Carbapenem-Resistant Klebsiella pneumoniae in Large Public Acute-Care Healthcare System, New York, New York, USA, 2016-2022.
Carbapenem-Resistant Klebsiella pneumoniae in Large Public Acute-Care Healthcare System, New York, New York, USA, 2016-2022.
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DOI：
10.3201/eid2910.230153
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发表时间：
2023-10
影响因子：
11.8
通讯作者：
Quale, John
中科院分区：
文献类型：
--
作者：
Lee, Jennifer;Sunny, Subin;Nazarian, Elizabeth;Fornek, Mary;Abdallah, Marie;Episcopia, Briana;Rowlinson, Marie-Claire;Quale, John
控制碳青霉烯类耐药肠球菌的传播是全球优先事项。利用国家医疗安全网络数据，我们描述了美国纽约纽约大型公共卫生系统中碳青霉烯类耐药肺炎克雷伯菌（CRKP）的流行病学变化。在2016-2020年期间，CRKP病例下降;然而，在2021年至2022年6月期间，出现了显着增加。在509例病例中，262例（51%）被认为是社区发病，包括149例住在家中的患者。在182株经证实或推定（头孢他啶/阿维巴坦敏感）酶的分离株中，143株为丝氨酸碳青霉烯酶;大多数确诊病例为克雷伯菌。肺炎碳青霉烯酶。其余39例为确诊或推定金属β-内酰胺酶;所有确诊病例均为新德里金属β-内酰胺酶。2020年后，具有金属β-内酰胺酶的分离株比例明显增加。大多数金属β-内酰胺酶患者来自长期护理机构。为了控制CRKP在纽约市的传播，需要一个包括监测和隔离的积极和普遍的计划。
Controlling the spread of carbapenem-resistant Enterobacterales is a global priority. Using National Healthcare Safety Network data, we characterized the changing epidemiology of carbapenem-resistant Klebsiella pneumoniae (CRKP) in a large public health system in New York, New York, USA. During 2016–2020, CRKP cases declined; however, during 2021–June 2022, a notable increase occurred. Of 509 cases, 262 (51%) were considered community-onset, including 149 in patients who were living at home. Of 182 isolates with proven or presumptive (ceftazidime/avibactam susceptible) enzymes, 143 were serine carbapenemases; most confirmed cases were K. pneumoniae carbapenemase. The remaining 39 cases were proven or presumptive metallo-β-lactamases; all confirmed cases were New Delhi metallo-β-lactamases. After 2020, a marked increase occurred in the percentage of isolates possessing metallo-β-lactamases. Most patients with metallo-β-lactamases originated from long-term care facilities. An aggressive and universal program involving surveillance and isolation will be needed to control the spread of CRKP in the city of New York.
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