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首页> 外文期刊>Reviews in medical microbiology >An overview of carbapenem-resistant Klebsiella pneumoniae: epidemiology and control measures
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An overview of carbapenem-resistant Klebsiella pneumoniae: epidemiology and control measures

机译：耐碳青霉烯类肺炎克雷伯菌的概述：流行病学和控制措施

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The emergence and dissemination of carbapenem resistance among Enterobacteria-ceae, especially Klebsiella pneumoniae, constitute a serious threat to public health, since carbapenems are the agents of last resort in the treatment of life-threatening infections caused by drug-resistant Enterobacteriaceae. In K. pneumoniae, carbapenem resistance was first reported a decade ago and has subsequently emerged in several countries. One particular group of transmissible plasmid-encoded carbapenemase enzymes, designated K. pneumoniae carbapenemase (KPC), confers carbapenem resistance to K. pneumoniae strains and is rapidly spreading worldwide. !n addition to KPC-producing K. pneumoniae, several different metallo-beta-lactamase-producing strains have been identified. These include New Delhi metallo-beta-lactamase, Verona integron-encoded metallo-beta-lactamase and imipenemase metallo-beta-lactamase. Finally, class D carbapenemases, including oxacillin-type carbapenemases, also occur in K. pneumoniae. Carbapenem-resistant K. pneumoniae (CRKP) can cause several types of healthcare-associated infections, including pneumonia, bloodstream infections, wound or surgical site infections, urinary tract infections and meningitis, and is associated with high mortality rates. Multifactorial intervention, including hand hygiene, contact precautions, patient and staff cohorting, minimizing invasive device use, promoting antimicrobial stewardship, screening, active surveillance testing and chlorhexidine bathing, may be an effective strategy for reducing the nosocomial transmission of CRKP. Moreover, the rapid notification of clinical infection whenever CRKP are identified from clinical specimens allows the timely implementation of control measures.
机译：碳青霉烯类耐药菌在肠杆菌科细菌特别是肺炎克雷伯菌中的出现和传播对公共卫生构成了严重威胁，因为碳青霉烯类药物是治疗由耐药性肠杆菌科引起的威胁生命的感染的最后手段。在肺炎克雷伯菌中，碳青霉烯耐药性在十年前首次报道，随后在几个国家出现。一类特殊的可传播质粒编码的碳青霉烯酶，称为肺炎克雷伯菌碳青霉烯酶（KPC），赋予了碳青霉烯类对肺炎克雷伯菌菌株的抗性，并迅速向全世界传播。除了产生KPC的肺炎克雷伯菌外，还鉴定了几种不同的产生金属β-内酰胺酶的菌株。这些包括新德里金属β-内酰胺酶，维罗纳整合子编码的金属β-内酰胺酶和亚胺培南酶金属β-内酰胺酶。最后，在肺炎克雷伯氏菌中也发生D类碳青霉烯酶，包括奥沙西林型碳青霉烯酶。耐碳青霉烯的肺炎克雷伯氏菌（CRKP）可以引起多种与医疗保健相关的感染，包括肺炎，血流感染，伤口或手术部位感染，尿路感染和脑膜炎，并与高死亡率相关。多因素干预措施，包括手部卫生，接触预防措施，患者和工作人员分组，最大程度地减少有创器械使用，促进抗菌管理，筛查，主动监测测试和洗必泰沐浴，可能是减少医院内CRKP传播的有效策略。此外，只要从临床标本中识别出CRKP，就可以迅速通知临床感染，从而可以及时实施控制措施。

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