1887
Surveillance Open Access
Like 0

Abstract

Introduction

In contrast to countries where carbapenemase-producing Enterobacterales (CPE) are endemic, only sporadic cases were reported in Switzerland until 2013. An aggravation of the epidemiological situation in neighbouring European countries indicated the need for a surveillance study in Switzerland.

Aim

We aimed to describe CPE distributions in Switzerland and identify epidemiological factors associated with changes in incidence.

Methods

Data on all human CPE isolates from 2013 to 2018 were collected by the Swiss Centre for Antibiotic Resistance (ANRESIS) and analysed for temporal and regional trends by Generalised Poisson regression. Isolates associated with infection or colonisation were included in a primary analysis; a secondary analysis included invasive isolates only. Statistical detection of regional clusters was performed with WHONET/SaTScan.

Results

We analysed 731 CPE isolates, of which 325 (44.5%) were associated with screenings and 173 (23.7%) with infections. Yearly detection of CPE isolates increased considerably during the study period from 65 to 212. The most frequently isolated species were (54%) and (28%). The most frequent genotypes were OXA-48 (43%), KPC (21%) and NDM (14%). In contrast to the French-speaking parts of Switzerland (West, Geneva) where OXA-48 were the predominant genotypes (around 60%), KPC was the most frequently detected genotype in the Italian-speaking region (63%). WHONET/SaTScan outbreak detection analysis identified seven clusters in five regions of Switzerland.

Conclusions

In a first continuous surveillance of CPE in Switzerland, we found that the epidemiological situation aggravated nationwide and that regional patterns of CPE genotypes mirrored the situation in neighbouring European countries.

Loading

Article metrics loading...

/content/10.2807/1560-7917.ES.2021.26.15.1900760
2021-04-15
2024-12-21
/content/10.2807/1560-7917.ES.2021.26.15.1900760
Loading
Loading full text...

Full text loading...

/deliver/fulltext/eurosurveillance/26/15/eurosurv-26-15-2.html?itemId=/content/10.2807/1560-7917.ES.2021.26.15.1900760&mimeType=html&fmt=ahah

References

  1. Xu M, Fu Y, Kong H, Chen X, Chen Y, Li L, et al. Bloodstream infections caused by Klebsiella pneumoniae: prevalence of blaKPC, virulence factors and their impacts on clinical outcome. BMC Infect Dis. 2018;18(1):358.  https://doi.org/10.1186/s12879-018-3263-x  PMID: 30064360 
  2. Xu L, Sun X, Ma X. Systematic review and meta-analysis of mortality of patients infected with carbapenem-resistant Klebsiella pneumoniae. Ann Clin Microbiol Antimicrob. 2017;16(1):18.  https://doi.org/10.1186/s12941-017-0191-3  PMID: 28356109 
  3. Wilson H, Török ME. Extended-spectrum β-lactamase-producing and carbapenemase-producing Enterobacteriaceae. Microb Genom. 2018;4(7):e000197.  https://doi.org/10.1099/mgen.0.000197  PMID: 30035710 
  4. Hardiman CA, Weingarten RA, Conlan S, Khil P, Dekker JP, Mathers AJ, et al. Horizontal transfer of carbapenemase-encoding plasmids and comparison with hospital epidemiology data. Antimicrob Agents Chemother. 2016;60(8):4910-9.  https://doi.org/10.1128/AAC.00014-16  PMID: 27270289 
  5. Nordmann P, Dortet L, Poirel L. Carbapenem resistance in Enterobacteriaceae: here is the storm! Trends Mol Med. 2012;18(5):263-72.  https://doi.org/10.1016/j.molmed.2012.03.003  PMID: 22480775 
  6. Queenan AM, Bush K. Carbapenemases: the versatile beta-lactamases. Clin Microbiol Rev. 2007;20(3):440-58.  https://doi.org/10.1128/CMR.00001-07  PMID: 17630334 
  7. Brolund A, Lagerqvist N, Byfors S, Struelens MJ, Monnet DL, Albiger B, et al. Worsening epidemiological situation of carbapenemase-producing Enterobacteriaceae in Europe, assessment by national experts from 37 countries, July 2018. Euro Surveill. 2019;24(9):1900123.  https://doi.org/10.2807/1560-7917.ES.2019.24.9.1900123  PMID: 30862330 
  8. Albiger B, Glasner C, Struelens MJ, Grundmann H, Monnet DL, European Survey of Carbapenemase-Producing Enterobacteriaceae (EuSCAPE) working group. Carbapenemase-producing Enterobacteriaceae in Europe: assessment by national experts from 38 countries, May 2015. Euro Surveill. 2015;20(45):30062.  https://doi.org/10.2807/1560-7917.ES.2015.20.45.30062  PMID: 26675038 
  9. Dortet L, Cuzon G, Ponties V, Nordmann P. Trends in carbapenemase-producing Enterobacteriaceae, France, 2012 to 2014. Euro Surveill. 2017;22(6):30461.  https://doi.org/10.2807/1560-7917.ES.2017.22.6.30461  PMID: 28205502 
  10. Poirel L, Schrenzel J, Cherkaoui A, Bernabeu S, Renzi G, Nordmann P. Molecular analysis of NDM-1-producing enterobacterial isolates from Geneva, Switzerland. J Antimicrob Chemother. 2011;66(8):1730-3.  https://doi.org/10.1093/jac/dkr174  PMID: 21628303 
  11. Poirel L, Lienhard R, Potron A, Malinverni R, Siegrist HH, Nordmann P. Plasmid-mediated carbapenem-hydrolysing β-lactamase KPC-2 in a Klebsiella pneumoniae isolate from Switzerland. J Antimicrob Chemother. 2011;66(3):675-6.  https://doi.org/10.1093/jac/dkq499  PMID: 21193473 
  12. Poirel L, Potron A, Nordmann P. OXA-48-like carbapenemases: the phantom menace. J Antimicrob Chemother. 2012;67(7):1597-606.  https://doi.org/10.1093/jac/dks121  PMID: 22499996 
  13. Glasner C, Albiger B, Buist G, Tambić Andrasević A, Canton R, Carmeli Y, et al. Carbapenemase-producing Enterobacteriaceae in Europe: a survey among national experts from 39 countries, February 2013. Euro Surveill. 2013;18(28):20525.  https://doi.org/10.2807/1560-7917.ES2013.18.28.20525  PMID: 23870096 
  14. Ruppé E, Olearo F, Pires D, Baud D, Renzi G, Cherkaoui A, et al. Clonal or not clonal? Investigating hospital outbreaks of KPC-producing Klebsiella pneumoniae with whole-genome sequencing. Clin Microbiol Infect. 2017;23(7):470-5.  https://doi.org/10.1016/j.cmi.2017.01.015  PMID: 28143787 
  15. Lemmenmeier E, Kohler P, Bruderer T, Goldenberger D, Kleger GR, Schlegel M. First documented outbreak of KPC-2-producing Klebsiella pneumoniae in Switzerland: infection control measures and clinical management. Infection. 2014;42(3):529-34.  https://doi.org/10.1007/s15010-013-0578-9  PMID: 24477886 
  16. Mueller L, Ottiger C, Demord A, Poirel L, Nordmann P. Multiple colonization with carbapenem-resistant Gram-negative bacteria acquired in India and transferred to Switzerland. Infection. 2019;47(4):669-71.  https://doi.org/10.1007/s15010-019-01307-4  PMID: 30972715 
  17. Olearo F, Pires D, Camus V, Harbart S. Carbapenemase-produzierende Enterobakterien (CPE): Strategien zur Überwachung und Betreuung von Patienten mit CPE. [Carbapenemase-producing Enterobacteria (CPE): Strategies for monitoring and care of patients with CPE]. Zurich: Swissnoso Bulletin. 2017/05. German. Available from: https://www.swissnoso.ch/fileadmin/swissnoso/Dokumente/6_Publikationen/Bulletin_Artikel_D/170606_Olearoetal_DE.pdf
  18. Cameron AC, Trivedi PK. Microeconometrics using stata. College Station, Texas: Stata Press; 2009. https://doi.org/10.1111/1475-4932.12006
  19. R Core Team. R: A language and environment for statistical computing. Vienna: R Foundation for Statistical Computing; 2019. Available from: https://www.R-project.org
  20. Kulldorff M, Heffernan R, Hartman J, Assunção R, Mostashari F. A space-time permutation scan statistic for disease outbreak detection. PLoS Med. 2005;2(3):e59.  https://doi.org/10.1371/journal.pmed.0020059  PMID: 15719066 
  21. Grundmann H, Glasner C, Albiger B, Aanensen DM, Tomlinson CT, Andrasević AT, et al. Occurrence of carbapenemase-producing Klebsiella pneumoniae and Escherichia coli in the European survey of carbapenemase-producing Enterobacteriaceae (EuSCAPE): a prospective, multinational study. Lancet Infect Dis. 2017;17(2):153-63.  https://doi.org/10.1016/S1473-3099(16)30257-2  PMID: 27866944 
  22. Lee CR, Lee JH, Park KS, Kim YB, Jeong BC, Lee SH. Global dissemination of carbapenemase-producing Klebsiella pneumoniae: epidemiology, genetic context, treatment options, and detection methods. Front Microbiol. 2016;7:895.  https://doi.org/10.3389/fmicb.2016.00895  PMID: 27379038 
  23. Berrazeg M, Diene S, Medjahed L, Parola P, Drissi M, Raoult D, et al. New Delhi Metallo-beta-lactamase around the world: an eReview using Google Maps. Euro Surveill. 2014;19(20):20809.  https://doi.org/10.2807/1560-7917.ES2014.19.20.20809  PMID: 24871756 
  24. Egli A, Blanc DS, Greub G, Keller PM, Lazarevic V, Lebrand A, et al. Improving the quality and workflow of bacterial genome sequencing and analysis: paving the way for a Switzerland-wide molecular epidemiological surveillance platform. Swiss Med Wkly. 2018;148:w14693.  https://doi.org/10.4414/smw.2018.14693  PMID: 30552858 
/content/10.2807/1560-7917.ES.2021.26.15.1900760
Loading

Data & Media loading...

Supplementary data

Submit comment
Close
Comment moderation successfully completed
This is a required field
Please enter a valid email address
Approval was a Success
Invalid data
An Error Occurred
Approval was partially successful, following selected items could not be processed due to error