Friedman N Deborah, Carmeli Yehuda, Walton Aaron Lea, Schwaber Mitchell James
1Barwon Health,Victoria,Australia.
2Tel Aviv Sourasky Medical Center,Tel Aviv,Israel.
Infect Control Hosp Epidemiol. 2017 May;38(5):580-594. doi: 10.1017/ice.2017.42. Epub 2017 Mar 15.
The incidence of carbapenem-resistant Enterobacteriaceae (CRE) has increased worldwide with great regional variability. Infections caused by these organisms are associated with crude mortality rates of up to 70%. The spread of CRE in healthcare settings is both an important medical problem and a major global public health threat. All countries are at risk of falling victim to the emergence of CRE; therefore, a preparedness plan is required to avoid the catastrophic natural course of this epidemic. Proactive and adequate preventive measures locally, regionally, and nationally are required to contain the spread of these bacteria. The keys to success in preventing the establishment of CRE endemicity in a region are early detection through targeted laboratory protocols and containment of spread through comprehensive infection control measures. This guideline provides a strategic roadmap for infection control measures based on the best available evidence and expert opinion, to enable preparation of a multifaceted preparedness plan to abort epidemics of CRE. Infect Control Hosp Epidemiol 2017;38:580-594.
耐碳青霉烯类肠杆菌科细菌(CRE)的发病率在全球范围内呈上升趋势,且存在很大的地区差异。这些微生物引起的感染与高达70%的粗死亡率相关。CRE在医疗机构中的传播既是一个重要的医学问题,也是对全球公共卫生的重大威胁。所有国家都面临着CRE出现的风险;因此,需要制定一个防范计划,以避免这场疫情的灾难性自然发展过程。需要在地方、区域和国家层面采取积极且充分的预防措施,以遏制这些细菌的传播。在一个地区预防CRE地方性流行成功的关键在于通过有针对性的实验室规程进行早期检测,以及通过全面的感染控制措施遏制传播。本指南基于现有最佳证据和专家意见,提供了一个感染控制措施的战略路线图,以便能够制定一个多方面的防范计划来终止CRE疫情。《感染控制与医院流行病学》2017年;38:580 - 594。