Author/Editor		Grundmann, Hajo; Glasner, Corinna; Albiger, Barbara; Aanensen, David M; Tomlinson, Chris T; Tambić Andrasević, Arjana; Cantón, Rafael; Carmeli, Yehuda; Friedrich, Alexander W; Giske, Christian G; Pirš, Mateja; Cerar Kišek, Tjaša
Title		Occurrence of carbapenemase-producing Klebsiella pneumoniae and Escherichia coli in the European survey of carbapenemase-producing Enterobacteriaceae (EuSCAPE)
Type		članek
Publication year		2016
Volume		str. str.
ISSN		0140-6736 - Lancet
Language		eng
Abstract		Background Gaps in the diagnostic capacity and heterogeneity of national surveillance and reporting standards in Europe make it diffi cult to contain carbapenemase-producing Enterobacteriaceae. We report the development of a consistent sampling framework and the results of the fi rst structured survey on the occurrence of carbapenemaseproducing Klebsiella pneumoniae and Escherichia coli in European hospitals. Methods National expert laboratories recruited hospitals with diagnostic capacities, who collected the fi rst 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 diff ered 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 eff orts in hospitals is crucial for controlling spread through local and national health care networks.
Keywords		enterobacteriaceae Escherichia coli multinational study enterobakterije Escherichia coli mednarodna raziskava