Detection, treatment, and prevention of carbapenemase-producing Enterobacteriaceae : Recommendations from an International Working Group

Hara, Gabriel Levy; Gould, Ian; Endimiani, Andrea; Pardo, Pilar Ramón; Daikos, George; Hsueh, Po-Ren; Mehtar, Shaheen; Petrikkos, George; Casellas, José María; Daciuk, Lucía; Paciel, Daniela; Novelli, Andrea; Saginur, Raphael; Pryluka, Daniel; Medina, Julio; Savio, Eduardo (2013). Detection, treatment, and prevention of carbapenemase-producing Enterobacteriaceae : Recommendations from an International Working Group. Journal of Chemotherapy, 25(3), pp. 129-140. Maney 10.1179/1973947812Y.0000000062

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The prevalence of carbapenemase-producing Enterobacteriaceae (CPE) has increased during the past 10 years. Its detection is frequently difficult, because they do not always show a minimum inhibitory concentration (MIC) value for carbapenems in the resistance range. Both broth microdilution and agar dilution methods are more sensitive than disk diffusion method, Etest and automated systems. Studies on antimicrobial treatment are based on a limited number of patients; therefore, the optimal treatment is not well established. Combination therapy with two active drugs appears to be more effective than monotherapy. Combination of a carbapenem with another active agent — preferentially an aminoglycoside or colistin — could lower mortality provided that the MIC is #4 mg/l and probably #8 mg/l, and is administered in a higher-dose/prolonged-infusion regimen. An aggressive infection control and prevention strategy is recommended, including reinforcement of hand hygiene, using contact precautions and early detection of CPE through use of targeted surveillance.

Item Type:

Journal Article (Review Article)

Division/Institute:

04 Faculty of Medicine > Service Sector > Institute for Infectious Diseases

UniBE Contributor:

Endimiani, Andrea

Subjects:

500 Science > 570 Life sciences; biology
600 Technology > 610 Medicine & health

ISSN:

1120-009X

Publisher:

Maney

Language:

English

Submitter:

Users 22 not found.

Date Deposited:

26 May 2014 10:04

Last Modified:

29 Jan 2015 04:57

Publisher DOI:

10.1179/1973947812Y.0000000062

Uncontrolled Keywords:

Carbapenemase producing Enterobacteriaceae, Carbapenemases, Detection, Klebsiella pneumoniae, Multiple drug resistance, Colistin, Infection control, Treatment

BORIS DOI:

10.7892/boris.53054

URI:

https://boris.unibe.ch/id/eprint/53054

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