Epidemic diffusion of KPC carbapenemase-producing Klebsiella pneumoniae in Italy: results of the first countrywide survey, 15 May to 30 June 2011

T Giani; B Pini; F Arena; V Conte; S Bracco; R Migliavacca; Collective the AMCLI-CRE Survey Participants; A Pantosti; L Pagani; F Luzzaro; G M Rossolini

doi:10.2807/ese.18.22.20489-en

Surveillance and outbreak reports Open Access

Like 0

Download

Epidemic diffusion of KPC carbapenemase-producing Klebsiella pneumoniae in Italy: results of the first countrywide survey, 15 May to 30 June 2011
T Giani¹ , B Pini² , F Arena¹ , V Conte¹ , S Bracco² , R Migliavacca³ , Collective the AMCLI-CRE Survey Participants⁴ , A Pantosti⁵ , L Pagani³ , F Luzzaro² , G M Rossolini^1,6,7
View Affiliations Hide Affiliations

Affiliations: ¹ Department of Medical Biotechnologies, University of Siena, Siena, Italy ² Microbiology and Virology Unit, A. Manzoni Hospital, Lecco, Italy ³ Department of Clinical Surgical Diagnostic and Pediatric Sciences, Section of Microbiology, University of Pavia, Pavia, Italy ⁴ The AMCLI-CRE Survey Participants are listed at the end of this article ⁵ Department of Infectious, Parasitic and Immune-Mediated Diseases, Italian National Health Institute, Rome, Italy ⁶ Department of Experimental and Clinical Medicine, University of Florence, Italy ⁷ Clinical Microbiology and Virology Unit, Department of Laboratory Medicine, Careggi University Hospital, Florence, Italy

Correspondence:
G Rossolini
gianmaria.rossolini unisi.it
View Citation Hide Citation

Citation style for this article: Giani T, Pini B, Arena F, Conte V, Bracco S, Migliavacca R, the AMCLI-CRE Survey Participants Collective, Pantosti A, Pagani L, Luzzaro F, Rossolini G M. Epidemic diffusion of KPC carbapenemase-producing Klebsiella pneumoniae in Italy: results of the first countrywide survey, 15 May to 30 June 2011. Euro Surveill. 2013;18(22):pii=20489. https://doi.org/10.2807/ese.18.22.20489-en Received: 07 Sept 2012

Previous Article
Table of Contents
Next Article

Abstract

Carbapenem-resistant Enterobacteriaceae (CRE) are emerging as a public health problem in various settings. In Italy, a rapid and remarkable increase of carbapenem-non-susceptible Klebsiella pneumoniae has been reported since 2010. Here we report on the results of a countrywide cross-sectional survey, carried out from 15 May to 30June 2011 to investigate the diffusion of CRE in Italy and to characterise the most prevalent resistance mechanisms and their dissemination patterns. CRE were reported from most (23 of 25) participating laboratories, with an overall proportion of 3.5% and 0.3% among consecutive non-duplicate clinical isolates of Enterobacteriaceae from inpatients (n=7,154) and outpatients (n=6,595), respectively. K. pneumoniae was the most frequent species (proportion of carbapenem-non-susceptible isolates: 11.9%), while a minority of CRE of other species were detected. Carbapenemase production was detected in the majority (85%) of CRE. KPC-type enzymes were by far the most common (89.5% of carbapenemase producers), followed by VIM-1 (9.2%) and OXA-48 (1.3%). KPC-producing K. pneumoniae (KPC-KP) were detected in most centres and contributed majorly to the epidemic dissemination of CRE recently observed in our country. Dissemination of KPC-KP was mostly sustained by strains of clonal complex 258 (ST-258 producing KPC-2 or KPC-3, and ST-512 producing KPC-3), while a minority belonged to ST-101.