与OXA-48类卡巴酶一起迅速扩散的肠杆菌
Gisele Peirano1,2, Johann D D Pitout1,2,3,4
1Division of Microbiology, Alberta Precision Laboratories, Calgary, Alberta, Canada.
Journal of clinical microbiology
|January 6, 2025
概括
肠道细菌中的OXA-48类卡巴酶,特别是Klebsiella pneumoniae和大肠杆菌,是一个日益增长的全球威胁. 这些耐卡巴胺的细菌通过质粒和克隆传播,使治疗和诊断复杂化.
科学领域:
- 微生物学 微生物学
- 传染性疾病 传染性疾病
- 抗微生物耐药性 抗微生物耐药性
背景情况:
- 与OXA-48类似的卡巴胺酶对卡巴胺疗法的有效性构成重大威胁.
- 这些碳烯酶在肠道细菌中普遍存在,特别是Klebsiella pneumoniae和Escherichia coli,在中东,北非和欧洲部分地区.
- 像OXA-48,OXA-181,OXA-232和OXA-244这样的特定变种显示出明显的地理特有性和日益增长的流行率.
研究的目的:
- 为了突出OXA-48类carbapenemases在Enterobacterales的全球传播和影响.
- 解释导致这些抗性基因占主导地位的机制.
- 为了强调实验室诊断的挑战和这些耐药细菌的无声传播.
主要方法:
- 关于OXA-48类卡巴胺酶的流行率和地理分布的流行病学数据的审查.
- 对遗传机制的分析,包括通过等离子体进行水平基因转移和通过细菌克隆进行垂直传播.
- 讨论与某些OXA变体相关的诊断复杂性.
主要成果:
- 类似OXA-48的碳烯酶是中东和北非以及一些欧洲国家的肠道细菌中最常见的碳烯酶.
- 携带这些基因的Klebsiella pneumoniae和Escherichia coli的特定克隆正在全球传播.
- 像OXA-244和OXA-484这样难以检测的变种有助于报告不足和无声传播.
结论:
- 在Klebsiella pneumoniae和大肠杆菌中的OXA-48类卡巴酶构成了显著且不断升级的全球健康挑战.
- 通过等离子体介导的水平传播和克隆垂直传播的结合促进了这些耐药基因的广泛传播.
- 实验室检测的复杂性需要加强监控,以制在医院和社区环境中无声传播.
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