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. 2017 Aug 3;22(31):30583.
doi: 10.2807/1560-7917.ES.2017.22.31.30583.

Evolving beta-lactamase epidemiology in Enterobacteriaceae from Italian nationwide surveillance, October 2013: KPC-carbapenemase spreading among outpatients

Tommaso Giani  1   2 , Alberto Antonelli  2   3 , Mariasofia Caltagirone  4 , Carola Mauri  5 , Jessica Nicchi  3 , Fabio Arena  1 , Elisabetta Nucleo  4 , Silvia Bracco  5 , Annalisa Pantosti  6 ; AMCLI-CoSA survey participants  7 ; Francesco Luzzaro  5 , Laura Pagani  4 , Gian Maria Rossolini  1   3   8
Affiliations

Evolving beta-lactamase epidemiology in Enterobacteriaceae from Italian nationwide surveillance, October 2013: KPC-carbapenemase spreading among outpatients

Tommaso Giani et al. Euro Surveill. .

Erratum in

  • Erratum for Euro Surveill. 2017;22(31).
    Eurosurveillance Editorial Team. Eurosurveillance Editorial Team. Euro Surveill. 2017 Aug 24;22(34):30601. doi: 10.2807/1560-7917.ES.2017.22.34.30601. Euro Surveill. 2017. PMID: 28857046 Free PMC article. No abstract available.

Abstract

Extended-spectrum beta-lactamases (ESBLs), AmpC-type beta-lactamases (ACBLs) and carbapenemases are among the most important resistance mechanisms in Enterobacteriaceae. This study investigated the presence of these resistance mechanisms in consecutive non-replicate isolates of Escherichia coli (n = 2,352), Klebsiella pneumoniae (n = 697), and Proteus mirabilis (n = 275) from an Italian nationwide cross-sectional survey carried out in October 2013. Overall, 15.3% of isolates were non-susceptible to extended-spectrum cephalosporins but susceptible to carbapenems (ESCR-carbaS), while 4.3% were also non-susceptible to carbapenems (ESCR-carbaR). ESCR-carbaS isolates were contributed by all three species, with higher proportions among isolates from inpatients (20.3%) but remarkable proportions also among those from outpatients (11.1%). Most ESCR-carbaS isolates were ESBL-positive (90.5%), and most of them were contributed by E. coli carrying blaCTX-M group 1 genes. Acquired ACBLs were less common and mostly detected in P. mirabilis. ESCR-carbaR isolates were mostly contributed by K. pneumoniae (25.1% and 7.7% among K. pneumoniae isolates from inpatients and outpatients, respectively), with blaKPC as the most common carbapenemase gene. Results showed an increasing trend for both ESBL and carbapenemase producers in comparison with previous Italian surveys, also among outpatients.

Keywords: Class C beta-lactamases; ESBL; Enterobacteriaceae; carbapenemase; epidemiology; outpatients.

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Conflict of interest statement

Conflict of interest: None declared.

Figures

Figure 1
Figure 1
Distribution of the centers participating in the survey, Italy, October 2013 (n=14)
Figure 2
Figure 2
Distribution of Escherichia coli, Klebsiella pneumoniae and Proteus mirabilis isolates according to resistance phenotypes and genotypes, nationwide surveillance survey, Italy, October 2013 (n=652 isolates)
See this image and copyright information in PMC

References

    1. European Centre for Disease Prevention and Control (ECDC). Point prevalence survey of healthcare- associated infections and antimicrobial use in European acute care hospitals. Stockholm: ECDC; 2013. Available from: http://ecdc.europa.eu/en/publications/publications/healthcare-associated...
    1. Van Boeckel TP, Gandra S, Ashok A, Caudron Q, Grenfell BT, Levin SA, et al. Global antibiotic consumption 2000 to 2010: an analysis of national pharmaceutical sales data. Lancet Infect Dis. 2014;14(8):742-50. 10.1016/S1473-3099(14)70780-7 - DOI - PubMed
    1. World Health Organization (WHO). Strategies for global surveillance of antimicrobial resistance: report of a technical consultation. Geneva: WHO; Oct 2013. Available from: http://www.who.int/drugresistance/publications/surveillance-meeting2012/...
    1. Falagas ME, Karageorgopoulos DE, Nordmann P. Therapeutic options for infections with Enterobacteriaceae producing carbapenem-hydrolyzing enzymes. Future Microbiol. 2011;6(6):653-66. 10.2217/fmb.11.49 - DOI - PubMed
    1. Maragakis LL, Perencevich EN, Cosgrove SE. Clinical and economic burden of antimicrobial resistance. Expert Rev Anti Infect Ther. 2008;6(5):751-63. 10.1586/14787210.6.5.751 - DOI - PubMed

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