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

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• 作者：Prof Hajo Grundmann ; MD^a ; ^b ; ^* ; ^{hajo.grundmann@uniklinik-freiburg.de} ; Corinna Glasner ; PhD^b ; ^c ; ^* ; Barbara Albiger ; PhD^d ; David M Aanensen ; PhD^c ; ^e ; Chris T Tomlinson ; PhD^f ; Prof Arjana Tambić Andrasević ; MD^g ; Prof Rafael Cantó ; n ; MD^h ; ⁱ ; Prof Yehuda Carmeli ; MD^j ; Prof Alexander W Friedrich ; MD^b ; Christian G Giske ; MD^k ; ^l ; Prof Youri Glupczynski ; MD^m ; ⁿ ; Prof Marek Gniadkowski ; PhD^o ; Prof David M Livermore ; PhD^p ; ^q ; Prof Patrice Nordmann ; PhD^r ; ^s ; Laurent Poirel ; PhD^r ; ^s ; Prof Gian M Rossolini ; MD^t ; ^u ; Prof Harald Seifert ; MD^v ; ^w ; Prof Alkiviadis Vatopoulos ; MD^x ; Prof Timothy Walsh ; PhD^y ; Prof Neil Woodford ; PhD^p ; Dominique L Monnet ; PhD^d ; the European Survey of Carbapenemase-Producing Enterobacteriaceae (EuSCAPE) Working Group^&dagger ;
• 刊名：The Lancet Infectious Diseases
• 出版年：2017
• 出版时间：February 2017
• 年：2017
• 卷：17
• 期：2
• 页码：153-163
• 全文大小：1684 K
• 卷排序：17

文摘

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.MethodsNational 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.FindingsBetween 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.InterpretationThis 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.FundingEuropean Centre for Disease Prevention and Control.