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拉丁美洲和加勒比地区产碳青霉烯酶革兰氏阴性菌监测:一项2015年至2020年的回顾性观察研究。

Carbapenemases producing gram-negative bacteria surveillance in Latin America and the caribbean: a retrospective observational study from 2015 to 2020.

作者信息

Pillonetto Marcelo, Wink Priscila Lamb, Melano Roberto G, Jiménez-Pearson María Antonieta, Melgarejo Touchet Nancy Lorena, Saavedra Rojas Sandra Yamile, Kulek Debora N O, Abreu Andre Luiz, Peral Renata Tigulini, Miorando Rogerio, Sati Hatim, Thomas Genara Romero, Galas Marcelo, Pardo Pilar Ramon, Kiffer Carlos R V, D'Alincourt Carvalho Assef Ana Paula

机构信息

Laboratorio Central de Saúde Pública do Paraná, São José dos Pinhais, PR, Brazil.

Pontificia Universidade Católica do Paraná, Curitiba, PR, Brazil.

出版信息

Lancet Reg Health Am. 2025 Jul 15;49:101185. doi: 10.1016/j.lana.2025.101185. eCollection 2025 Sep.

Abstract

BACKGROUND

The rise of multidrug-resistant (MDR) bacteria represents a public health threat, with carbapenem resistance exacerbating this challenge. This study investigates carbapenemase-producing bacteria (CPB) across the Latin America and the Caribbean (LAC) region.

METHODS

A retrospective observational study was conducted across 12 LAC countries from 2015 to 2020. A total of 58,909 isolates were analyzed utilizing polymerase chain reaction (PCR) to detect key carbapenemases in Enterobacterales, , and complex (ABC).

FINDINGS

47,804/58,909 (81.14%) carbapenemases were identified, with Brazil accounting for 73% of these. The majority were reported in carbapenem-resistant Enterobacterales-CRE (65.33%; 31,230/47,804), followed by carbapenem-resistant ABC-CRAB (22.05%; 10,542/47,804), and carbapenem-resistant -CRPA (6050/47,804; 12.66%). Among CRE, was the most detected gene (78.67%; 24,569/31,230), with being the most commonly associated species (75.9%). A relevant upward trend in was observed. CRPA exhibited diverse profiles, with (47.64%) being the most common. In CRAB, was found in 88.80% (9361/10,542) of isolates. Carbapenemase co-production was detected in 2.60% (1190/47,804) of isolates, with CRPA + being the most frequent.

INTERPRETATION

This study highlights a high prevalence of CPB in LAC, with a stable trend in but a rising trend in . These findings underscore the urgent need for strengthened surveillance and public health interventions to combat carbapenemase-mediated resistance in the region.

FUNDING

None.

摘要

背景

多重耐药(MDR)细菌的出现对公共卫生构成威胁,碳青霉烯类耐药性加剧了这一挑战。本研究调查了拉丁美洲和加勒比地区(LAC)产碳青霉烯酶的细菌(CPB)。

方法

2015年至2020年在12个LAC国家进行了一项回顾性观察研究。共分析了58909株分离株,利用聚合酶链反应(PCR)检测肠杆菌科、不动杆菌属和铜绿假单胞菌属中的关键碳青霉烯酶。

结果

共鉴定出47804/58909(81.14%)株产碳青霉烯酶菌株,其中巴西占73%。大多数报告于耐碳青霉烯类肠杆菌科细菌(CRE)(65.33%;31230/47804),其次是耐碳青霉烯类鲍曼不动杆菌(CRAB)(22.05%;10542/47804)和耐碳青霉烯类铜绿假单胞菌(CRPA)(6050/47804;12.66%)。在CRE中,blaKPC是检测到最多的基因(78.67%;24569/31230),肺炎克雷伯菌是最常见的相关菌种(75.9%)。观察到blaNDM呈相关上升趋势。CRPA表现出多种谱型,blaVIM(47.64%)最为常见。在CRAB中,88.80%(9361/10542)的分离株中检测到blaOXA-23。在2.60%(1190/47804)的分离株中检测到碳青霉烯酶的共产生,CRPA中blaVIM+blaNDM最为常见。

解读

本研究强调了LAC地区CPB的高流行率,blaKPC呈稳定趋势,但blaNDM呈上升趋势。这些发现强调了加强监测和公共卫生干预以对抗该地区碳青霉烯酶介导的耐药性的迫切需要。

资金

无。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/54d4/12281157/4e8024a8f7f6/gr1.jpg

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