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KMID : 1144820230290030109
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대한의생명과학회지
2023 Volume.29 No. 3 p.109 ~ p.120
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Carbapenemase-Producing Enterobacterales: Epidemiology, Detection, and Treatment
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Baek Yun-Hee
Shin Kyeong-Seob
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Abstract
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Recently, the explosive increase of carbapenemase-producing Enterobacterales (CPE) in the worldwide poses a serious threat. The purpose of this study is to investigate epidemiology, detection, and treatment of CPE. Three main carbapenemase are reported worldwide, which were KPC, NDM, and OXA-48-like. KPC type are mostly found in USA, China, Europe, and Latin America. NDM type are mostly found in South Asia. OXA-48-like are often seen in the Mediterranean and Northern Africa. In Korea, CPE have increased explosively since 2015. In 2021, 18,099 CPE were isolated, which were Klebsiella pneumoniae, Escherichia coli, and Enterobacter cloacae in order. The CPE genotype was distributed with KPC, NDM, OXA type in order. Phenotypic detection methods include carbapenemase production tests (CPT) and differential tests of CPE. CPTs include modified Hodge test, modified carbapenem inactivation method (mCIM), Carba NP test, among which mCIM is the most widely used due to easy accessibility and accuracy. A lot of genotypic methods are being done for quick results, and commercialized kits using multiplex real-time PCR and microarray are widely used. Colistin and tigecycline are used as the first line of CPE treatment and are used in combination with second line drugs such as meropenem and fosfomycin.
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KEYWORD
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Carbapenemase producing Enterobacterales, Epidemiology, Detection, Treatment
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