Background: Nowadays, emergence of Carbapenemase-Producing Enterobacterales (CPE) throughout the world has become a public health problem, especially in countries with limited resources. In recent years, CPE of type O...Background: Nowadays, emergence of Carbapenemase-Producing Enterobacterales (CPE) throughout the world has become a public health problem, especially in countries with limited resources. In recent years, CPE of type OXA-48 (Ambler class D) have been identified in Dakar. The aim of this study was to evaluate the phenotypic detection of OXA-48 CPE using a temocillin disc (30 μg). Methodology: A retrospective study was carried out at Medical Biology Laboratory of Pasteur Institute in Dakar on Ertapenem-Resistant Enterobacterales (ERE) strains isolated from 2015 to 2017. These strains were then tested with a 30 μg temocillin disc. Any strain resistant to temocillin (inhibition diameter Results: Forty-one ERE isolated during the study period were tested, of which 34 (82.9%) were OXA-48 based on phenotypic detection using temocillin disc and confirmed by PCR (100%). OXA-48 CPE strains detected were composed of Klebsiella pneumoniae (n = 14;41.2%), Enterobacter cloacae (n = 8;23.5%), Escherichia coli (n = 7, 20.5%), Citrobacter freundii (n = 3;8.8%), Cronobacter sakazakii (n = 1;3%) and Morganella morganii (n = 1;3%). Conclusion: Temocillin resistance has a good positive predictive value for detecting OXA-48 CPE by phenotypic method, confirmed by PCR. Temocillin is therefore a good marker for detection of OXA-48 CPE except Hafnia alvei.展开更多
目的系统评价成人肠道耐碳青霉烯类肠杆菌目细菌(CRE)定植病例医院感染发病率,为CRE医院感染的预防和控制提供参考依据。方法计算机检索Embase、Cochrane、PubMed、Web of Science、CNKI、万方、维普、中国生物医学文献数据库(CBM)8个...目的系统评价成人肠道耐碳青霉烯类肠杆菌目细菌(CRE)定植病例医院感染发病率,为CRE医院感染的预防和控制提供参考依据。方法计算机检索Embase、Cochrane、PubMed、Web of Science、CNKI、万方、维普、中国生物医学文献数据库(CBM)8个数据库自建库至2023年6月CRE肠道定植病例医院感染发病率的相关文献,应用Stata 17.0软件进行Meta分析,采用敏感性分析评价研究结果的稳定性,采用Egger’s检验评价发表偏倚。结果共纳入16篇文献,其中英文11篇,中文5篇,总样本量2151例患者。Meta分析结果显示,成人肠道CRE定植病例医院感染发病率为23.1%(95%CI:14.8%~32.5%)。以不同研究设计类型、发表年份,以及研究调查的地域、科室和感染部位分组因素进行亚组分析,亚组间的合并效应量比较,差异均无统计学意义(均P>0.05)。在CRE定植发展为医院感染中,耐碳青霉烯类肺炎克雷伯菌(CRKP)占比96.0%(95%CI:86.8%~100%),定植病例中血流感染发病率为18.2%(95%CI:10.3%~27.6%)。CRE定植病例30天病死率为32.6%(95%CI:20.5%~45.9%),CRE感染病例30天病死率为36.9%(95%CI:16.0%~60.2%)。结论近年来CRE定植病例医院感染发病率较高,需对高危科室进行主动筛查和重点干预,以降低CRE定植病例医院感染发病率。展开更多
文摘Background: Nowadays, emergence of Carbapenemase-Producing Enterobacterales (CPE) throughout the world has become a public health problem, especially in countries with limited resources. In recent years, CPE of type OXA-48 (Ambler class D) have been identified in Dakar. The aim of this study was to evaluate the phenotypic detection of OXA-48 CPE using a temocillin disc (30 μg). Methodology: A retrospective study was carried out at Medical Biology Laboratory of Pasteur Institute in Dakar on Ertapenem-Resistant Enterobacterales (ERE) strains isolated from 2015 to 2017. These strains were then tested with a 30 μg temocillin disc. Any strain resistant to temocillin (inhibition diameter Results: Forty-one ERE isolated during the study period were tested, of which 34 (82.9%) were OXA-48 based on phenotypic detection using temocillin disc and confirmed by PCR (100%). OXA-48 CPE strains detected were composed of Klebsiella pneumoniae (n = 14;41.2%), Enterobacter cloacae (n = 8;23.5%), Escherichia coli (n = 7, 20.5%), Citrobacter freundii (n = 3;8.8%), Cronobacter sakazakii (n = 1;3%) and Morganella morganii (n = 1;3%). Conclusion: Temocillin resistance has a good positive predictive value for detecting OXA-48 CPE by phenotypic method, confirmed by PCR. Temocillin is therefore a good marker for detection of OXA-48 CPE except Hafnia alvei.
文摘目的系统评价成人肠道耐碳青霉烯类肠杆菌目细菌(CRE)定植病例医院感染发病率,为CRE医院感染的预防和控制提供参考依据。方法计算机检索Embase、Cochrane、PubMed、Web of Science、CNKI、万方、维普、中国生物医学文献数据库(CBM)8个数据库自建库至2023年6月CRE肠道定植病例医院感染发病率的相关文献,应用Stata 17.0软件进行Meta分析,采用敏感性分析评价研究结果的稳定性,采用Egger’s检验评价发表偏倚。结果共纳入16篇文献,其中英文11篇,中文5篇,总样本量2151例患者。Meta分析结果显示,成人肠道CRE定植病例医院感染发病率为23.1%(95%CI:14.8%~32.5%)。以不同研究设计类型、发表年份,以及研究调查的地域、科室和感染部位分组因素进行亚组分析,亚组间的合并效应量比较,差异均无统计学意义(均P>0.05)。在CRE定植发展为医院感染中,耐碳青霉烯类肺炎克雷伯菌(CRKP)占比96.0%(95%CI:86.8%~100%),定植病例中血流感染发病率为18.2%(95%CI:10.3%~27.6%)。CRE定植病例30天病死率为32.6%(95%CI:20.5%~45.9%),CRE感染病例30天病死率为36.9%(95%CI:16.0%~60.2%)。结论近年来CRE定植病例医院感染发病率较高,需对高危科室进行主动筛查和重点干预,以降低CRE定植病例医院感染发病率。
