Emergence of carbapenem-resistant Enterobacteriaceae in a UK paediatric hospital

作者：Drew R J^*; Turton J F; Hill R L R; Livermore D M; Woodford N; Paulus S; Cunliffe N A

来源：Journal of Hospital Infection, 2013, 84(4): 300-304.

DOI：10.1016/j.jhin.2013.05.003

• Antimicrobial resistance
• Carbapenemases
• KPC
• NDM

Background: Carbapenem-resistant Enterobacteriaceae are an emerging global infection threat. However, there are few data describing their clinical importance in children. %26lt;br%26gt;Aim: This retrospective study reviewed the prevalence and resistance mechanisms of carbapenem-resistant Enterobacteriaceae grown from clinical and surveillance samples in a large tertiary referral children%26apos;s hospital in the UK. %26lt;br%26gt;Methods: Carbapenem-resistant Enterobacteriaceae were sought in specimens submitted for diagnostic and surveillance purposes at Alder Hey Children%26apos;s NHS Foundation Trust, Liverpool, between September 2011 and August 2012. Mechanisms of resistance were identified using phenotypic and/or molecular methods. Variable number tandem repeat profiling was used to type carbapenemase-producing strains. %26lt;br%26gt;Findings: During the 12-month study period, carbapenem-resistant Enterobacteriaceae were recovered from 24 patients. Five isolates were from clinical diagnostic specimens whereas 19 of 421 patients had positive rectal surveillance swabs (4.5%). Of the 24 isolates, seven (all Klebsiella spp.) harboured carbapenemases: three had bla(KPC) and four bla(NDM), whereas 17 had resistance due to combinations of AmpC or extended-spectrum beta-lactamase activity plus impermeability. %26lt;br%26gt;Conclusion: Carbapenem-resistant Enterobacteriaceae and, in particular, those with carbapenemases, are an emerging infection problem in a major paediatric hospital in the UK. Active surveillance is required to monitor and control their spread.

• 出版日期2013-8