Occurrence of carbapenemase-producing Klebsiella pneumoniae and Escherichia coli in the European survey of carbapenemase-producing Enterobacteriaceae (EuSCAPE): a prospective, multinational study

Grundmann, Hajo; Glasner, Corinna; Albiger, Barbara; Aanensen, David M.; Tomlinson, Chris T.; Andrasević, Arjana Tambić; Cantón, Rafael; Carmeli, Yehuda; Friedrich, Alexander W.; Giske, Christian G.; Glupczynski, Youri; Gniadkowski, Marek; Livermore, David M.; Nordmann, Patrice; Poirel, Laurent; Rossolini, Gian M.; Seifert, Harald; Vatopoulos, Alkiviadis; Walsh, Timothy; Woodford, Neil; Monnet, Dominique L.; European Survey of Carbapenemase-Producing Enterobacteriaceae (EuSCAPE) Working Group

doi:10.1016/S1473-3099(16)30257-2

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Journal article

Occurrence of carbapenemase-producing Klebsiella pneumoniae and Escherichia coli in the European survey of carbapenemase-producing Enterobacteriaceae (EuSCAPE): a prospective, multinational study

Grundmann, Hajo Department of Infection Prevention and Hospital Hygiene, Faculty of Medicine, University of Freiburg, Freiburg, Germany - Department of Medical Microbiology, University of Groningen, University Medical Center Groningen, Netherlands
Glasner, Corinna Department of Medical Microbiology, University of Groningen, University Medical Center Groningen, Netherlands - The Centre for Genomic Pathogen Surveillance, Wellcome Trust Genome Campus, Cambridgeshire, UK
Albiger, Barbara European Centre for Disease Prevention and Control, Stockholm, Sweden
Aanensen, David M. The Centre for Genomic Pathogen Surveillance, Wellcome Trust Genome Campus, Cambridgeshire, UK - Department of Infectious Disease Epidemiology, School of Public Health, Imperial College London, London, UK
Tomlinson, Chris T. Department of Surgery and Cancer, South Kensington Campus, Imperial College London, London, UK
Andrasević, Arjana Tambić Department of Clinical Microbiology, University Hospital for Infectious Diseases, Zagreb, Croatia
Cantón, Rafael Servicio de Microbiología, Hospital Universitario Ramón y Cajal and Instituto Ramón y Cajal de Investigación Sanitaria (IRYCIS), Madrid, Spain - Unidad de Resistencia a Antibióticos y Virulencia Bacteriana asociada al Consejo Superior de Investigaciones Científicas (CSIC), Madrid, Spain
Carmeli, Yehuda Division of Epidemiology, Tel-Aviv Sourasky Medical Centre, Tel-Aviv, Israel
Friedrich, Alexander W. Department of Medical Microbiology, University of Groningen, University Medical Center Groningen, Netherlands
Giske, Christian G. Division of Clinical Microbiology, Department of Laboratory Medicine, Karolinska Institutet, Stockholm, Sweden - Department of Clinical Microbiology, Karolinska University Hospital, Stockholm, Sweden
Glupczynski, Youri Department of Clinical Microbiology, CHU Dinant-Godinne UCL, Namur, Université Catholique de Louvain, Yvoir, Belgium - National Reference Laboratory for Antibiotic Resistance Monitoring in Gram-negative Bacteria, CHU Dinant-Godinne UCL, Namur, Université Catholique de Louvain, Yvoir, Belgium
Gniadkowski, Marek Department of Molecular Microbiology, National Medicines Institute, Warsaw, Poland
Livermore, David M. Antimicrobial Resistance and Healthcare Associated Infections (AMRHAI) Reference Unit, Reference Microbiology Services, Public Health England, London, UK - Norwich Medical School, University of East Anglia, Norwich, UK
Nordmann, Patrice INSERM U914 (Emerging Resistance to Antibiotics), Associated National Reference Center for Antibiotic Resistance, Faculté de Médecine et Université Paris-Sud, K Bicêtre, France - Medical and Molecular Microbiology Unit, Department of Medicine, Faculty of Science, University of Fribourg, Switzerland
Poirel, Laurent INSERM U914 (Emerging Resistance to Antibiotics), Associated National Reference Center for Antibiotic Resistance, Faculté de Médecine et Université Paris-Sud, K Bicêtre, France - Medical and Molecular Microbiology Unit, Department of Medicine, Faculty of Science, University of Fribourg, Switzerland
Rossolini, Gian M. Dipartimento di Biotecnologie Mediche, Università di Siena, Siena, Italy - SOD Microbiologia e Virologia, Azienda Ospedaliera-Universitaria Careggi, Fondazione Don Carlo Gnocchi, Firenze, Italy
Seifert, Harald Institute for Medical Microbiology, Immunology and Hygiene, Cologne University, Cologne, Germany - German Center for Infection Research (DZIF), Braunschweig, Germany
Vatopoulos, Alkiviadis Department of Microbiology, National School of Public Health, Athens, Greece
Walsh, Timothy Section of Medical Microbiology IIB, School of Medical Sciences, Cardiff University, Heath Park Hospital, Cardiff, UK
Woodford, Neil Antimicrobial Resistance and Healthcare Associated Infections (AMRHAI) Reference Unit, Reference Microbiology Services, Public Health England, London, UK
Monnet, Dominique L. European Centre for Disease Prevention and Control, Stockholm, Sweden
European Survey of Carbapenemase-Producing Enterobacteriaceae (EuSCAPE) Working Group

01.02.2017

Published in:

The Lancet Infectious Diseases. - 2017, vol. 17, no. 2, p. 153–163

English Gaps in the diagnostic capacity and heterogeneity of national surveillance and reporting standards in Europe make it difficult to contain carbapenemase-producing Enterobacteriaceae. We report the development of a consistent sampling framework and the results of the first structured survey on the occurrence of carbapenemase- producing Klebsiella pneumoniae and Escherichia coli in European hospitals.Methods: National expert laboratories recruited hospitals with diagnostic capacities, who collected the first ten carbapenem non-susceptible clinical isolates of K pneumoniae or E coli and ten susceptible same-species comparator isolates and pertinent patient and hospital information. Isolates and data were relayed back to national expert laboratories, which made laboratory-substantiated information available for central analysis.Findings: Between Nov 1, 2013, and April 30, 2014, 455 sentinel hospitals in 36 countries submitted 2703 clinical isolates (2301 [85%] K pneumoniae and 402 (15%) E coli). 850 (37%) of 2301 K pneumoniae samples and 77 (19%) of 402 E coli samples were carbapenemase (KPC, NDM, OXA-48-like, or VIM) producers. The ratio of K pneumoniae to E coli was 11:1. 1·3 patients per 10 000 hospital admissions had positive clinical specimens. Prevalence differed greatly, with the highest rates in Mediterranean and Balkan countries. Carbapenemase-producing K pneumoniae isolates showed high resistance to last-line antibiotics.Interpretation: This initiative shows an encouraging commitment by all participants, and suggests that challenges in the establishment of a continent-wide enhanced sentinel surveillance for carbapenemase-producing Enterobacteriaeceae can be overcome. Strengthening infection control efforts in hospitals is crucial for controlling spread through local and national health care networks.

Faculty

Faculté des sciences et de médecine

Department

Médecine 3ème année

Language