Colistin resistance superimposed to endemic carbapenem-resistant Klebsiella pneumoniae: a rapidly evolving problem in Italy, November 2013 to April 2014

M. Monaco; T Giani; M Raffone; F Arena; A Garcia-Fernandez; S Pollini; collective Network EuSCAPE-Italy; H Grundmann; A Pantosti; G M Rossolini

doi:10.2807/1560-7917.ES2014.19.42.20939

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Colistin resistance superimposed to endemic carbapenem-resistant Klebsiella pneumoniae: a rapidly evolving problem in Italy, November 2013 to April 2014
M. Monaco^1,2 , T Giani^2,3 , M Raffone^1,4 , F Arena³ , A Garcia-Fernandez¹ , S Pollini³ , collective Network EuSCAPE-Italy⁵ , H Grundmann⁶ , A Pantosti¹ , G M Rossolini^3,7,8
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Affiliations: ¹ Department of Infectious, Parasitic and Immune-mediated Diseases, Istituto Superiore di Sanità, Rome, Italy ² MM and TG have equally contributed to this work ³ Department of Medical Biotechnologies, University of Siena, Siena, Italy ⁴ Federico II University Hospital, Neaples, Italy ⁵ The network EuSCAPE-Italy participants are listed at the end of this article ⁶ Department of Medical Microbiology, University of Groningen, University Medical Center Groningen, the Netherlands ⁷ Department of Experimental and Clinical Medicine, University of Florence, Florence, Italy ⁸ Clinical Microbiology and Virology Unit, Florence Careggi University Hospital, Florence, Italy

Correspondence:
A Pantosti
annalisa.pantosti iss.it
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Citation style for this article: Monaco M., Giani T, Raffone M, Arena F, Garcia-Fernandez A, Pollini S, Network EuSCAPE-Italy collective, Grundmann H, Pantosti A, Rossolini G M. Colistin resistance superimposed to endemic carbapenem-resistant Klebsiella pneumoniae: a rapidly evolving problem in Italy, November 2013 to April 2014. Euro Surveill. 2014;19(42):pii=20939. https://doi.org/10.2807/1560-7917.ES2014.19.42.20939 Received: 08 Oct 2014

Abstract

Consecutive non-replicate clinical isolates (n=191) of carbapenem non-susceptible Enterobacteriaceae were collected from 21 hospital laboratories across Italy from November 2013 to April 2014 as part of the European Survey on Carbapenemase-producing Enterobacteriaceae (EuSCAPE) project. Klebsiella pneumoniae carbapenemase-producing K. pneumoniae (KPC-KP) represented 178 (93%) isolates with 76 (43%) respectively resistant to colistin, a key drug for treating carbapenamase-producing Enterobacteriaceae. KPC-KP colistin-resistant isolates were detected in all participating laboratories. This underscores a concerning evolution of colistin resistance in a setting of high KPC-KP endemicity.