Abstract
In Tuscany, Italy, New Delhi metallo-beta-lactamase-producing carbapenem-resistant Enterobacterales (NDM-CRE) have increased since November 2018. Between November 2018 and October 2019, 1,645 samples were NDM-CRE-positive: 1,270 (77.2%) cases of intestinal carriage, 129 (7.8%) bloodstream infections and 246 (14.9%) infections/colonisations at other sites. Klebsiella pneumoniae were prevalent (1,495; 90.9%), with ST147/NDM-1 the dominant clone. Delayed outbreak identification and response resulted in sustained NDM-CRE transmission in the North-West area of Tuscany, but successfully contained spread within the region.
Highlights
Lara Tavoschi1, Silvia Forni2, Andrea Porretta1,5, Lorenzo Righi3, Filippo Pieralli4, Francesco Menichetti5, Marco Falcone5, Giulia Gemignani5, Spartaco Sani6, Paola Vivani7, Tommaso Bellandi8, Danilo Tacconi9, Lucia Turini10, Giulio Toccafondi3, Gaetano Privitera1,5, Pierluigi Lopalco1,5, Angelo Baggiani1,5, Fabrizio Gemmi2, Grazia Luchini5, Maurizio Petrillo11, Lorenzo
An increase in isolates of NDM-producing carbapenem-resistant Enterobacterales (NDM-CRE) in samples obtained from patients admitted to hospitals in the North-West (NW) area of Tuscany has been registered since the last months of 2018 [1], leading, in
[1,5], resulting in growing concern for these pathogens to become endemic in the region [6,7]
Summary
Citation style for this article: Tavoschi Lara , Forni Silvia , Porretta Andrea , Righi Lorenzo , Pieralli Filippo , Menichetti Francesco , Falcone Marco , Gemignani Giulia , Sani Spartaco , Vivani. In Tuscany, Italy, New Delhi metallo-beta-lactamaseproducing carbapenem-resistant Enterobacterales (NDM-CRE) have increased since November 2018. An increase in isolates of NDM-producing carbapenem-resistant Enterobacterales (NDM-CRE) in samples obtained from patients admitted to hospitals in the North-West (NW) area of Tuscany has been registered since the last months of 2018 [1], leading, in. The introduction of standardised routine screening of newly admitted patients across Tuscany in June 2019 www.eurosurveillance.org resulted in a progressive increase in NDM-CRE detection in all TH and DH until September 2019, when a declining trend was noticed (Figures 1 and 3A). BSI: bloodstream infection; DH: district hospital; ICU: intensive care unit; LTCU: long-term care unit; NA: ward data not available; NDM-CRE: New Delhi metallo-beta-lactamase-producing carbapenem-resistant Enterobacterales; TH: teaching hospital. Pneumoniae strain had played a major role at least in the beginning of the outbreak
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