2018 Fiscal Year Final Research Report
Clinical Epidemiology of Carbapenem-REsistant Enteribacteriaceae
| Project/Area Number |
16K21652
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| Research Category |
Grant-in-Aid for Young Scientists (B)
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| Allocation Type | Multi-year Fund |
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| Research Field |
Infectious disease medicine
Epidemiology and preventive medicine
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| Research Institution | National Center for Global Health and Medicine |
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Principal Investigator |
Hayakawa Kayoko 国立研究開発法人国立国際医療研究センター, その他部局等, その他 (70646778)
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| Research Collaborator |
OHMAGARI NORIO 国立研究開発法人国立国際医療研究センター, その他部局等, センター長
AKIYAMA TOHRU (MIYOSHI TOHRU) 国立研究開発法人国立国際医療研究センター研究所, 感染制御研究部病原微生物学, 研究室長
NAGASHIMA MAKI 国立研究開発法人国立国際医療研究センター, その他部局等
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| Project Period (FY) |
2016-04-01 – 2019-03-31
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| Keywords | カルバペネム耐性腸内細菌科細菌 / カルバペネム / 多剤耐性 |
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| Outline of Final Research Achievements |
Patients with isolation of carbapenem-resistant Enterobacteriaceae (CRE) with meropenem were included from 08/2016 to 03/2018. Ninety isolates (27 CPE and 63 NCPE) were collected from 88 patients (53 male) in 9 hospitals. CPE (Carbapenemase-producing Enterobacteriaceae)included 10 E. cloacae (ENC), 6 K. pneumoniae (KP), 4 E. coli (EC), 3 C. freundii (CF), 2 K. oxytoca, and 1 each of E. aerogenes (EA) and S. marcescens (SM). NCPE (Non-CPE) included 34 EA, 15 ENC, 4 each of EC, KP, SM, and 2 CF. All CPE were positive for IMP carbapenemase. Levofloxacin, gentamicin, and amikacin resistance were found in 6 (22%), 4 (15%), and 1 (4%) CPE, respectively, and 6 (10%), 6 (10%), and 0 NCPE, respectively. Cases of CPE involved older patients with more frequent use of devices and carbapenem exposure. The mortality was similar in the 2 groups. Length of hospital stay after CPE/NCPE isolation was higher in the CPE group after adjustment for the confounding effects.
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| Free Research Field |
医療疫学・薬剤耐性菌の疫学
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| Academic Significance and Societal Importance of the Research Achievements |
CPEとNCPEでは臨床疫学的特徴が異なることが示唆された。カルバペネムの曝露歴や医療デバイスの使用歴は有意にCPEで多く、また、CPEのほうが高齢で合併症のある患者に多かった。死亡率や感染率（保菌でなはく）は両者で同様であったが、検出後の在院日数はCPEで高い傾向があり、カルバペネムの耐性に至る微生物学的要因の同定（即ちCPEか否か）は院内感染対策や抗菌薬適正使用の判断を行う上でも重要と考えられた。
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