Abstract
Consecutive non-replicate clinical isolates (n=191) of carbapenem non-susceptible Enterobacteriaceae were collected from 21 hospital laboratories across Italy from November 2013 to April 2014 as part of the European Survey on Carbapenemase-producing Enterobacteriaceae (EuSCAPE) project. Klebsiella pneumonia carbapenemase-producing K. pneumoniae (KPC-KP) represented 178 (93%) isolates with 76 (43%) respectively resistant to colistin, a key drug for treating carbapenamase-producing Enterobacteriaceae. KPC-KP colistin-resistant isolates were detected in all participating laboratories. This underscores a concerning evolution of colistin resistance in a setting of high KPC-KP endemicity.
Highlights
Carbapenem-resistant Enterobacteriaceae (CRE) emerged in recent years as one of the most challenging group of antibiotic-resistant pathogens
41(23%) had Klebsiella pneumoniae carbapenemase (KPC)-KP isolates detected while in intensive care unit (ICU), 127 (71%) were found while in a medical or surgical ward, and 10 (6%) were outpatients or patients seen at the emergency department
Most recent data from April 2014 to date are not available at this time, the results of this survey confirmed the widespread endemicity of K. pneumoniae carbapenemase-producing K. pneumoniae (KPC-KP) in Italian healthcare facilities, and their predominant role among carbapenemase-producing Enterobacteriaceae (CPE)
Summary
Carbapenem-resistant Enterobacteriaceae (CRE) emerged in recent years as one of the most challenging group of antibiotic-resistant pathogens. EuSCAPE is funded by the European Centre for Disease Prevention and Control (ECDC) and coordinated by the Department of Medical Microbiology of the University Medical Center Groningen in the Netherlands This initiative aims to foster active surveillance of CPE through improving the diagnostic capacity of microbiological laboratories in Europe [10]. In each participating country the National Expert Laboratory (NEL) collected and characterised clinical isolates of suspected carbapenem non-susceptible K. pneumoniae or Escherichia coli obtained from a sentinel network of peripheral laboratories (PLs). PLs identified suspected carbapenem non-susceptible K. pneumoniae or E. coli by automated systems Vitek 2 (bioMérieux, Marcy l’Etoile, France) or Phoenix (Becton Dickinson Diagnostic Systems, Sparks, MD, USA) These isolates were sent to the NEL in Rome, who in collaboration with the NEL in Siena, performed confirmation and further characterisation.
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