A systematic review of the epidemiology of carbapenem-resistant Enterobacteriaceae in the United States.

A systematic review of the epidemiology of carbapenem-resistant Enterobacteriaceae in the United States.
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DOI:
10.1186/s13756-018-0346-9
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发表时间:
2018
影响因子:
5.5
通讯作者:
Perencevich EN
Perencevich EN
中科院分区:
医学2区
文献类型:
--
作者:
Livorsi DJ;Chorazy ML;Schweizer ML;Balkenende EC;Blevins AE;Nair R;Samore MH;Nelson RE;Khader K;Perencevich EN

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耐碳青霉烯类肠杆菌科(CRE)在美国构成了紧迫的公共卫生威胁。规划和监测国家应对CRE的一个重要步骤是了解其流行病学和相关结果。我们对研究美国CRE感染的发病率和结局的研究进行了系统的文献综述。我们通过奥维德、CDSR、DARE、CENTRAL、NHS EED、Scopus和Web of Science在MEDLINE中检索了2000年1月1日至2016年2月1日发表的关于美国研究中心CRE发生率和结局的文章。五项研究评估了发病率,但许多研究对病例使用了不同的定义。在整个美国人群中,报告的CRE发生率为0.3-2.93例感染/10万人-年。感染率最高的是长期急性护理(LTAC)医院。没有足够的数据来评估感染率随时间的变化趋势。4项研究评价了结局。在一些但不是所有研究中,CRE患者的死亡率较高。虽然美国CRE感染的发病率在全国范围内仍然较低,但在LTAC中发病率最高。评估CRE感染患者结局的研究数量有限,规模较小,并且得出了相互矛盾的结果。未来的研究应该测量各种临床结果,并充分调整混杂因素,以更好地评估CRE的全部负担。本文的在线版本(10.1186/s13756-018-0346-9)包含补充材料,可供授权用户使用。
Carbapenem-resistant Enterobacteriaceae (CRE) pose an urgent public health threat in the United States. An important step in planning and monitoring a national response to CRE is understanding its epidemiology and associated outcomes. We conducted a systematic literature review of studies that investigated incidence and outcomes of CRE infection in the US. We performed searches in MEDLINE via Ovid, CDSR, DARE, CENTRAL, NHS EED, Scopus, and Web of Science for articles published from 1/1/2000 to 2/1/2016 about the incidence and outcomes of CRE at US sites. Five studies evaluated incidence, but many used differing definitions for cases. Across the entire US population, the reported incidence of CRE was 0.3–2.93 infections per 100,000 person-years. Infection rates were highest in long-term acute-care (LTAC) hospitals. There was insufficient data to assess trends in infection rates over time. Four studies evaluated outcomes. Mortality was higher in CRE patients in some but not all studies. While the incidence of CRE infections in the United States remains low on a national level, the incidence is highest in LTACs. Studies assessing outcomes in CRE-infected patients are limited in number, small in size, and have reached conflicting results. Future research should measure a variety of clinical outcomes and adequately adjust for confounders to better assess the full burden of CRE. The online version of this article (10.1186/s13756-018-0346-9) contains supplementary material, which is available to authorized users.
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