酶的流行情况和特征的最新数据。共检测到2021株非重复的CPE临床分离株。研究期间，碳青霉烯酶阳性肠杆菌目细菌的数量显著增加（<0.05）。在调查的四年中，KPC一直是主要的碳青霉烯酶类型，分别占CPE分离株的40.7%、39.9%、53.5%和45.7%。然而，研究发现从VIM型到NDM金属β-内酰胺酶类型迅速转变，改变了医院环境中碳青霉烯酶的流行病学状况。值得注意的是，在CPEs中，与第一个研究年份（2020年）相比，新冠疫情后时期（2022年和2023年）几乎所有测试抗生素（包括那些被视为最后手段的抗生素）的耐药率都显著提高。通过侧流免疫测定法对CREs进行鉴定并筛查五种最常见的碳青霉烯酶基因[碳青霉烯酶（KPC）、维罗纳整合子介导的金属β-内酰胺酶（VIM）、新德里金属β-内酰胺酶（NDM）、亚胺培南酶（IMP）和水解奥沙西林（OXA-48）]，并使用FilmArray系统对从血培养物中分离出的CREs进行分析。还对它们的临床和流行病学特征以及抗菌药物敏感性谱进行了分析。鉴于这种令人担忧的情况，且治疗选择有限使其更加恶化，需要开发新的有效抗菌药物。持续监测碳青霉烯酶不断变化的流行病学情况对于采取合理的公共卫生干预措施也至关重要。
