俄亥俄州一家大型教学医院中产生碳青霉烯酶的肠杆菌:与州立监测机构的比较以及对患者特征的回顾性分析

IF 1.8 Q3 INFECTIOUS DISEASES Infection Prevention in Practice Pub Date : 2024-04-27 DOI:10.1016/j.infpip.2024.100366
Amanda Carroll , Rebekah Carman , Tammy Bannerman , Preeti Pancholi
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引用次数: 0

摘要

背景全世界产碳青霉烯酶的耐碳青霉烯类肠杆菌(CP-CRE)越来越多,尤其是在医疗机构。在俄亥俄州,对耐碳青霉烯类肠杆菌(CRE)的监测始于 2018 年,据作者所知,有关这些病例的数据迄今尚未公布。本研究分析了俄亥俄州一家大型教学医院和俄亥俄州卫生部实验室(ODHL)的 CRE 数据。方法 使用 mCIM 检测碳青霉烯酶的产生,使用 rtPCR 检测质粒介导的碳青霉烯酶基因。从俄亥俄州的一家大型教学医院收集了 344 例标准护理分离菌株的数据,包括从病历审查中收集的数据。ODHL 提供了 4,391 例 CRE 分离物的去标识监控数据。研究结果虽然 KPC 是最常见的碳青霉烯酶基因(n=1590),但在研究的分离菌株中还检测到了 NDM(n=98)、VIM(n=10)、IMP(n=39)和 OXA-48 (n=35)。肺炎克雷伯菌和泄殖腔肠杆菌是最常见的 CRE,肺炎克雷伯菌中最常检测到碳青霉烯酶基因。住院治疗和长期护理与 CP-CRE 有关,而且在女性中更为常见。更好地了解 CRE 的流行情况、质粒介导的碳青霉烯酶基因以及受影响的人群对于追踪疾病的传播非常重要。对碳青霉烯类耐药菌的进一步研究和监控可以更好地了解它们在该州的流行情况。
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Carbapenemase producing Enterobacterales at a large teaching hospital in Ohio: comparison to state surveillance and retrospective analysis of patient characteristics

Background

The presence of carbapenemase-producing carbapenem-resistant Enterobacterales (CP-CRE) around the world is increasing, particularly in healthcare settings. Surveillance testing for plasmid-mediated carbapenemase genes is necessary to tracking CP-CRE infections.

Aim

In the state of Ohio, surveillance of carbapenem-resistant Enterobacterales (CRE) began in 2018, and to the authors' knowledge data on these cases has not been published to date. This study analyzed data on CRE from a large teaching hospital in Ohio, and by the Ohio Department of Health Laboratory (ODHL).

Methods

Carbapenemase production was detected using mCIM, and plasmid-mediated carbapenemase genes were detected using rtPCR. Data was collected on 344 standard-of-care isolates from a large teaching hospital in Ohio, including data collected from chart review. Deidentified surveillance data on 4,391 CRE isolates was provided by the ODHL. Statistical analysis was performed using binary logistic regression.

Findings

While KPC was the most common carbapenemase gene (n=1590), NDM (n=98), VIM (n=10), IMP (n=39) and OXA-48 (n=35) were also detected in the isolates studied. Klebsiella pneumoniae and Enterobacter cloacae were the most common CRE, and carbapenemase genes were most commonly detected in K. pneumoniae. Inpatient hospital stays and long-term care were associated with CP-CRE and were more common in women.

Conclusion

Surveillance data shows that CP-CRE are present in Ohio, most commonly in Klebsiella pneumoniae. A better understanding of the prevalence of CRE, plasmid-mediated carbapenemase genes present, and the populations affected are important when tracking the spread of disease. Further study and surveillance of carbapenem-resistant organisms can provide a better understanding of their prevalence in the state.

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来源期刊
Infection Prevention in Practice
Infection Prevention in Practice Medicine-Public Health, Environmental and Occupational Health
CiteScore
4.80
自引率
0.00%
发文量
58
审稿时长
61 days
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