The Transmissibility of Antibiotic-Resistant Enterobacteriaceae in Intensive Care Units.
The Transmissibility of Antibiotic-Resistant Enterobacteriaceae in Intensive Care Units.
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DOI：
10.1093/cid/cix825
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发表时间：
2018-02-01
期刊：
影响因子：
--
通讯作者：
Bootsma MCJ
中科院分区：
文献类型：
--
作者：
Gurieva T;Dautzenberg MJD;Gniadkowski M;Derde LPG;Bonten MJM;Bootsma MCJ
在一项在13个欧洲重症监护病房进行的国际研究中，使用协议化监测和微生物分析，非大肠埃希菌肠杆菌科（主要是肺炎克雷伯菌）对广谱头孢菌素耐药的细菌传播能力是大肠埃希菌的3.7倍。杆菌在重症监护病房（ICU）中，由对广谱头孢菌素（ESC）耐药的肠杆菌科引起的感染在全球范围内的出现至少部分是由交叉传播引起的。然而，细菌物种的个体传播能力尚未被量化。在对13个欧洲ICU的多中心研究进行的事后分析中，使用前瞻性监测数据和数学模型来估计大肠埃希菌和非大肠埃希菌的传播能力和单次入院繁殖数（RA）。大肠杆菌肠杆菌科（非EcE），均为ESC耐药。监测是基于耐ESC肠杆菌科的显色选择性培养基，允许鉴定E。大肠杆菌和克雷伯氏菌属、肠杆菌属、沙雷氏菌属和柠檬酸杆菌属，归类为非EcE。在纳入的11420例患者中，非EcE的住院患病率为3.8%（74%为肺炎克雷伯菌），E的住院患病率为3.3%。杆菌非EcE和E的获得率分别为7.4/100和2.6/100。大肠杆菌中表达。估计非EcE的传播能力是E的3.7倍（95%可信区间[CrI]，1.4-11.3）。大肠杆菌的单次繁殖数（RA）为0.17（95%CrI，0.094 - 0.29）和0.047（95%CrI，0.018 - 0.098）。杆菌在ICU，非EcE，主要是K。pneumoniae的传播力是E.杆菌这些细菌的估计RA值低于临界阈值1，表明在这些ICU中，根据当前的感染控制政策，疫情通常较小。
In an international study in 13 European intensive care units using protocolized surveillance and microbiological analysis, the transmission capacity of bacteria resistant to expanded-spectrum cephalosporins was 3.7 times higher for non-Escherichia coli Enterobacteriaceae (mainly Klebsiella pneumoniae) than for E. coli. The global emergence of infections caused by Enterobacteriaceae resistant to expanded-spectrum cephalosporins (ESCs) in intensive care units (ICUs) is, at least partly, driven by cross-transmission. Yet, individual transmission capacities of bacterial species have not been quantified. In this post hoc analysis of a multicenter study in 13 European ICUs, prospective surveillance data and a mathematical model were used to estimate transmission capacities and single-admission reproduction numbers (RA) of Escherichia coli and non–E. coli Enterobacteriaceae (non-EcE), all being ESC resistant. Surveillance was based on a chromogenic selective medium for ESC-resistant Enterobacteriaceae, allowing identification of E. coli and of Klebsiella, Enterobacter, Serratia, and Citrobacter species, grouped as non-EcE. Among 11420 patients included, the admission prevalence was 3.8% for non-EcE (74% being Klebsiella pneumoniae) and 3.3% for E. coli. Acquisition rates were 7.4 and 2.6 per 100 admissions at risk for non-EcE and E. coli, respectively. The estimated transmission capacity of non-EcE was 3.7 (95% credibility interval [CrI], 1.4–11.3) times higher than that of E. coli, yielding single-admission reproduction numbers (RA) of 0.17 (95% CrI, .094–.29) for non-EcE and 0.047 (95% CrI, .018–.098) for E. coli. In ICUs, non-EcE, mainly K. pneumoniae, are 3.7 times more transmissible than E. coli. Estimated RA values of these bacteria were below the critical threshold of 1, suggesting that in these ICUs outbreaks typically remain small with current infection control policies.
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影响因子：
9.4
作者：
Willemse-Erix, Diana;Bakker-Schut, Tom;Maquelin, Kees
通讯作者：
Maquelin, Kees
DOI：
10.1093/cid/cis581
发表时间：
2012-10
期刊：
Clinical infectious diseases : an official publication of the Infectious Diseases Society of America
影响因子：
--
作者：
Hilty M;Betsch BY;Bögli-Stuber K;Heiniger N;Stadler M;Küffer M;Kronenberg A;Rohrer C;Aebi S;Endimiani A;Droz S;Mühlemann K
通讯作者：
Mühlemann K
影响因子：
4.9
作者：
Harris, Anthony D.;Kotetishvili, Mamuka;Johnson, J. Kristie
通讯作者：
Johnson, J. Kristie
影响因子：
4.9
作者：
Baraniak, A.;Izdebski, R.;Gniadkowski, M.
通讯作者：
Gniadkowski, M.
影响因子：
11.8
作者：
Ammerlaan, H. S. M.;Harbarth, S.;Bonten, M. J. M.
通讯作者：
Bonten, M. J. M.