Evolving beta-lactamase epidemiology in Enterobacteriaceae from Italian nationwide surveillance, October 2013: KPC-carbapenemase spreading among outpatients

T. Giani, A. Antonelli, M. Caltagirone, C. Mauri, J. Nicchi, F. Arena, E. Nucleo, S. Bracco, A. Pantosti, C. Vismara, B. Pini, S. Andreoni, P. A. Dusi, R. Aschbacher, C. Scarparo, M. Sarti, C. Venturelli, P. Pecile, E. Manso, T. SpanuM. Labonia, G. Buonopane, C. Giraldi, F. Luzzaro, L. Pagani, Gian Maria Rossolini, The AMCLI-CoSA survey participants

Research output: Contribution to journalArticlepeer-review

Abstract

Extended-spectrum beta-lactamases (ESBLs), AmpCtype beta-lactamases (ACBLs) and carbapenemases are among the most important resistance mechanisms in Enterobacteriaceae. This study investigated the presence of these resistance mechanisms in consecutive non-replicate isolates of Escherichia coli (n = 2,352), Klebsiella pneumoniae (n = 697), and Proteus mirabilis (n = 275) from an Italian nationwide cross-sectional survey carried out in October 2013. Overall, 15.3% of isolates were non-susceptible to extended-spectrum cephalosporins but susceptible to carbapenems (ESCR-carbaS), while 4.3% were also non-susceptible to carbapenems (ESCR-carbaR). ESCR-carbaS isolates were contributed by all three species, with higher proportions among isolates from inpatients (20.3%) but remarkable proportions also among those from outpatients (11.1%). Most ESCRcarbaS isolates were ESBL-positive (90.5%), and most of them were contributed by E. coli carrying blaCTX-M group 1 genes. Acquired ACBLs were less common and mostly detected in P. mirabilis. ESCR-carbaR isolates were mostly contributed by K. pneumoniae (25.1% and 7.7% among K. pneumoniae isolates from inpatients and outpatients, respectively), with blaKPC as the most common carbapenemase gene. Results showed an increasing trend for both ESBL and carbapenemase producers in comparison with previous Italian surveys, also among outpatients.

Original languageEnglish
JournalEurosurveillance
Volume22
Issue number31
DOIs
Publication statusPublished - Aug 3 2017

ASJC Scopus subject areas

  • Epidemiology
  • Public Health, Environmental and Occupational Health
  • Virology

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