Artiles-León Cristina María, Rodríguez-Restrepo Sarita, Torres-Jiménez Ivonne Andrea, de Las Delicias Quintana-Estellés María, Viedma-Moreno Esther, Arrazola-Martínez Pilar, Jaén-Herreros Felisa, Sanz-Gallardo Inmaculada, Suárez-García Esther, Craviotto-Vallejo Ana, de Miguel-García Sara
Hospital Universitario 12 de Octubre, Madrid, España.
Rev Esp Quimioter. 2025 Jun 4;38(4):287-293. doi: 10.37201/req/015.2025.
Carbapenemase-producing Enterobacteriaceae (CPE) of the New Delhi metallo-β-lactamase (NDM) type are a growing public health concern due to their rapid dissemination, widespread antimicrobial resistance and associated increase in morbidity and mortality. The aim of this study was to describe the epidemiological characteristics of patients with NDM-type CPE (NDM-CPE) isolates.
A descriptive study of patients with at least one CPE-NDM isolate between December 1, 2022, and December 31, 2023. Demographic and clinical evolution data were collected from electronic medical records.
NDM-CPE were identified in 77 patients, 87% of whom were adults and 75.3% were male. Thirty-two-point five percent were immunosuppressed. A total of 84.4% required hospital admission (60% in ICU) and 66.2% underwent surgery. The median time between admission and the first microbiological isolation of NDM-CPE was 18 days (RIC: 4-32 days). The most frequent microorganism was (92.2%), followed by (4.2%), and (4.2%). A total of 58.4% carried genes coding for NDM and OXA-48 carbapenemases, 40.3% for only NDM, and 1.3% for NDM and VIM. A total of 45.5% were patients with positive colonization samples for NDM-CPE, of whom 31.4% developed infection. Overall mortality at study end was 24.7 %.
Early identification of carriers, strengthening epidemiological and molecular surveillance, and prompt implementation of control measures are essential to interrupt transmission chains and protect the most vulnerable patients.
新德里金属β-内酰胺酶（NDM）型产碳青霉烯酶肠杆菌科细菌（CPE）因其迅速传播、广泛的抗菌药物耐药性以及相关的发病率和死亡率增加，日益引起公共卫生关注。本研究的目的是描述NDM型CPE（NDM-CPE）分离株患者的流行病学特征。
对2022年12月1日至2023年12月31日期间至少有一株CPE-NDM分离株的患者进行描述性研究。从电子病历中收集人口统计学和临床演变数据。
在77例患者中鉴定出NDM-CPE，其中87%为成年人，75.3%为男性。32.5%的患者免疫功能低下。共有84.4%的患者需要住院治疗（60%入住重症监护病房），66.2%的患者接受了手术。入院至首次微生物学分离出NDM-CPE的中位时间为18天（四分位间距：4-32天）。最常见的微生物是 （92.2%），其次是 （4.2%）和 （4.2%）。共有58.4%的患者携带编码NDM和OXA-48碳青霉烯酶的基因，40.3%的患者仅携带NDM基因，1.3%的患者携带NDM和VIM基因。共有45.5%的患者NDM-CPE定植样本呈阳性，其中31.4%发生了感染。研究结束时的总体死亡率为24.7%。
早期识别携带者、加强流行病学和分子监测以及迅速实施控制措施对于中断传播链和保护最脆弱的患者至关重要。
