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. 2019 Jan;24(5):1800159.
doi: 10.2807/1560-7917.ES.2019.24.5.1800159.

Bloodstream infections due to carbapenemase-producing Enterobacteriaceae in Italy: results from nationwide surveillance, 2014 to 2017

Simone Iacchini  1 , Michela Sabbatucci  1   2 , Carlo Gagliotti  3 , Gian Maria Rossolini  4   5 , Maria Luisa Moro  3 , Stefania Iannazzo  6 , Fortunato D'Ancona  1 , Patrizio Pezzotti  1 , Annalisa Pantosti  1
Affiliations

Bloodstream infections due to carbapenemase-producing Enterobacteriaceae in Italy: results from nationwide surveillance, 2014 to 2017

Simone Iacchini et al. Euro Surveill. 2019 Jan.

Abstract

Following the rapid increase of infections due to carbapenemase-producing Enterobacteriaceae (CPE) in Italy, the national surveillance of bloodstream infections (BSI) due to CPE (Klebsiella pneumoniae and Escherichia coli) was instituted in 2013. All CPE-BSI cases reported to the surveillance in the years 2014-17 were analysed in order to investigate incidence rate (IR), trend, main individual characteristics and enzymes involved in CPE resistance. Throughout this period, 7,632 CPE-BSI cases (IR: 3.14/100,000 inhabitants) were reported from all 21 regions and autonomous provinces in Italy, with an increasing number of reported cases (2014: 1,403; 2015: 1,838; 2016: 2,183; 2017: 2,208). CPE-BSI cases mainly occurred in subjects aged over 60 years (70.9%) and more frequently in males (62.7%) than in females. Most of the cases originated in hospitals (87.2%), mainly in intensive care units (38.0%), and were associated with central or peripheral venous catheter use (23.9%) or with urinary tract infections (21.1%). Almost all CPE-BSI (98.1%) were due to K. pneumoniae carrying the K. pneumoniae carbapenemase (KPC) enzyme (95.2%). These data show that carbapenemase-producing K. pneumoniae are endemic in our country, causing a high number of BSI and representing a threat to patient safety.

Keywords: Italy; bloodstream infections; carbapenem-resistant Enterobacteriaceae; carbapenemase-producing Enterobacteriaceae; surveillance.

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Conflict of interest statement

Conflict of interest: None declared.

Figures

Figure 1
Figure 1
(A) Frequency and (B) incidence rate per 100,000 inhabitants by month and year of bloodstream infections due to carbapenemase-producing Enterobacteriaceae reported to the national surveillance system, Italy, 2014–2017
Figure 2
Figure 2
(A) Frequency, (B) incidence rate per 100,000 inhabitants and (C) incidence rate per 100,000 hospital patient days of bloodstream infection cases due to carbapenemase-producing Enterobacteriaceae stratified by age group and sex reported to the national surveillance system, Italy, 2014–2017
See this image and copyright information in PMC

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