拉丁美洲和加勒比地区碳青霉烯酶产生革兰氏阴性菌的监测：2015年至2020年的回顾性观察研究

IF 7 Q1 HEALTH CARE SCIENCES & SERVICES

Lancet Regional Health-Americas Pub Date : 2025-07-15 DOI:10.1016/j.lana.2025.101185

Marcelo Pillonetto , Priscila Lamb Wink , Roberto G. Melano , María Antonieta Jiménez-Pearson , Nancy Lorena Melgarejo Touchet , Sandra Yamile Saavedra Rojas , Debora N.O. Kulek , Andre Luiz Abreu , Renata Tigulini Peral , Rogerio Miorando , Hatim Sati , Genara Romero Thomas , Marcelo Galas , Pilar Ramon Pardo , Carlos R.V. Kiffer , Ana Paula D'Alincourt Carvalho Assef

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引用次数: 0

摘要

耐多药细菌（MDR）的增加是一种公共卫生威胁，碳青霉烯类耐药性加剧了这一挑战。本研究调查了整个拉丁美洲和加勒比地区（LAC）产碳青霉烯酶细菌（CPB）。方法2015 - 2020年在12个LAC国家进行回顾性观察性研究。采用聚合酶链反应（PCR）对58,909株分离菌株进行了碳青霉烯酶检测，检测了肠杆菌、铜绿假单胞菌和鲍曼不动杆菌复体（ABC）的关键酶。共发现47,804/58,909（81.14%）种碳青霉烯酶，其中巴西占73%。以耐碳青霉烯类肠杆菌- cre (65.33%；31,230/47,804)，其次是碳青霉烯耐药ABC-CRAB (22.05%；耐碳青霉烯P. aeruginosa-CRPA (6050/47,804；12.66%)。在CRE中，blaKPC是检出最多的基因（78.67%）；24,569/31,230)，肺炎克雷伯菌是最常见的相关菌（75.9%）。观察到相关的blaNDM上升趋势。CRPA表现出不同的特征，以blaVIM（47.64%）最为常见。在螃蟹中，88.80%（9361/ 10542）的分离株中检出blaOXA-23。在2.60%（1190/47,804）的分离株中检测到碳青霉烯酶共产，以CRPA blaIMP + blaVIM最常见。本研究强调了CPB在LAC的高患病率，在blaKPC中呈稳定趋势，而在blaNDM中呈上升趋势。这些发现强调迫切需要加强监测和公共卫生干预，以对抗该地区碳青霉烯酶介导的耐药性。

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Carbapenemases producing gram-negative bacteria surveillance in Latin America and the caribbean: a retrospective observational study from 2015 to 2020

Background

The rise of multidrug-resistant (MDR) bacteria represents a public health threat, with carbapenem resistance exacerbating this challenge. This study investigates carbapenemase-producing bacteria (CPB) across the Latin America and the Caribbean (LAC) region.

Methods

A retrospective observational study was conducted across 12 LAC countries from 2015 to 2020. A total of 58,909 isolates were analyzed utilizing polymerase chain reaction (PCR) to detect key carbapenemases in Enterobacterales, Pseudomonas aeruginosa, and Acinetobacter baumannii complex (ABC).

Findings

47,804/58,909 (81.14%) carbapenemases were identified, with Brazil accounting for 73% of these. The majority were reported in carbapenem-resistant Enterobacterales–CRE (65.33%; 31,230/47,804), followed by carbapenem-resistant ABC-CRAB (22.05%; 10,542/47,804), and carbapenem-resistant P. aeruginosa–CRPA (6050/47,804; 12.66%). Among CRE, bla_KPC was the most detected gene (78.67%; 24,569/31,230), with Klebsiella pneumoniae being the most commonly associated species (75.9%). A relevant upward trend in bla_NDM was observed. CRPA exhibited diverse profiles, with bla_VIM (47.64%) being the most common. In CRAB, bla_OXA-23 was found in 88.80% (9361/10,542) of isolates. Carbapenemase co-production was detected in 2.60% (1190/47,804) of isolates, with CRPA bla_IMP + bla_VIM being the most frequent.

Interpretation

This study highlights a high prevalence of CPB in LAC, with a stable trend in bla_KPC but a rising trend in bla_NDM. These findings underscore the urgent need for strengthened surveillance and public health interventions to combat carbapenemase-mediated resistance in the region.

Funding

None.

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来源期刊

Lancet Regional Health-Americas Multiple-

CiteScore

8.00

自引率

0.00%

发文量

期刊介绍： The Lancet Regional Health – Americas, an open-access journal, contributes to The Lancet's global initiative by focusing on health-care quality and access in the Americas. It aims to advance clinical practice and health policy in the region, promoting better health outcomes. The journal publishes high-quality original research advocating change or shedding light on clinical practice and health policy. It welcomes submissions on various regional health topics, including infectious diseases, non-communicable diseases, child and adolescent health, maternal and reproductive health, emergency care, health policy, and health equity.