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. 2021 Apr;26(15):1900760.
doi: 10.2807/1560-7917.ES.2021.26.15.1900760.

Temporal and regional incidence of carbapenemase-producing Enterobacterales, Switzerland, 2013 to 2018

Alban Ramette  1   2 , Michael Gasser  1   2 , Patrice Nordmann  3 , Reinhard Zbinden  4 , Jacques Schrenzel  5 , Damir Perisa  6 , Andreas Kronenberg  1
Affiliations

Temporal and regional incidence of carbapenemase-producing Enterobacterales, Switzerland, 2013 to 2018

Alban Ramette et al. Euro Surveill. 2021 Apr.

Abstract

IntroductionIn contrast to countries where carbapenemase-producing Enterobacterales (CPE) are endemic, only sporadic cases were reported in Switzerland until 2013. An aggravation of the epidemiological situation in neighbouring European countries indicated the need for a surveillance study in Switzerland.AimWe aimed to describe CPE distributions in Switzerland and identify epidemiological factors associated with changes in incidence.MethodsData on all human CPE isolates from 2013 to 2018 were collected by the Swiss Centre for Antibiotic Resistance (ANRESIS) and analysed for temporal and regional trends by Generalised Poisson regression. Isolates associated with infection or colonisation were included in a primary analysis; a secondary analysis included invasive isolates only. Statistical detection of regional clusters was performed with WHONET/SaTScan.ResultsWe analysed 731 CPE isolates, of which 325 (44.5%) were associated with screenings and 173 (23.7%) with infections. Yearly detection of CPE isolates increased considerably during the study period from 65 to 212. The most frequently isolated species were Klebsiella pneumoniae (54%) and Escherichia coli (28%). The most frequent genotypes were OXA-48 (43%), KPC (21%) and NDM (14%). In contrast to the French-speaking parts of Switzerland (West, Geneva) where OXA-48 were the predominant genotypes (around 60%), KPC was the most frequently detected genotype in the Italian-speaking region (63%). WHONET/SaTScan outbreak detection analysis identified seven clusters in five regions of Switzerland.ConclusionsIn a first continuous surveillance of CPE in Switzerland, we found that the epidemiological situation aggravated nationwide and that regional patterns of CPE genotypes mirrored the situation in neighbouring European countries.

Keywords: CPE; Carbapenemase-producing Enterobacterales; Switzerland; genotypes; outbreak; temporal and regional trends.

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Conflict of interest statement

Conflict of interest: None declared.

Figures

Figure 1
Figure 1
Evolution over time of CPE isolates related to colonisation and infection, Switzerland, 2013–2018 (n = 731)
Figure 2
Figure 2
Geographical distribution of CPE genotypes per 100,000 inhabitants, Switzerland, 2013–2018 (n = 682)
Figure 3
Figure 3
Factors affecting the number of CPE isolates in a multivariable Poisson regression Switzerland, 2013–2018 (n = 731)
See this image and copyright information in PMC

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