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 Tambić Andrasević, Rafael Cantón, 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, Petra Apfalter, Rainer Hartl, Youri Glupczynski, Te Din Huang, Tanya Strateva, Yuliya Marteva-Proevska, Arjana Tambic Andraševic, Iva Butic, Despo Pieridou-Bagatzouni, Panagiota Maikanti-Charalampous, Jaroslav Hrabak, Helena Zemlickova, Anette M. Hammerum, Lotte Jakobsen, Marina Ivanova, Anastasia Pavelkovich, Jari Jalava, Monica Österblad, Sophie Vaux, Laurent Dortet, Martin Kaase, Sören G. Gatermann, Alkiviadis Vatopoulos, Kyriaki Tryfinopoulou, Ákos Tóth, Laura Jánvári, Teck Wee Boo, Elaine McGrath, Annalisa Pantosti, European Survey of Carbapenemase-Producing Enterobacteriaceae (EuSCAPE) Working Group

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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%] 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 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 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.

Original languageEnglish
Pages (from-to)153-163
Number of pages11
JournalThe Lancet Infectious Diseases
Volume17
Issue number2
Early online dateNov 18 2016
DOIs
Publication statusPublished - Feb 1 2017

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Klebsiella pneumoniae
Enterobacteriaceae
Pneumonia
Prospective Studies
Escherichia coli
Sentinel Surveillance
Balkan Peninsula
Hospital Laboratories
Carbapenems
Centers for Disease Control and Prevention (U.S.)
Infection Control
carbapenemase
Surveys and Questionnaires
Anti-Bacterial Agents
Delivery of Health Care

ASJC Scopus subject areas

  • Infectious Diseases

Cite this

Grundmann, H., Glasner, C., Albiger, B., Aanensen, D. M., Tomlinson, C. T., Andrasević, A. T., ... European Survey of Carbapenemase-Producing Enterobacteriaceae (EuSCAPE) Working Group (2017). Occurrence of carbapenemase-producing Klebsiella pneumoniae and Escherichia coli in the European survey of carbapenemase-producing Enterobacteriaceae (EuSCAPE): a prospective, multinational study. The Lancet Infectious Diseases, 17(2), 153-163. https://doi.org/10.1016/S1473-3099(16)30257-2

Occurrence of carbapenemase-producing Klebsiella pneumoniae and Escherichia coli in the European survey of carbapenemase-producing Enterobacteriaceae (EuSCAPE) : a prospective, multinational study. / Grundmann, Hajo; Glasner, Corinna; Albiger, Barbara; Aanensen, David M.; Tomlinson, Chris T.; Andrasević, Arjana Tambić; Cantón, Rafael; Carmeli, Yehuda; Friedrich, Alexander W.; Giske, Christian G.; Glupczynski, Youri; Gniadkowski, Marek; Livermore, David M.; Nordmann, Patrice; Poirel, Laurent; Rossolini, Gian M.; Seifert, Harald; Vatopoulos, Alkiviadis; Walsh, Timothy; Woodford, Neil; Monnet, Dominique L.; Apfalter, Petra; Hartl, Rainer; Glupczynski, Youri; Huang, Te Din; Strateva, Tanya; Marteva-Proevska, Yuliya; Andraševic, Arjana Tambic; Butic, Iva; Pieridou-Bagatzouni, Despo; Maikanti-Charalampous, Panagiota; Hrabak, Jaroslav; Zemlickova, Helena; Hammerum, Anette M.; Jakobsen, Lotte; Ivanova, Marina; Pavelkovich, Anastasia; Jalava, Jari; Österblad, Monica; Vaux, Sophie; Dortet, Laurent; Kaase, Martin; Gatermann, Sören G.; Vatopoulos, Alkiviadis; Tryfinopoulou, Kyriaki; Tóth, Ákos; Jánvári, Laura; Boo, Teck Wee; McGrath, Elaine; Pantosti, Annalisa; European Survey of Carbapenemase-Producing Enterobacteriaceae (EuSCAPE) Working Group.

In: The Lancet Infectious Diseases, Vol. 17, No. 2, 01.02.2017, p. 153-163.

Research output: Contribution to journalArticle

Grundmann, H, Glasner, C, Albiger, B, Aanensen, DM, Tomlinson, CT, Andrasević, AT, Cantón, R, Carmeli, Y, Friedrich, AW, Giske, CG, Glupczynski, Y, Gniadkowski, M, Livermore, DM, Nordmann, P, Poirel, L, Rossolini, GM, Seifert, H, Vatopoulos, A, Walsh, T, Woodford, N, Monnet, DL, Apfalter, P, Hartl, R, Glupczynski, Y, Huang, TD, Strateva, T, Marteva-Proevska, Y, Andraševic, AT, Butic, I, Pieridou-Bagatzouni, D, Maikanti-Charalampous, P, Hrabak, J, Zemlickova, H, Hammerum, AM, Jakobsen, L, Ivanova, M, Pavelkovich, A, Jalava, J, Österblad, M, Vaux, S, Dortet, L, Kaase, M, Gatermann, SG, Vatopoulos, A, Tryfinopoulou, K, Tóth, Á, Jánvári, L, Boo, TW, McGrath, E, Pantosti, A & European Survey of Carbapenemase-Producing Enterobacteriaceae (EuSCAPE) Working Group 2017, 'Occurrence of carbapenemase-producing Klebsiella pneumoniae and Escherichia coli in the European survey of carbapenemase-producing Enterobacteriaceae (EuSCAPE): a prospective, multinational study', The Lancet Infectious Diseases, vol. 17, no. 2, pp. 153-163. https://doi.org/10.1016/S1473-3099(16)30257-2
Grundmann, Hajo ; Glasner, Corinna ; Albiger, Barbara ; Aanensen, David M. ; Tomlinson, Chris T. ; Andrasević, Arjana Tambić ; Cantón, Rafael ; Carmeli, Yehuda ; Friedrich, Alexander W. ; Giske, Christian G. ; Glupczynski, Youri ; Gniadkowski, Marek ; Livermore, David M. ; Nordmann, Patrice ; Poirel, Laurent ; Rossolini, Gian M. ; Seifert, Harald ; Vatopoulos, Alkiviadis ; Walsh, Timothy ; Woodford, Neil ; Monnet, Dominique L. ; Apfalter, Petra ; Hartl, Rainer ; Glupczynski, Youri ; Huang, Te Din ; Strateva, Tanya ; Marteva-Proevska, Yuliya ; Andraševic, Arjana Tambic ; Butic, Iva ; Pieridou-Bagatzouni, Despo ; Maikanti-Charalampous, Panagiota ; Hrabak, Jaroslav ; Zemlickova, Helena ; Hammerum, Anette M. ; Jakobsen, Lotte ; Ivanova, Marina ; Pavelkovich, Anastasia ; Jalava, Jari ; Österblad, Monica ; Vaux, Sophie ; Dortet, Laurent ; Kaase, Martin ; Gatermann, Sören G. ; Vatopoulos, Alkiviadis ; Tryfinopoulou, Kyriaki ; Tóth, Ákos ; Jánvári, Laura ; Boo, Teck Wee ; McGrath, Elaine ; Pantosti, Annalisa ; European Survey of Carbapenemase-Producing Enterobacteriaceae (EuSCAPE) Working Group. / Occurrence of carbapenemase-producing Klebsiella pneumoniae and Escherichia coli in the European survey of carbapenemase-producing Enterobacteriaceae (EuSCAPE) : a prospective, multinational study. In: The Lancet Infectious Diseases. 2017 ; Vol. 17, No. 2. pp. 153-163.
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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{\%}] 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 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 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.",
author = "Hajo Grundmann and Corinna Glasner and Barbara Albiger and Aanensen, {David M.} and Tomlinson, {Chris T.} and Andrasević, {Arjana Tambić} and Rafael Cant{\'o}n and Yehuda Carmeli and Friedrich, {Alexander W.} and Giske, {Christian G.} and Youri Glupczynski and Marek Gniadkowski and Livermore, {David M.} and Patrice Nordmann and Laurent Poirel and Rossolini, {Gian M.} and Harald Seifert and Alkiviadis Vatopoulos and Timothy Walsh and Neil Woodford and Monnet, {Dominique L.} and Petra Apfalter and Rainer Hartl and Youri Glupczynski and Huang, {Te Din} and Tanya Strateva and Yuliya Marteva-Proevska and Andraševic, {Arjana Tambic} and Iva Butic and Despo Pieridou-Bagatzouni and Panagiota Maikanti-Charalampous and Jaroslav Hrabak and Helena Zemlickova and Hammerum, {Anette M.} and Lotte Jakobsen and Marina Ivanova and Anastasia Pavelkovich and Jari Jalava and Monica {\"O}sterblad and Sophie Vaux and Laurent Dortet and Martin Kaase and Gatermann, {S{\"o}ren G.} and Alkiviadis Vatopoulos and Kyriaki Tryfinopoulou and {\'A}kos T{\'o}th and Laura J{\'a}nv{\'a}ri and Boo, {Teck Wee} and Elaine McGrath and Annalisa Pantosti and {European Survey of Carbapenemase-Producing Enterobacteriaceae (EuSCAPE) Working Group}",
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T1 - Occurrence of carbapenemase-producing Klebsiella pneumoniae and Escherichia coli in the European survey of carbapenemase-producing Enterobacteriaceae (EuSCAPE)

T2 - a prospective, multinational study

AU - Grundmann, Hajo

AU - Glasner, Corinna

AU - Albiger, Barbara

AU - Aanensen, David M.

AU - Tomlinson, Chris T.

AU - Andrasević, Arjana Tambić

AU - Cantón, Rafael

AU - Carmeli, Yehuda

AU - Friedrich, Alexander W.

AU - Giske, Christian G.

AU - Glupczynski, Youri

AU - Gniadkowski, Marek

AU - Livermore, David M.

AU - Nordmann, Patrice

AU - Poirel, Laurent

AU - Rossolini, Gian M.

AU - Seifert, Harald

AU - Vatopoulos, Alkiviadis

AU - Walsh, Timothy

AU - Woodford, Neil

AU - Monnet, Dominique L.

AU - Apfalter, Petra

AU - Hartl, Rainer

AU - Glupczynski, Youri

AU - Huang, Te Din

AU - Strateva, Tanya

AU - Marteva-Proevska, Yuliya

AU - Andraševic, Arjana Tambic

AU - Butic, Iva

AU - Pieridou-Bagatzouni, Despo

AU - Maikanti-Charalampous, Panagiota

AU - Hrabak, Jaroslav

AU - Zemlickova, Helena

AU - Hammerum, Anette M.

AU - Jakobsen, Lotte

AU - Ivanova, Marina

AU - Pavelkovich, Anastasia

AU - Jalava, Jari

AU - Österblad, Monica

AU - Vaux, Sophie

AU - Dortet, Laurent

AU - Kaase, Martin

AU - Gatermann, Sören G.

AU - Vatopoulos, Alkiviadis

AU - Tryfinopoulou, Kyriaki

AU - Tóth, Ákos

AU - Jánvári, Laura

AU - Boo, Teck Wee

AU - McGrath, Elaine

AU - Pantosti, Annalisa

AU - European Survey of Carbapenemase-Producing Enterobacteriaceae (EuSCAPE) Working Group

PY - 2017/2/1

Y1 - 2017/2/1

N2 - 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 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 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.

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