{"title":"耐碳青霉烯的Providencia spp：门口的威胁。","authors":"Onur Ozalp, Baran Ortakci, Selda Komec, Ozlem, Eda, Ozlem Altuntas Aydin","doi":"10.1016/j.jhin.2025.06.007","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>Providencia species are emerging opportunistic pathogens associated with nosocomial infections, particularly in immunocompromised patients and those with prolonged hospital stays. The increasing prevalence of carbapenem-resistant Providencia spp. poses a significant therapeutic challenge due to limited treatment options.</p><p><strong>Objectives: </strong>This study aimed to evaluate the clinical characteristics, risk factors, and outcomes of patients with carbapenem-resistant and carbapenem-sensitive Providencia infections.</p><p><strong>Methods: </strong>A retrospective, observational study was conducted, including hospitalised patients with Providencia spp. isolates between 1 January 2020 and 1 January 2024. Patients were stratified based on carbapenem susceptibility. Clinical data, risk factors, and mortality rates were compared between carbapenem-resistant and carbapenem-sensitive cases. Statistical analyses were performed to identify independent risk factors for carbapenem resistance.</p><p><strong>Results: </strong>Among 118 Providencia-associated infections, 53 (44.9%) were carbapenem-resistant. Providencia rettgeri was the predominant species (67.8%), with a significantly higher carbapenem resistance rate than P. stuartii (p=0.003). Carbapenem-resistant infections were most commonly urinary tract infections (58.5%), while carbapenem-sensitive infections were more frequently associated with skin and soft tissue infections (40.0%) (p<0.001). Carbapenem-resistant cases exhibited longer hospital stays, increased ICU admissions, and higher mortality rates (p<0.05). Risk factors for carbapenem resistance included prior ICU admission, mechanical ventilation, urinary catheterisation, and prior carbapenem use.</p><p><strong>Conclusion: </strong>Carbapenem-resistant Providencia infections are associated with increased morbidity and mortality. Given the limited therapeutic options, infection control measures and antimicrobial stewardship programmes should be strengthened. Further large-scale studies are needed to characterise resistance mechanisms and optimal treatment strategies.</p>","PeriodicalId":54806,"journal":{"name":"Journal of Hospital Infection","volume":" ","pages":""},"PeriodicalIF":3.9000,"publicationDate":"2025-06-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Carbapenem-Resistant Providencia spp.: The Threat at the Door.\",\"authors\":\"Onur Ozalp, Baran Ortakci, Selda Komec, Ozlem, Eda, Ozlem Altuntas Aydin\",\"doi\":\"10.1016/j.jhin.2025.06.007\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background: </strong>Providencia species are emerging opportunistic pathogens associated with nosocomial infections, particularly in immunocompromised patients and those with prolonged hospital stays. The increasing prevalence of carbapenem-resistant Providencia spp. poses a significant therapeutic challenge due to limited treatment options.</p><p><strong>Objectives: </strong>This study aimed to evaluate the clinical characteristics, risk factors, and outcomes of patients with carbapenem-resistant and carbapenem-sensitive Providencia infections.</p><p><strong>Methods: </strong>A retrospective, observational study was conducted, including hospitalised patients with Providencia spp. isolates between 1 January 2020 and 1 January 2024. Patients were stratified based on carbapenem susceptibility. Clinical data, risk factors, and mortality rates were compared between carbapenem-resistant and carbapenem-sensitive cases. Statistical analyses were performed to identify independent risk factors for carbapenem resistance.</p><p><strong>Results: </strong>Among 118 Providencia-associated infections, 53 (44.9%) were carbapenem-resistant. Providencia rettgeri was the predominant species (67.8%), with a significantly higher carbapenem resistance rate than P. stuartii (p=0.003). Carbapenem-resistant infections were most commonly urinary tract infections (58.5%), while carbapenem-sensitive infections were more frequently associated with skin and soft tissue infections (40.0%) (p<0.001). Carbapenem-resistant cases exhibited longer hospital stays, increased ICU admissions, and higher mortality rates (p<0.05). Risk factors for carbapenem resistance included prior ICU admission, mechanical ventilation, urinary catheterisation, and prior carbapenem use.</p><p><strong>Conclusion: </strong>Carbapenem-resistant Providencia infections are associated with increased morbidity and mortality. Given the limited therapeutic options, infection control measures and antimicrobial stewardship programmes should be strengthened. Further large-scale studies are needed to characterise resistance mechanisms and optimal treatment strategies.</p>\",\"PeriodicalId\":54806,\"journal\":{\"name\":\"Journal of Hospital Infection\",\"volume\":\" \",\"pages\":\"\"},\"PeriodicalIF\":3.9000,\"publicationDate\":\"2025-06-24\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Journal of Hospital Infection\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1016/j.jhin.2025.06.007\",\"RegionNum\":3,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q1\",\"JCRName\":\"INFECTIOUS DISEASES\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Journal of Hospital Infection","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1016/j.jhin.2025.06.007","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"INFECTIOUS DISEASES","Score":null,"Total":0}
Carbapenem-Resistant Providencia spp.: The Threat at the Door.
Background: Providencia species are emerging opportunistic pathogens associated with nosocomial infections, particularly in immunocompromised patients and those with prolonged hospital stays. The increasing prevalence of carbapenem-resistant Providencia spp. poses a significant therapeutic challenge due to limited treatment options.
Objectives: This study aimed to evaluate the clinical characteristics, risk factors, and outcomes of patients with carbapenem-resistant and carbapenem-sensitive Providencia infections.
Methods: A retrospective, observational study was conducted, including hospitalised patients with Providencia spp. isolates between 1 January 2020 and 1 January 2024. Patients were stratified based on carbapenem susceptibility. Clinical data, risk factors, and mortality rates were compared between carbapenem-resistant and carbapenem-sensitive cases. Statistical analyses were performed to identify independent risk factors for carbapenem resistance.
Results: Among 118 Providencia-associated infections, 53 (44.9%) were carbapenem-resistant. Providencia rettgeri was the predominant species (67.8%), with a significantly higher carbapenem resistance rate than P. stuartii (p=0.003). Carbapenem-resistant infections were most commonly urinary tract infections (58.5%), while carbapenem-sensitive infections were more frequently associated with skin and soft tissue infections (40.0%) (p<0.001). Carbapenem-resistant cases exhibited longer hospital stays, increased ICU admissions, and higher mortality rates (p<0.05). Risk factors for carbapenem resistance included prior ICU admission, mechanical ventilation, urinary catheterisation, and prior carbapenem use.
Conclusion: Carbapenem-resistant Providencia infections are associated with increased morbidity and mortality. Given the limited therapeutic options, infection control measures and antimicrobial stewardship programmes should be strengthened. Further large-scale studies are needed to characterise resistance mechanisms and optimal treatment strategies.
期刊介绍：
The Journal of Hospital Infection is the editorially independent scientific publication of the Healthcare Infection Society. The aim of the Journal is to publish high quality research and information relating to infection prevention and control that is relevant to an international audience.
The Journal welcomes submissions that relate to all aspects of infection prevention and control in healthcare settings. This includes submissions that:
provide new insight into the epidemiology, surveillance, or prevention and control of healthcare-associated infections and antimicrobial resistance in healthcare settings;
provide new insight into cleaning, disinfection and decontamination;
provide new insight into the design of healthcare premises;
describe novel aspects of outbreaks of infection;
throw light on techniques for effective antimicrobial stewardship;
describe novel techniques (laboratory-based or point of care) for the detection of infection or antimicrobial resistance in the healthcare setting, particularly if these can be used to facilitate infection prevention and control;
improve understanding of the motivations of safe healthcare behaviour, or describe techniques for achieving behavioural and cultural change;
improve understanding of the use of IT systems in infection surveillance and prevention and control.
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