Carbapenem-resistant enterobacteriaceae infections: Taiwan aspects

Shio Shin Jean, Nan-Yao Lee, Hung Jen Tang, Min Chi Lu, Wen-Chien Ko, Po Ren Hsueh

研究成果: Review article

5 引文 (Scopus)

摘要

Carbapenem-resistant Enterobacteriaceae (CRE), a major resistance concern emerging during the last decade because of significantly compromising the efficacy of carbapenem agents, has currently become an important focus of infection control. Many investigations have shown a high association of CRE infections with high case-fatality rates. In Taiwan, a few surveys observed that a significant proportion (29–47%) of the CR-Klebsiella pneumoniae isolates harbored a plasmidic allele encoding K. pneumoniae carbapenemases (KPC, especially KPC-2). A significant increase in the number of oxacillinase (OXA)-48-like carbapenemases among CR-K. pneumoniae isolates was observed between 2012 and 2015. By striking contrast, isolates of CR-Escherichia coli and CR-Enterobacter species in Taiwan had a much lower percentage of carbapenemase production than CR-K. pneumoniae isolates. This differs from isolates found in China as well as in the India subcontinent. Apart from the hospital setting, CRE was also cultured from the inpatients from communities or long-term care facilities (LTCF). Therefore, implementation of regular CRE screening of LTCF residents, strict disinfectant use in nursing homes and hospital settings, and appropriate control of antibiotic prescriptions is suggested to alleviate the spread of clinical CRE isolates in Taiwan. Although there are some promising new antibiotics against CRE, such as ceftazidime-avibactam, meropenem-vaborbactam, aztreonam-avibactam and cefiderocol, these agents are not available in Taiwan currently. Therefore, in order to effectively decrease case-fatality rates among patients with the infections owing to carbapenemase-producing CRE isolates, combination antibiotic schemes, including colistin (or amikacin) and/or tigecycline in combination with an anti-pseudomonal carbapenem agent, remain the mainstay for treating clinical CRE infections.

原文English
文章編號2888
期刊Frontiers in Microbiology
9
發行號NOV
DOIs
出版狀態Published - 2018 十一月 27

指紋

Enterobacteriaceae Infections
Carbapenems
Taiwan
Enterobacteriaceae
Klebsiella pneumoniae
meropenem
Long-Term Care
Anti-Bacterial Agents
Aztreonam
Colistin
Enterobacter
Amikacin
Mortality
Disinfectants
Infection Control
Nursing Homes
Prescriptions
Inpatients
India

All Science Journal Classification (ASJC) codes

  • Microbiology
  • Microbiology (medical)

引用此文

Jean, Shio Shin ; Lee, Nan-Yao ; Tang, Hung Jen ; Lu, Min Chi ; Ko, Wen-Chien ; Hsueh, Po Ren. / Carbapenem-resistant enterobacteriaceae infections : Taiwan aspects. 於: Frontiers in Microbiology. 2018 ; 卷 9, 編號 NOV.
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abstract = "Carbapenem-resistant Enterobacteriaceae (CRE), a major resistance concern emerging during the last decade because of significantly compromising the efficacy of carbapenem agents, has currently become an important focus of infection control. Many investigations have shown a high association of CRE infections with high case-fatality rates. In Taiwan, a few surveys observed that a significant proportion (29–47{\%}) of the CR-Klebsiella pneumoniae isolates harbored a plasmidic allele encoding K. pneumoniae carbapenemases (KPC, especially KPC-2). A significant increase in the number of oxacillinase (OXA)-48-like carbapenemases among CR-K. pneumoniae isolates was observed between 2012 and 2015. By striking contrast, isolates of CR-Escherichia coli and CR-Enterobacter species in Taiwan had a much lower percentage of carbapenemase production than CR-K. pneumoniae isolates. This differs from isolates found in China as well as in the India subcontinent. Apart from the hospital setting, CRE was also cultured from the inpatients from communities or long-term care facilities (LTCF). Therefore, implementation of regular CRE screening of LTCF residents, strict disinfectant use in nursing homes and hospital settings, and appropriate control of antibiotic prescriptions is suggested to alleviate the spread of clinical CRE isolates in Taiwan. Although there are some promising new antibiotics against CRE, such as ceftazidime-avibactam, meropenem-vaborbactam, aztreonam-avibactam and cefiderocol, these agents are not available in Taiwan currently. Therefore, in order to effectively decrease case-fatality rates among patients with the infections owing to carbapenemase-producing CRE isolates, combination antibiotic schemes, including colistin (or amikacin) and/or tigecycline in combination with an anti-pseudomonal carbapenem agent, remain the mainstay for treating clinical CRE infections.",
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Carbapenem-resistant enterobacteriaceae infections : Taiwan aspects. / Jean, Shio Shin; Lee, Nan-Yao; Tang, Hung Jen; Lu, Min Chi; Ko, Wen-Chien; Hsueh, Po Ren.

於: Frontiers in Microbiology, 卷 9, 編號 NOV, 2888, 27.11.2018.

研究成果: Review article

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