产KPC酶肺炎克雷伯菌的文献阅读报告.ppt

碳青霉烯酶分类 KPC种类 KPC-1KPC-2 A recent correction in the gene sequence of KPC-1 revealed that KPC-1 and KPC-2 were in fact identical enzymes; hence, the KPC-1 designation is no longer used. 2006-2008年间我国已报道的KPC型碳青酶烯酶 1.Srinivasan A, Patel JB. Infect Control Hosp Epidemiol 2008; 29:1107–9.2.Bratu S, Landman D, Haag R et al. Arch Intern Med 2005; 165 : 1430 – 5.3. Lomaestro BM, Tobin EH, Shang W et al. Clin Infect Dis2006; 43: e26 – 8. Data on healthcare-associated infections reported to the CDC from 2007 indicated that 8% of all Klebsiella isolates were carbapenem-resistant K. pneumoniae (CRKP), in comparison with ,1% in 2000. KPC-producing isolates have now been reported from several countries outside the USA. France,China, Sweden, Norway, Colombia, Brazil, Scotland, Trinidad Tobago, and Poland have all identified pathogens harbouringKPCs. Epidemic situations have also been reported in Israeland and Greece. KPC传播--质粒转导 肠杆菌科－碳青霉烯类CLSI折点的历史演变 改良Hodge (MHT) In vitro susceptibility A systematic review of published studies and reports of treatment outcomes of KPC infections using MEDLINE (2001 – 2011） A total of 38 articles comprising 105 cases were included in the analysis. The majority of infections were due to K. pneumoniae (89%). The most common site of infectio n was blood (52%), followed by respiratory (30%), and urine (10%). Combination versus monotherapy A total of 15 papers involving 55 unique patient cases were reviewed. Tigecycline and the aminoglycosides were associated with positive outcomes in the majority of cases. Clinical success rates were low when the polymyxins were used as monotherapy, but were much higher when they were used in combination. Bloodstream infections caused by KPC-producing Klebsiella pneumoniae Bloodstream infections caused by KPC-producing Klebsiella pneumoniae Bloodstream infections caused by KPC-producing Klebsiella pneumoniae It is evident that KPC-KP BSIs are associated with high mortality rates. It is of