• 主题
高级搜索  >
历史搜索 清空历史
首页> 外文期刊>Acute and critical care. >Outbreak of Imipenemase-1-Producing Carbapenem-Resistant iKlebsiella pneumoniae/i in an Intensive Care Unit
【24h】

Outbreak of Imipenemase-1-Producing Carbapenem-Resistant iKlebsiella pneumoniae/i in an Intensive Care Unit

机译：重症监护病房中产生抗亚胺培南酶-1的耐碳青霉烯的肺炎克雷伯菌的暴发

获取原文
           
页面导航
  • 摘要
  • 著录项
  • 相似文献
  • 相关主题

摘要

Background Carbapenem-resistant Enterobacteriaceae (CRE) with acquired metallo β-lactamase (MBL) resistance have been increasingly reported worldwide and associated with significant mortality and morbidity. Here, an outbreak of genetically related strains of Klebsiella pneumoniae producing the imipenemase (IMP)-1 MBL in a medical intensive care unit (MICU) in Korea is reported. Methods Since isolating carbapenem-resistant K. pneumoniae (CRKP) at the MICU of the hospital on August 10, 2011, surveillance cultures for CRE in 31 hospitalized patients were performed from August to September 2011. Carbapenem resistance was determined based on the disk diffusion method outlined in the Clinical and Laboratory Standards Institute guidelines. Polymerase chain reaction (PCR) was performed for genes coding for β-lactamase. Associations among isolates were assessed via pulsed-field gel electrophoresis (PFGE). In addition, a surveillance study of environmental cultures and health-care workers (HCWs) was conducted in the MICU during the same time frame. Results During the study period, non-duplicated CRKP specimens were discovered in four patients in the MICU, suggestive of an outbreak. On August 10, 2011, CRKP was isolated from the sputum of a 79-year-old male patient who was admitted to the MICU. A surveillance study to detect additional CRE carriers by rectal swab revealed an additional three CRKP isolates. PCR and sequencing of the four isolates identified the presence of the IMP-1 gene. In addition, PFGE showed that the four isolated strains were genetically related. CRE was not identified in specimens taken from the hands of HCWs or other environmental sources during surveillance following the outbreak. Transmission of the carbapenemase-producing Enterobacteriaceae strain was controlled by isolation of the patients and strict contact precautions. Conclusions This study shows that rapid and systemic detection of CRE and strict infection controls are important steps in preventing nosocomial transmission.
机译：背景技术在世界范围内，越来越多地报道了具有获得性金属β-内酰胺酶（MBL）耐药性的耐碳青霉烯肠杆菌科（CRE），其死亡率和发病率均很高。在这里，据报道在韩国的医疗重症监护病房（MICU）中爆发了产生亚胺培南酶（IMP）-1 MBL的肺炎克雷伯菌的遗传相关菌株。方法自2011年8月10日在医院MICU分离出耐碳青霉烯肺炎克雷伯菌（CRKP）以来，于2011年8月至2011年9月对31例住院患者进行了CRE监测培养。在临床和实验室标准协会指南中概述。对编码β-内酰胺酶的基因进行聚合酶链反应（PCR）。通过脉冲场凝胶电泳（PFGE）评估分离株之间的关联。此外，同期在MICU进行了环境文化和卫生保健工作者（HCW）的监视研究。结果在研究期间，在MICU的4例患者中发现了无重复的CRKP标本，提示发生了暴发。 2011年8月10日，从一名入院MICU的79岁男性患者的痰中分离出CRKP。一项通过直肠拭子检测其他CRE携带者的监视研究发现了另外三个CRKP分离株。四种分离物的PCR和测序确定了IMP-1基因的存在。另外，PFGE显示这四个分离的菌株是遗传相关的。在暴发后的监测期间，从医护人员或其他环境来源采集的标本中未发现CRE。通过隔离患者和严格的接触预防措施来控制产生碳青霉烯酶的肠杆菌科细菌的传播。结论这项研究表明，快速，系统地检测CRE和严格的感染控制是预防医院传播的重要步骤。

著录项

相似文献

  • 外文文献
  • 中文文献
  • 专利
获取原文

客服邮箱：kefu@zhangqiaokeyan.com

京公网安备：11010802029741号 ICP备案号：京ICP备15016152号-6 六维联合信息科技 (北京) 有限公司©版权所有

  • 客服微信

  • 服务号