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Bloodstream infections due to carbapenemase-producing Enterobacteriaceae in Italy: results from nationwide surveillance, 2014 to 2017
- Simone Iacchini1 , Michela Sabbatucci1,2 , Carlo Gagliotti3 , Gian Maria Rossolini4,5 , Maria Luisa Moro3 , Stefania Iannazzo6 , Fortunato D’Ancona1 , Patrizio Pezzotti1 , Annalisa Pantosti1
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View Affiliations Hide AffiliationsAffiliations: 1 Department of Infectious Diseases, Istituto Superiore di Sanità, Rome, Italy 2 European Programme for Public Health Microbiology Training (EUPHEM), European Centre for Disease Prevention and Control (ECDC), Stockholm, Sweden 3 Agenzia Sanitaria e Sociale Regionale – Regione Emilia-Romagna, Bologna, Italy 4 Careggi University Hospital, Florence, Italy 5 Department of Experimental and Clinical Medicine, University of Florence, Florence, Italy 6 Ufficio V – Prevention of Communicable Diseases and International Prophylaxis, Ministry of Health, Rome, ItalySimone Iacchinisimone.iacchini iss.it
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Citation style for this article: Iacchini Simone, Sabbatucci Michela, Gagliotti Carlo, Rossolini Gian Maria, Moro Maria Luisa, Iannazzo Stefania, D’Ancona Fortunato, Pezzotti Patrizio, Pantosti Annalisa. Bloodstream infections due to carbapenemase-producing Enterobacteriaceae in Italy: results from nationwide surveillance, 2014 to 2017. Euro Surveill. 2019;24(5):pii=1800159. https://doi.org/10.2807/1560-7917.ES.2019.24.5.1800159 Received: 28 Mar 2018; Accepted: 23 Oct 2018
Abstract
Following the rapid increase of infections due to carbapenemase-producing Enterobacteriaceae (CPE) in Italy, the national surveillance of bloodstream infections (BSI) due to CPE (Klebsiella pneumoniae and Escherichia coli) was instituted in 2013. All CPE-BSI cases reported to the surveillance in the years 2014–17 were analysed in order to investigate incidence rate (IR), trend, main individual characteristics and enzymes involved in CPE resistance. Throughout this period, 7,632 CPE-BSI cases (IR: 3.14/100,000 inhabitants) were reported from all 21 regions and autonomous provinces in Italy, with an increasing number of reported cases (2014: 1,403; 2015: 1,838; 2016: 2,183; 2017: 2,208). CPE-BSI cases mainly occurred in subjects aged over 60 years (70.9%) and more frequently in males (62.7%) than in females. Most of the cases originated in hospitals (87.2%), mainly in intensive care units (38.0%), and were associated with central or peripheral venous catheter use (23.9%) or with urinary tract infections (21.1%). Almost all CPE-BSI (98.1%) were due to K. pneumoniae carrying the K. pneumoniae carbapenemase (KPC) enzyme (95.2%). These data show that carbapenemase-producing K. pneumoniae are endemic in our country, causing a high number of BSI and representing a threat to patient safety.
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Supplement S1
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