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Prolonged outbreak of New Delhi metallo-beta-lactamase-producing carbapenem-resistant Enterobacterales (NDM-CRE), Tuscany, Italy, 2018 to 2019
- Lara Tavoschi1 , Silvia Forni2 , Andrea Porretta1,5 , Lorenzo Righi3 , Filippo Pieralli4 , Francesco Menichetti5 , Marco Falcone5 , Giulia Gemignani5 , Spartaco Sani6 , Paola Vivani7 , Tommaso Bellandi8 , Danilo Tacconi9 , Lucia Turini10 , Giulio Toccafondi3 , Gaetano Privitera1,5 , Pierluigi Lopalco1,5 , Angelo Baggiani1,5 , Fabrizio Gemmi2 , Grazia Luchini5 , Maurizio Petrillo11 , Lorenzo Roti10 , Patrizio Pezzotti12 , Annalisa Pantosti12 , Stefania Iannazzo13 , Maria Teresa Mechi3 , Gian Maria Rossolini4,14 , on behalf of the Tuscan Clinical Microbiology Laboratory Network15
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View Affiliations Hide AffiliationsAffiliations: 1 Department of Translational Research and New technologies in Medicine and Surgery, University of Pisa, Pisa, Italy 2 Regional Health Agency of Tuscany, Florence, Italy 3 Quality of care and Clinical networks, Tuscany Region, Florence, Italy 4 Florence Careggi University Hospital, Florence, Italy 5 University Hospital of Pisa, Pisa, Italy 6 Livorno Hospital, Toscana North-West Health Authority, Livorno, Italy 7 Massa Carrara Hospital, Toscana North-West Health Authority, Massa Carrara, Italy 8 Toscana North-West Health Authority, Lucca, Italy 9 Arezzo Hospital, Toscana South-East Health Authority, Arezzo, Italy 10 Toscana North-West Health Authority, Pisa, Italy 11 Fondazione Toscana Gabriele Monasterio, Pisa, Italy 12 Istituto Superiore di Sanità, Rome, Italy 13 Ministry of Health, Rome, Italy 14 Department of Experimental Medicine, University of Florence, Florence, Italy 15 The members of the network are acknowledged at the end of the articleAndrea Porrettaandrea.porretta unipi.it
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Citation style for this article: Tavoschi Lara, Forni Silvia, Porretta Andrea, Righi Lorenzo, Pieralli Filippo, Menichetti Francesco, Falcone Marco, Gemignani Giulia, Sani Spartaco, Vivani Paola, Bellandi Tommaso, Tacconi Danilo, Turini Lucia, Toccafondi Giulio, Privitera Gaetano, Lopalco Pierluigi, Baggiani Angelo, Gemmi Fabrizio, Luchini Grazia, Petrillo Maurizio, Roti Lorenzo, Pezzotti Patrizio, Pantosti Annalisa, Iannazzo Stefania, Mechi Maria Teresa, Rossolini Gian Maria, on behalf of the Tuscan Clinical Microbiology Laboratory Network. Prolonged outbreak of New Delhi metallo-beta-lactamase-producing carbapenem-resistant Enterobacterales (NDM-CRE), Tuscany, Italy, 2018 to 2019. Euro Surveill. 2020;25(6):pii=2000085. https://doi.org/10.2807/1560-7917.ES.2020.25.6.2000085 Received: 03 Feb 2020; Accepted: 13 Feb 2020
Abstract
In Tuscany, Italy, New Delhi metallo-beta-lactamase-producing carbapenem-resistant Enterobacterales (NDM-CRE) have increased since November 2018. Between November 2018 and October 2019, 1,645 samples were NDM-CRE-positive: 1,270 (77.2%) cases of intestinal carriage, 129 (7.8%) bloodstream infections and 246 (14.9%) infections/colonisations at other sites. Klebsiella pneumoniae were prevalent (1,495; 90.9%), with ST147/NDM-1 the dominant clone. Delayed outbreak identification and response resulted in sustained NDM-CRE transmission in the North-West area of Tuscany, but successfully contained spread within the region.
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