| Autor: |
Bonomo RA; Medical Service, Louis Stokes Cleveland Department of Veterans Affairs Medical Center, Cleveland, Ohio.; Departments of Medicine, Pharmacology, Molecular Biology, and Microbiology, Case Western Reserve University and Research Service, CWRU-VA Center for Antimicrobial Resistance and Epidemiology (CARES), Cleveland, Ohio., Burd EM; Department of Pathology and Laboratory Medicine, Atlanta, Georgia.; Department of Medicine, Division of Infectious Diseases, Emory University School of Medicine, Atlanta, Georgia., Conly J; Departments of Medicine, Pathology and Laboratory Medicine, Microbiology, Calgary, Alberta, Canada.; Immunology and Infectious Diseases, Synder Institute for Chronic Diseases, Cumming School of Medicine, University of Calgary, and Alberta Health Services, Calgary, Alberta, Canada., Limbago BM; Division of Healthcare Quality Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia., Poirel L; Medical and Molecular Microbiology Unit, Department of Medicine, Faculty of Science, University of Fribourg, Switzerland., Segre JA; Microbial Genomics Section, Translational and Functional Genomics Branch, National Human Genome Research Institute, Bethesda, Maryland., Westblade LF; Department of Pathology and Laboratory Medicine, New York, New York.; Department of Medicine, Division of Infectious Diseases, Weill Cornell Medicine, New York, New York. |
| Abstrakt: |
The dramatic increase in the prevalence and clinical impact of infections caused by bacteria producing carbapenemases is a global health concern. Carbapenemase production is especially problematic when encountered in members of the family Enterobacteriaceae. Due to their ability to readily spread and colonize patients in healthcare environments, preventing the transmission of these organisms is a major public health initiative and coordinated international effort are needed. Central to the treatment and control of carbapenemase-producing organisms (CPOs) are phenotypic (growth-/biochemical-dependent) and nucleic acid-based carbapenemase detection tests that identify carbapenemase activity directly or their associated molecular determinants. Importantly, bacterial isolates harboring carbapenemases are often resistant to multiple antibiotic classes, resulting in limited therapy options. Emerging agents, novel antibiotic combinations and treatment regimens offer promise for management of these infections. This review highlights our current understanding of CPOs with emphasis on their epidemiology, detection, treatment, and control. |
