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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, Andrasevic, Arjana Tambic, 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, Koraqi, Andi, Lacej, Denada, Apfalter, Petra, Hartl, Rainer, Glupczynski, Youri, Huang, Te-Din, Strateva, Tanya, Marteva-Proevska, Yuliya, Andrasevic, Arjana Tambic, Butic, Iva, Pieridou-Bagatzouni, Despo, Maikanti-Charalampous, Panagiota, Hrabak, Jaroslav, Zemlickova, Helena, Hammerum, Anette, Jakobsen, Lotte, Ivanova, Marina, Pavelkovich, Anastasia, Jalava, Jari, österblad, Monica, Dortet, Laurent, Vaux, Sophie, Kaase, Martin, Gatermann, Sören G., Vatopoulos, Alkiviadis, Tryfinopoulou, Kyriaki, Tóth, ákos, Jánvári, Laura, Boo, Teck Wee, McGrath, Elaine, Carmeli, Yehuda, Adler, Amos, Pantosti, Annalisa, Monaco, Monica, Raka, Lul, Kurti, Arsim, Balode, Arta, Saule, Mara, Miciuleviciene, Jolanta, Mierauskaite, Aiste, Perrin-Weniger, Monique, Reichert, Paul, Nestorova, Nina, Debattista, Sonia, Mijovic, Gordana, Lopicic, Milena, Samuelsen, ørjan, Haldorsen, Bjørg, Zabicka, Dorota, Literacka, Elzbieta, Caniça, Manuela, Manageiro, Vera, Kaftandzieva, Ana, Trajkovska-Dokic, Elena, Damian, Maria, Lixandru, Brandusa, Jelesic, Zora, Trudic, Anika, Niks, Milan, Schreterova, Eva, Pirs, Mateja, Cerar, Tjasa, Oteo, Jesús, Aracil, Belén, Giske, Christian, Sjöström, Karin, Gür, Deniz, Cakar, Asli, Woodford, Neil, Hopkins, Katie, Wiuff, Camilla and Brown, Derek J. 2017. Occurrence of carbapenemase-producing Klebsiella pneumoniae and Escherichia coli in the European survey of carbapenemase-producing Enterobacteriaceae (EuSCAPE): a prospective, multinational study. Lancet Infectious Diseases 17 (2) , pp. 153-163. 10.1016/S1473-3099(16)30257-2

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Abstract

Background 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.

Item Type: Article
Date Type: Publication
Status: Published
Schools: Medicine
Additional Information: The European Survey of Carbapenemase-Producing Enterobacteriaceae (EuSCAPE) Working Group
Publisher: Elsevier: Lancet
ISSN: 1473-3099
Funders: EU
Date of First Compliant Deposit: 21 July 2017
Date of Acceptance: 13 October 2016
Last Modified: 04 Mar 2021 16:30
URI: http://orca.cf.ac.uk/id/eprint/102769

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