Carriage of multidrug-resistant carbapenemase-producing gram-negative bacteria in patients admitted to NHS Greater Glasgow and Clyde hospitals: Implications for treatment.

IF 16.4 1区化学 Q1 CHEMISTRY, MULTIDISCIPLINARY

Accounts of Chemical Research Pub Date : 2023-12-01 Epub Date: 2023-10-17 DOI:10.1177/14782715231205919

Megan Espie, Aleksandra Marek, Leonard Farrugia, Mairi MacLeod, Abhijit M Bal

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引用次数: 0

Abstract

Background: Infections caused by gram-negative carbapenemase-producing organisms (CPO) have become a global phenomenon. Screening of patients for CPO that was carried out at 48-h intervals enables early detection of carriers for infection control purposes and planning therapy.

Methods: We investigated the bacterial flora detected on screening, the enzymes that conferred resistance and the proportion of patients who developed bacteraemia with CPO and their therapy.

Results: In all, 27 patients had a positive screen for CPO. A small but significant (7.5%) proportion of patients were not detected on initial screening. Escherichia coli and Klebsiella were predominant. New-Delhi metallo β-lactamase and oxacillin carbapenemases were the main enzymatic mechanisms of resistance. Four (14.8%) patients developed bacteraemia with CPO (30- and 90-day survival 100% and 75%, respectively).

Conclusion: A single negative screen does not rule out colonisation. A significant proportion of patients colonised with CPO develop bacteraemia. Vigilance is needed to prevent the nosocomial spread of CPO.

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NHS大格拉斯哥和克莱德医院患者携带耐多药碳青霉烯酶产生的革兰氏阴性菌：对治疗的影响。

背景：革兰氏阴性碳青霉烯酶产生菌（CPO）引起的感染已成为一种全球性现象。每隔48小时对患者进行CPO筛查，可以早期发现携带者，用于感染控制和计划治疗。方法：我们调查了筛选中检测到的菌群、产生耐药性的酶、CPO患者发生菌血症的比例及其治疗。结果：共有27例患者CPO筛查呈阳性。一小部分（7.5%）患者在初次筛查中未被发现。以大肠杆菌和克雷伯菌为主。新德里金属β-内酰胺酶和苯唑西林碳青霉烯酶是耐药的主要酶机制。四名（14.8%）患者因CPO出现菌血症（30天和90天生存率分别为100%和75%）。讨论：单次阴性筛查并不排除定植。CPO定植的患者中有相当一部分出现菌血症。需要保持警惕，以防止CPO在医院内传播。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Accounts of Chemical Research 化学-化学综合

CiteScore

31.40

自引率

1.10%

发文量

312

审稿时长

2 months

期刊介绍： Accounts of Chemical Research presents short, concise and critical articles offering easy-to-read overviews of basic research and applications in all areas of chemistry and biochemistry. These short reviews focus on research from the author’s own laboratory and are designed to teach the reader about a research project. In addition, Accounts of Chemical Research publishes commentaries that give an informed opinion on a current research problem. Special Issues online are devoted to a single topic of unusual activity and significance. Accounts of Chemical Research replaces the traditional article abstract with an article "Conspectus." These entries synopsize the research affording the reader a closer look at the content and significance of an article. Through this provision of a more detailed description of the article contents, the Conspectus enhances the article's discoverability by search engines and the exposure for the research.