Otu Akaninyene, McCormick Jacquelyn, Henderson Katherine L, Ledda Alice, Meunier Danièle, Patel Bharat, Brown Colin S, Singleton Susie, Mason Emily L, Islam Jasmin, Moore Ginny, Hopkins Katie L, Jeyaratnam Dakshika
Antimicrobial Resistance and Healthcare Associated Infections Division, Epidemic and Emerging Infections (EEI) Directorate, UK Health Security Agency, UK.
National Institute for Health and Care Research (NIHR) Health Protection Research Unit in Healthcare Associate Infections and Antimicrobial Resistance, University of Oxford, Oxford, UK in Partnership with the UK Health Security Agency, UK.
Infect Prev Pract. 2025 Aug 12;7(4):100480. doi: 10.1016/j.infpip.2025.100480. eCollection 2025 Dec.
Carbapenemase-producing organisms (CPOs) are an increasing global public health threat for which there are limited effective and affordable therapeutic options. The rise in the incidence of CPO infections and colonisations recorded across the UK and beyond over the last 20 years necessitates a need to review and update strategies for control. It is important to review other countries' frameworks for CPO control and significant CPO outbreaks as these could inform the design of an efficient public health response. Despite many nations reacting to the rise by upscaling public health surveillance of CPOs (and the introduction of mandatory notification in England), improvements in laboratory detection methods, and the linkage of data across jurisdictions, significant challenges remain. For example, though predominantly acquired via cross-transmission between patients in healthcare, there are reports of human infections putatively acquired from CPOs harboured in the natural environment. Given the role of one-health in AMR, this is an important consideration. In this article, we outline some of the CPO control strategies adopted across different countries to give a sense of the global picture, and expand on why, in addition to controls in healthcare, there is a strong need to consider a One-Health approach. We describe the existing framework for CPO control in England and emphasise the importance of an integrated, multi-disciplinary and cross-sectoral strategy for dealing with the multifaceted problem posed by CPO in England.
产碳青霉烯酶生物体（CPOs）对全球公共卫生构成了日益严重的威胁，针对这一威胁的有效且经济实惠的治疗选择有限。过去20年里，英国及其他地区CPO感染和定植发生率的上升，使得有必要审查和更新控制策略。审查其他国家CPO控制框架以及重大CPO疫情很重要，因为这可为设计有效的公共卫生应对措施提供参考。尽管许多国家通过加强CPO公共卫生监测（以及在英格兰引入强制通报）、改进实验室检测方法和跨辖区数据联动来应对这种上升趋势，但重大挑战依然存在。例如，尽管CPO主要通过医疗保健机构中患者之间的交叉传播获得，但有报告称人类感染可能源自自然环境中携带的CPO。鉴于“同一健康”在抗菌药物耐药性方面的作用，这是一个重要考量因素。在本文中，我们概述了不同国家采取的一些CPO控制策略，以展现全球概况，并详述为何除了医疗保健机构中的控制措施外，还迫切需要考虑“同一健康”方法。我们描述了英格兰现有的CPO控制框架，并强调了采用综合、多学科和跨部门策略来应对英格兰CPO带来的多方面问题的重要性。
