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. 2020 Feb;25(6):2000085.
doi: 10.2807/1560-7917.ES.2020.25.6.2000085.

Prolonged outbreak of New Delhi metallo-beta-lactamase-producing carbapenem-resistant Enterobacterales (NDM-CRE), Tuscany, Italy, 2018 to 2019

Lara Tavoschi  1 , Silvia Forni  2 , Andrea Porretta  1   3 , Lorenzo Righi  4 , Filippo Pieralli  5 , Francesco Menichetti  3 , Marco Falcone  3 , Giulia Gemignani  3 , Spartaco Sani  6 , Paola Vivani  7 , Tommaso Bellandi  8 , Danilo Tacconi  9 , Lucia Turini  10 , Giulio Toccafondi  4 , Gaetano Privitera  1   3 , Pierluigi Lopalco  1   3 , Angelo Baggiani  1   3 , Fabrizio Gemmi  2 , Grazia Luchini  3 , Maurizio Petrillo  11 , Lorenzo Roti  10 , Patrizio Pezzotti  12 , Annalisa Pantosti  12 , Stefania Iannazzo  13 , Maria Teresa Mechi  4 , Gian Maria Rossolini  14   5 ; Tuscan Clinical Microbiology Laboratory Network  15
Affiliations

Prolonged outbreak of New Delhi metallo-beta-lactamase-producing carbapenem-resistant Enterobacterales (NDM-CRE), Tuscany, Italy, 2018 to 2019

Lara Tavoschi et al. Euro Surveill. 2020 Feb.

Abstract

In Tuscany, Italy, New Delhi metallo-beta-lactamase-producing carbapenem-resistant Enterobacterales (NDM-CRE) have increased since November 2018. Between November 2018 and October 2019, 1,645 samples were NDM-CRE-positive: 1,270 (77.2%) cases of intestinal carriage, 129 (7.8%) bloodstream infections and 246 (14.9%) infections/colonisations at other sites. Klebsiella pneumoniae were prevalent (1,495; 90.9%), with ST147/NDM-1 the dominant clone. Delayed outbreak identification and response resulted in sustained NDM-CRE transmission in the North-West area of Tuscany, but successfully contained spread within the region.

Keywords: Enterobacterales; Italy; Klebsiella pneumoniae; New Delhi metallo-beta-lactamase; outbreak.

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Conflict of interest statement

Conflict of interest: None declared.

Figures

Figure 1
Figure 1
Actions to control the outbreak of NDM-CRE cases, by week of implementation, Tuscany, Italy, November 2018–October 2019
Figure 2
Figure 2
Number of tests and epidemic curve of NDM-CRE cases by week of detection, Tuscany, Italy, November 2018–October 2019 (n = 1,645)
Figure 3
Figure 3
Epidemic curve, NDM-CRE cases, by week of detection and area, Tuscany, Italy, November 2018–October 2019 (n = 1,645)
Figure 4
Figure 4
Health facilities and numbers of NDM-CRE bloodstream infections, Tuscany, Italy, November 2018–October 2019 (n = 129)
See this image and copyright information in PMC

References

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