Portal de Periódicos da CAPES

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

2016; Elsevier BV; Volume: 17; Issue: 2 Linguagem: Inglês

10.1016/s1473-3099(16)30257-2

1474-4457

Hajo Grundmann, Corinna Glasner, Barbara Albiger, David M. Aanensen, Christopher Tomlinson, Arjana Tambić Andrašević, Rafael Cantón, Yehuda Carmeli, Alexander W. Friedrich, Christian G. Giske, Y. Glupczynski, Marek Gniadkowski, David M. Livermore, Patrice Nordmann, Laurent Poirel, Gian María Rossolini, Harald Seifert, Alkiviadis Vatopoulos, Timothy R. Walsh, Neil Woodford, Dominique L Monnet, Andi Koraqi, Denada Lacej, Petra Apfalter, Rainer Hartl, Y. Glupczynski, Te‐Din Huang, Tanya Strateva, Y. Marteva-Proevska, Arjana Tambić Andrašević, Iva Butić, Despo Pieridou-Bagatzouni, Panagiota Maikanti-Charalampous, Jaroslav Hrabák, Helena Žemličková, Anette M. Hammerum, Lotte Jakobsen, Marina Ivanova, Anastasia Pavelkovich, Jari Jalava, Monica Österblad, Laurent Dortet, Sophie Vaux, Martin Kaase, Sören Gatermann, Alkiviadis Vatopoulos, Kyriaki Tryfinopoulou, Ákos Tóth, Laura Jánvári, Teck Wee Boo, Elaine McGrath, Yehuda Carmeli, Amos Adler, Annalisa Pantosti, Monica Monaco, Lul Raka, Arsim Kurti, Arta Balode, Māra Saule, Jolanta Miciulevičienė, Aistė Mierauskaitė, Monique Perrin-Weniger, Paul Reichert, Nina Nestorova, Sonia Debattista, Gordana Mijović, Milena Lopičić, Ørjan Samuelsen, Bjørg Haldorsen, Dorota Żabicka, Elżbieta Literacka, Manuela Caniça, Vera Manageiro, Ana Kaftandzieva, Elena Trajkovska-Dokic, Maria Damian, Brânduşa Elena Lixandru, Zora Jelesić, Anika Trudić, M Nikś, Eva Schréterová, Mateja Pirš, Tjaša Cerar, Jesús Oteo, Belén Aracil, Christian G. Giske, Karin Sjöström, Deniz Gür, Aslı Çakar, Neil Woodford, Katie L. Hopkins, Camilla Wiuff, Derek Brown,

Urinary Tract Infections Management

Background 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. Methods National 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. Findings Between 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. Interpretation This 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. Funding European Centre for Disease Prevention and Control.