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

Hajo Grundmann*, Corinna Glasner, Barbara Albiger, David M. Aanensen, Chris T. Tomlinson, Arjana Tambic Andrasevic, Rafael Canton, Yehuda Carmeli, Alexander W. Friedrich, Christian G. Giske, Youri Glupczynski, Marek Gniadkowski, David M. Livermore, Patrice Nordmann, Laurent Poirel, Gian M. Rossolini, Harald Seifert, Alkiviadis Vatopoulos, Timothy Walsh, Neil WoodfordDominique L. Monnet, European Survey Carbapenemase-Prod

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review

272 Citations (Scopus)

Abstract

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%] Kpneurnoniae and 402 (15%) Ecoli). 850 (37%) of 2301 Kpneumoniae samples and 77 (19%) of 402 Ecoli 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 10000 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 Entero-bacteriaeceae can be overcome. Strengthening infection control efforts in hospitals is crucial for controlling spread through local and national health care networks.

Original languageEnglish
Pages (from-to)153-163
Number of pages11
JournalLancet Infectious Diseases
Volume17
Issue number2
DOIs
Publication statusPublished - Feb-2017

Keywords

  • HOSPITALS
  • SUSCEPTIBILITY
  • RESISTANCE
  • OUTBREAK
  • KPC-3

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