综述：产KPC型碳青霉烯酶的细菌的现实威胁

David

                               
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Volume 9, Issue 4, April 2009, Pages 228-236
Review The real threat of Klebsiella pneumoniae carbapenemase-producing bacteria
产KPC型碳青霉烯酶的细菌的现实威胁

Patrice Nordmann MDa,

                               
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,

                               
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, Gaelle Cuzon PharmDa and Thierry Naas PhDa
aService de Bactériologie-Virologie-Hygiène, INSERM U914 “Emerging Resistance to Antibiotics”, Hôpital de Bicêtre, Assistance Publique/Hôpitaux de Paris, Faculté de Médecine and Université Paris Sud, K -Bicêtre, France


Available online 25 March 2009.


SummaryFrom early this decade, Enterobacteriaceae that produce Klebsiella pneumoniae carbapenemases (KPC) were reported in the USA and subsequently worldwide. These KPC-producing bacteria are predominantly involved in nosocomial and systemic infections; although they are mostly Enterobacteriaceae, they can also be, rarely, Pseudomonas aeruginosa isolates. KPC β lactamases (KPC-1 to KPC-7) confer decreased susceptibility or resistance to virtually all β lactams. Carbapenems (imipenem, meropenem, and ertapenem) may thus become inefficient for treating enterobacterial infections with KPC-producing bacteria, which are, in addition, resistant to many other non-β-lactam molecules, leaving few available therapeutic options. Detection of KPC-producing bacteria may be difficult based on routine antibiotic susceptibility testing. It is therefore crucial to implement efficient infection control measures to limit the spread of these pathogens.

Article OutlineFirst detection, structure, and hydrolysis spectrum Clinical features and epidemiology Molecular genetics Detection Treatment options Conclusions Search strategy and selection criteria Acknowledgements References