"Stormy waters ahead": global emergence of carbapenemases.
"Stormy waters ahead": global emergence of carbapenemases.
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“暴风雨的水”：全球碳青霉酶出现。
DOI：
10.3389/fmicb.2013.00048
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发表时间：
2013
影响因子：
5.2
通讯作者：
Bonomo RA
中科院分区：
文献类型：
--
作者：
Patel G;Bonomo RA
碳青霉烯类曾被认为是抵御肠杆菌科严重感染的最后一道防线，现在却面临灭绝的威胁。对碳青霉烯类耐药的革兰氏阴性病原体的日益分离迫使从业者依赖于不确定的替代方案。仅在5年前，关于肠杆菌科碳青霉烯类耐药性的报告是零星的，主要限于病例报告、三级护理中心、重症监护病房和暴发环境。肠杆菌科是社区和医疗保健相关感染的常见原因。由β-内酰胺酶或碳青霉烯酶介导的碳青霉烯类耐药性已变得广泛，随着现有或正在开发的可靠抗菌药的缺乏，国际上的重点已转移到早期发现和感染控制上。然而，随着肺炎克雷伯菌碳青霉烯酶、新德里金属β-内酰胺酶-1和最近的OXA-48(苯唑西林酶-48)的报道变得越来越普遍，随着旅行的便利，高耐药性革兰氏阴性病原体感染仅限于病患，严重暴露于抗生素和医疗保健的假设正在迅速消除。在此，我们提供了一份状态报告，描述了临床医生面临的越来越多的挑战，并预测了未来的“暴风雨”。
Carbapenems, once considered the last line of defense against of serious infections with Enterobacteriaceae, are threatened with extinction. The increasing isolation of carbapenem-resistant Gram-negative pathogens is forcing practitioners to rely on uncertain alternatives. As little as 5 years ago, reports of carbapenem resistance in Enterobacteriaceae, common causes of both community and healthcare-associated infections, were sporadic and primarily limited to case reports, tertiary care centers, intensive care units, and outbreak settings. Carbapenem resistance mediated by β-lactamases, or carbapenemases, has become widespread and with the paucity of reliable antimicrobials available or in development, international focus has shifted to early detection and infection control. However, as reports of Klebsiella pneumoniae carbapenemases, New Delhi metallo-β-lactamase-1, and more recently OXA-48 (oxacillinase-48) become more common and with the conveniences of travel, the assumption that infections with highly resistant Gram-negative pathogens are limited to the infirmed and the heavily antibiotic and healthcare exposed are quickly being dispelled. Herein, we provide a status report describing the increasing challenges clinicians are facing and forecast the “stormy waters” ahead.
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影响因子：
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