Giuseppe
Emeritus
Carbapenem-non-susceptible Enterobacteriaceae in Europe: conclusions from a meeting of national experts (Euro Surveill., abstract, edited)
[Source: Eurosurveillance, full text: <cite cite="http://www.eurosurveillance.org/ViewArticle.aspx?ArticleId=19711">Eurosurveillance - View Article</cite>. Abstract, edited.]
Eurosurveillance, Volume 15, Issue 46, 18 November 2010
Euroroundups
Carbapenem-non-susceptible Enterobacteriaceae in Europe: conclusions from a meeting of national experts
H Grundmann 1,2, D M Livermore 3, C G Giske 4, R Canton 5,6, G M Rossolini 7, J Campos 8, A Vatopoulos 9, M Gniadkowski 10, A Toth 11, Y Pfeifer 12, V Jarlier 13, Y Carmeli 14, the CNSE Working Group 15
1. Department of Medical Microbiology, University Medical Centre, Groningen, the Netherlands
2. National Institute for Public Health and the Environment (RIVM), Bilthoven, the Netherlands
3. Antibiotic Resistance Monitoring and Reference Laboratory, Health Protection Agency Centre for Infections, London, United Kingdom
4. Microbiology and Tumour Biology Centre, Karolinska Institute, Stockholm, Sweden
5. Microbiology Service, CIBER Epidemiology and Public Health (CIBERESP), University hospital Cajal and Institute Ram?n and Cajal for Health Research (IRYCIS), Madrid, Spain
6. Associated Resistance Unit National Research Council (Unidad de Resistencia Asociada al Consejo Superior de Investigaciones Cient?ficas; CSIC), Madrid, Spain
7. Department of Molecular Biology, Section Microbiology, University of Siena, Siena, Italy
8. Antibiotic Laboratory, National Centre of Microbiology, Instituto de Salud Carlos III, Madrid, Spain
9. Department of Microbiology, National School of Public Health, Athens, Greece
10. National Medicines Institute, Warsaw, Poland
11. Department of Bacteriology, National Centre for Epidemiology, Budapest, Hungary
12. Robert Koch Institute, Nosocomial Infections, Wernigerode, Germany
13. University Pierre and Marie Curie?Hospital Piti?-Salp?tri?re, Assistance Publique?H?pitaux de Paris, Paris, France
14. Tel Aviv Sourasky Medical Center, Tel Aviv, Israel
15. The members of the group are listed at the end of the article
Citation style for this article: Grundmann H, Livermore DM, Giske CG, Canton R, Rossolini GM, Campos J, Vatopoulos A, Gniadkowski M, Toth A, Pfeifer Y, Jarlier V, Carmeli Y, the CNSE Working Group. Carbapenem-non-susceptible Enterobacteriaceae in Europe: conclusions from a meeting of national experts. Euro Surveill. 2010;15(46)
ii=19711. Available online: http://www.eurosurveillance.org/ViewArticle.aspx?ArticleId=19711
Date of submission: 01 September 2010
The emergence and global spread of carbapenemase-producing Enterobacteriaceae is of great concern to health services worldwide. These bacteria are often resistant to all beta-lactam antibiotics and frequently co-resistant to most other antibiotics, leaving very few treatment options. The epidemiology is compounded by the diversity of carbapenem-hydrolysing enzymes and the ability of their genes to spread between different bacterial species. Difficulties are also encountered by laboratories when trying to detect carbapenemase production during routine diagnostic procedures due to an often heterogeneous expression of resistance. Some of the resistance genes are associated with successful clonal lineages which have a selective advantage in those hospitals where antimicrobial use is high and opportunities for transmission exist; others are more often associated with transmissible plasmids. A genetically distinct strain of Klebsiella pneumoniae sequence type (ST) 258 harbouring the K. pneumoniae carbapenemases (KPC) has been causing epidemics of national and international proportions. It follows the pathways of patient referrals, causing hospital outbreaks along the way. Simultaneously, diverse strains harbouring New Delhi metallo-beta-lactamase (NDM-1) are repeatedly being imported into Europe, commonly via patients with prior medical exposure in the Indian subcontinent. Since the nature and scale of carbapenem-non-susceptible Entrobacteriaceae as a threat to hospital patients in Europe remains unclear, a consultation of experts from 31 countries set out to identify the gaps in diagnostic and response capacity, to index the magnitude of carbapenem-non-susceptibility across Europe using a novel five-level staging system, and to provide elements of a strategy to combat this public health issue in a concerted manner.
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[Source: Eurosurveillance, full text: <cite cite="http://www.eurosurveillance.org/ViewArticle.aspx?ArticleId=19711">Eurosurveillance - View Article</cite>. Abstract, edited.]
Eurosurveillance, Volume 15, Issue 46, 18 November 2010
Euroroundups
Carbapenem-non-susceptible Enterobacteriaceae in Europe: conclusions from a meeting of national experts
H Grundmann 1,2, D M Livermore 3, C G Giske 4, R Canton 5,6, G M Rossolini 7, J Campos 8, A Vatopoulos 9, M Gniadkowski 10, A Toth 11, Y Pfeifer 12, V Jarlier 13, Y Carmeli 14, the CNSE Working Group 15
1. Department of Medical Microbiology, University Medical Centre, Groningen, the Netherlands
2. National Institute for Public Health and the Environment (RIVM), Bilthoven, the Netherlands
3. Antibiotic Resistance Monitoring and Reference Laboratory, Health Protection Agency Centre for Infections, London, United Kingdom
4. Microbiology and Tumour Biology Centre, Karolinska Institute, Stockholm, Sweden
5. Microbiology Service, CIBER Epidemiology and Public Health (CIBERESP), University hospital Cajal and Institute Ram?n and Cajal for Health Research (IRYCIS), Madrid, Spain
6. Associated Resistance Unit National Research Council (Unidad de Resistencia Asociada al Consejo Superior de Investigaciones Cient?ficas; CSIC), Madrid, Spain
7. Department of Molecular Biology, Section Microbiology, University of Siena, Siena, Italy
8. Antibiotic Laboratory, National Centre of Microbiology, Instituto de Salud Carlos III, Madrid, Spain
9. Department of Microbiology, National School of Public Health, Athens, Greece
10. National Medicines Institute, Warsaw, Poland
11. Department of Bacteriology, National Centre for Epidemiology, Budapest, Hungary
12. Robert Koch Institute, Nosocomial Infections, Wernigerode, Germany
13. University Pierre and Marie Curie?Hospital Piti?-Salp?tri?re, Assistance Publique?H?pitaux de Paris, Paris, France
14. Tel Aviv Sourasky Medical Center, Tel Aviv, Israel
15. The members of the group are listed at the end of the article
Citation style for this article: Grundmann H, Livermore DM, Giske CG, Canton R, Rossolini GM, Campos J, Vatopoulos A, Gniadkowski M, Toth A, Pfeifer Y, Jarlier V, Carmeli Y, the CNSE Working Group. Carbapenem-non-susceptible Enterobacteriaceae in Europe: conclusions from a meeting of national experts. Euro Surveill. 2010;15(46)
ii=19711. Available online: http://www.eurosurveillance.org/ViewArticle.aspx?ArticleId=19711Date of submission: 01 September 2010
The emergence and global spread of carbapenemase-producing Enterobacteriaceae is of great concern to health services worldwide. These bacteria are often resistant to all beta-lactam antibiotics and frequently co-resistant to most other antibiotics, leaving very few treatment options. The epidemiology is compounded by the diversity of carbapenem-hydrolysing enzymes and the ability of their genes to spread between different bacterial species. Difficulties are also encountered by laboratories when trying to detect carbapenemase production during routine diagnostic procedures due to an often heterogeneous expression of resistance. Some of the resistance genes are associated with successful clonal lineages which have a selective advantage in those hospitals where antimicrobial use is high and opportunities for transmission exist; others are more often associated with transmissible plasmids. A genetically distinct strain of Klebsiella pneumoniae sequence type (ST) 258 harbouring the K. pneumoniae carbapenemases (KPC) has been causing epidemics of national and international proportions. It follows the pathways of patient referrals, causing hospital outbreaks along the way. Simultaneously, diverse strains harbouring New Delhi metallo-beta-lactamase (NDM-1) are repeatedly being imported into Europe, commonly via patients with prior medical exposure in the Indian subcontinent. Since the nature and scale of carbapenem-non-susceptible Entrobacteriaceae as a threat to hospital patients in Europe remains unclear, a consultation of experts from 31 countries set out to identify the gaps in diagnostic and response capacity, to index the magnitude of carbapenem-non-susceptibility across Europe using a novel five-level staging system, and to provide elements of a strategy to combat this public health issue in a concerted manner.
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