PDF(Pubmed)
Abstract：
Worldwide, hospital-acquired infections (HAIs) are continuously rising within healthcare settings, leading to high mortality and morbidity rates. Many hospitals have reported the spread of carbapenemases globally, specifically within the E. coli and K. pneumoniae species. This study was aimed at analyzing the state of hospital-acquired, carbapenem-resistant E. coli and K. pneumoniae in the United Kingdom between 2009 and 2021. Moreover, the study analyzed the most efficacious approaches to patient management for controlling the carbapenem-resistant Enterobacteriaceae (CRE) spread. Initially, 1094 articles were identified as relevant for screening, and among them, 49 papers were eligible for full-text screening, with a total of 14 articles meeting the inclusion criteria. The information was recorded from published articles through PubMed, the Web of Science, Scopus, Science Direct, and the Cochrane library and was used to search for hospital-acquired carbapenem-resistant E. coli and K pneumoniae in the UK between 2009 and 2021, in order to evaluate the spread of CRE in hospitals. The total number of carbapenem-resistant E. coli was 1083 and this was 2053 for carbapenem-resistant K. pneumoniae in more than 63 UK hospitals. KPC was the dominant carbapenemase produced by K. pneumoniae. The results showed that the treatment options considered depended on the type of carbapenemase produced; K. pneumoniae showed more resistance to a treatment options, i.e., Colistin, than the other carbapenemase. The current state of the UK is at minimal risk for a CRE outbreak; however, appropriate treatment and infection control measures are highly required to prevent this CRE spread at the regional and global levels. The present study findings have an important message for physicians, healthcare workers, and policymakers about hospital-acquired carbapenem-resistant E. coli and K. pneumoniae spread and approaches to patient management.
摘要：
全球,医院获得性感染(HAIs)在医疗机构中不断上升，导致高死亡率和发病率。许多医院报告了碳青霉烯酶在全球的传播，特别是在大肠杆菌和肺炎克雷伯菌物种内。本研究旨在分析医院获得性的状况，2009年至2021年英国碳青霉烯类耐药大肠杆菌和肺炎克雷伯菌。此外，该研究分析了控制耐碳青霉烯类肠杆菌(CRE)传播的最有效的患者管理方法.最初，1094篇文章被确定为与筛查相关，其中,49篇论文有资格进行全文筛选，共有14篇文章符合纳入标准。这些信息是通过PubMed从发表的文章中记录的，WebofScience,Scopus,科学直接，和Cochrane文库，并用于在2009年至2021年期间在英国搜索医院获得的碳青霉烯类耐药大肠杆菌和肺炎克雷伯菌，以评估CRE在医院中的传播。在63多家英国医院中，耐碳青霉烯的大肠杆菌总数为1083，耐碳青霉烯的肺炎克雷伯菌总数为2053。KPC是肺炎克雷伯菌产生的主要碳青霉烯酶。结果表明，所考虑的治疗方案取决于产生的碳青霉烯酶的类型；肺炎克雷伯菌对治疗方案表现出更大的抗性，即，粘菌素,比其他的碳青霉烯酶.英国目前的状况是CRE爆发的风险很小；然而，必须采取适当的治疗和感染控制措施，以防止这种CRE在区域和全球范围内传播。目前的研究结果对医生有重要的信息，医护人员,和政策制定者关于医院获得性碳青霉烯类耐药大肠杆菌和肺炎克雷伯菌的传播以及患者管理方法。
