CID 2011: 多重耐药细菌的跨国传播

细菌耐药

Clin Infect Dis. 2011 Jul 1;53(1):49-56.

Country-to-country transfer of patients and the risk of multi-resistant bacterial infection.

Rogers BA, Aminzadeh Z, Hayashi Y, Paterson DL.
SourceUniversity of Queensland Centre for Clinical Research, The University of Queensland, Herston, Brisbane, Australia. benrogers@uq.edu.au

Abstract
Management of patients with a history of healthcare contact in multiple countries is now a reality for many clinicians. Leisure tourism, the burgeoning industry of medical tourism, military conflict, natural disasters, and changing patterns of human migration may all contribute to this emerging epidemiological trend. Such individuals may be both vectors and victims of healthcare-associated infection with multiresistant bacteria. Current literature describes intercountry transfer of multiresistant Acinetobacter spp and Klebsiella pneumoniae (including Klebsiella pneumoniae carbapenemase- and New Delhi metallo-β-lactamase-producing strains), methicillin-resistant Staphylococcus aureus, vancomycin-resistant enterococci, and hypervirulent Clostridium difficile. Introduction of such organisms to new locations has led to their dissemination within hospitals. Healthcare institutions should have sound infection prevention strategies to mitigate the risk of dissemination of multiresistant organisms from patients who have been admitted to hospitals in other countries. Clinicians may also need to individualize empiric prescribing patterns to reflect the risk of multiresistant organisms in these patients.