碳青霉烯类耐药肠杆菌科细菌的流行病学分析、检测及临床治疗

碳青霉烯类耐药肠杆菌科细菌(Carbapenem-Resistant Enterobacteriaceae, CRE)近十年来在全球范围内迅速传播,给人类健康带来了巨大的挑战。质粒介导的碳青霉烯酶耐药基因的水平传播是引起CRE激增的主要原因,因此及时准确地检测CRE,尤其是产碳青霉烯酶的CRE,对临床治疗的指导和感染的预防控制具有十分重要的意义。目前已经研发了多种快速检测CRE的表型和基因型检测方法,且有望应用于临床微生物实验室。临床上对CRE感染的治疗方案十分有限,通常联合采用多种活性抗菌药物进行治疗,而目前活性和安全性改善的新药尚处于临床开发的后期阶段。

Epidemiological analysis, detection and clinical treatment of carbapenem- resistant Enterobacteriaceae

Carbapenem-Resistant Enterobacteriaceae (CRE) has rapidly spread globally in the past decade, which has brought great challenges to global human health. And the plasmid-mediated horizontal propagation of carbapenemase genes is the main reason for sharply increasing of CRE, therefore, timely and accurate detection of CRE, especially the carbapenemase producing CRE, is very important for clinical treatment guidance and infection prevention and control. A number of rapid detection methods including phenotypes and genotypes detection of CRE have been developed and are expected to be used in clinical microbiology laboratories. The clinical treatment options for CRE infection are very limited, and a variety of active antibacterial drugs are commonly used in combination. At present, new drugs with improved activity and safety are still in the late stage of clinical development.