Clinical epidemiology of the global expansion of Klebsiella pneumoniae carbapenemases

被引：1422

作者：

Munoz-Price, L. Silvia ^{[1
,2
,3
]}

Poirel, Laurent ^{[4
,5
]}

Bonomo, Robert A. ^{[6
,7
,8
]}

Schwaber, Mitchell J. ^{[9
]}

Daikos, George L. ^{[10
]}

Cormican, Martin ^{[11
]}

Cornaglia, Giuseppe ^{[12
]}

Garau, Javier ^{[13
]}

Gniadkowski, Marek ^{[14
]}

Hayden, Mary K. ^{[15
,16
]}

Kumarasamy, Karthikeyan ^{[17
]}

Livermore, David M. ^{[18
,19
]}

Maya, Juan J. ^{[20
]}

Nordmann, Patrice ^{[4
,5
]}

Patel, Jean B. ^{[21
]}

Paterson, David L. ^{[22
]}

Pitout, Johann ^{[23
,24
]}

Villegas, Maria Virginia ^{[20
]}

Wang, Hui ^{[25
]}

Woodford, Neil ^{[19
]}

Quinn, John P. ^{[26
]}

机构：

[1] Univ Miami, Miller Sch Med, Dept Med, Dept Publ Hlth Sci, Miami, FL 33136 USA

[2] Univ Miami, Miller Sch Med, Dept Anesthesiol, Miami, FL 33136 USA

[3] Jackson Mem Hosp, Dept Infect Control, Miami, FL 33136 USA

[4] Hop Bicetre, AP HP, Serv Bacteriol Virol, INSERM Emerging Resistance Antibiot U914,Fac Med, K Bicetre, France

[5] Univ Paris Sud, K Bicetre, France

[6] Louis Stokes Cleveland Dept Vet Affairs, Res Serv, Cleveland, OH USA

[7] Case Western Reserve Univ, Dept Med Pharmacol, Dept Mol Biol, Cleveland, OH 44106 USA

[8] Case Western Reserve Univ, Dept Microbiol, Cleveland, OH 44106 USA

[9] Israel Minist Hlth, Natl Ctr Infect Control, Tel Aviv, Israel

[10] Univ Athens, Sch Med, Dept Propaedeut Med, GR-11527 Athens, Greece

[11] Natl Univ Ireland Galway, Sch Med, Antimicrobial Resistance & Microbial Ecol ARME Gr, Galway, Ireland

[12] Univ Verona, Dept Pathol & Diagnost, I-37100 Verona, Italy

[13] Univ Barcelona, Infect Dis Unit, Hosp Univ Mutua Terrassa, Barcelona, Spain

[14] Natl Med Inst, Dept Mol Microbiol, Warsaw, Poland

[15] Rush Univ, Med Ctr, Dept Med, Chicago, IL 60612 USA

[16] Rush Univ, Med Ctr, Dept Pathol, Chicago, IL 60612 USA

[17] Univ Madras, Dept Microbiol, Dr ALM PG IBMS, Madras, Tamil Nadu, India

[18] Univ E Anglia, Norwich Med Sch, Norwich NR4 7TJ, Norfolk, England

[19] Publ Hlth England, Antimicrobial Resistance & Healthcare Assoc Infec, London, England

[20] Int Ctr Med Res andTraining CIDEIM, Cali, Colombia

[21] Ctr Dis Control & Prevent, Atlanta, GA USA

[22] Univ Queensland, Clin Res Ctr, Royal Brisbane & Womens Hosp, Herston, Qld, Australia

[23] Calgary Lab Serv, Div Microbiol, Calgary, AB, Canada

[24] Univ Calgary, Dept Pathol & Lab Med, Calgary, AB, Canada

[25] Peking Univ Peoples Hosp, Dept Clin Lab, Beijing, Peoples R China

[26] AstraZeneca, Waltham, MA USA

来源：

LANCET INFECTIOUS DISEASES | 2013年 / 13卷 / 09期

关键词：

HYDROLYZING BETA-LACTAMASE; KPC-PRODUCING ENTEROBACTERIACEAE; GRAM-NEGATIVE BACILLI; ESCHERICHIA-COLI; PSEUDOMONAS-AERUGINOSA; K.-PNEUMONIAE; RESISTANT ENTEROBACTERIACEAE; MOLECULAR CHARACTERIZATION; CITROBACTER-FREUNDII; 1ST IDENTIFICATION;

D O I：

10.1016/S1473-3099(13)70190-7

中图分类号：

R51 [传染病];

学科分类号：

100401 ;

摘要：

Klebsiella pneumoniae carbapenemases (KPCs) were originally identified in the USA in 1996. Since then, these versatile beta-lactamases have spread internationally among Gram-negative bacteria, especially K pneumoniae, although their precise epidemiology is diverse across countries and regions. The mortality described among patients infected with organisms positive for KPC is high, perhaps as a result of the limited antibiotic options remaining (often colistin, tigecycline, or aminoglycosides). Triple drug combinations using colistin, tigecycline, and imipenem have recently been associated with improved survival among patients with bacteraemia. In this Review, we summarise the epidemiology of KPCs across continents, and discuss issues around detection, present antibiotic options and those in development, treatment outcome and mortality, and infection control. In view of the limitations of present treatments and the paucity of new drugs in the pipeline, infection control must be our primary defence for now.

引用

页码：785 / 796

页数：12

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