1887
Surveillance and outbreak report Open Access
Like 0

Abstract

Carbapenemase-producing (CPE) strains have been increasingly reported in Belgium. We aimed to determine the proportion of CPE among isolated from hospitalised patients and community outpatients in Belgium in 2015. For the hospitalised patients, the results were compared to a previous similar survey performed in the same hospitals in 2012. Twenty-four hospital-based and 10 private laboratories collected prospectively 200 non-duplicated isolates from clinical specimens. All isolates were screened locally by carbapenem disk diffusion using European Committee on Antimicrobial Susceptibility Testing methodology. Putative CPE strains with inhibition zone diameters below the screening breakpoints were referred centrally for confirmation of carbapenemase production. From September to November 2015, we found a proportion of clinical CPE of 0.55% (26/4,705) and of 0.60% (12/1,991) among hospitalised patients and among ambulatory outpatients respectively. (26/38) and OXA-48-like carbapenemase (28/38) were the predominant species and enzyme among CPE. One OXA-48-producing isolated from a hospital was found carrying plasmid-mediated MCR-1 colistin resistance. Compared with the 2012 survey, we found a significant increased proportion of clinical CPE (0.55% in 2015 vs 0.25% in 2012; p = 0.02) and an increased proportion of hospitals (13/24 in 2015 vs 8/24 in 2012) with at least one CPE detected. The study results confirmed the concerning spread of CPE including a colistin-resistant MCR-1 producer in hospitals and the establishment of CPE in the community in Belgium.

Loading

Article metrics loading...

/content/10.2807/1560-7917.ES.2017.22.19.30530
2017-05-11
2024-04-23
http://instance.metastore.ingenta.com/content/10.2807/1560-7917.ES.2017.22.19.30530
Loading
Loading full text...

Full text loading...

/deliver/fulltext/eurosurveillance/22/19/eurosurv-22-19-3.html?itemId=/content/10.2807/1560-7917.ES.2017.22.19.30530&mimeType=html&fmt=ahah

References

  1. Nordmann P, Naas T, Poirel L. Global spread of Carbapenemase-producing Enterobacteriaceae. Emerg Infect Dis. 2011;17(10):1791-8.  https://doi.org/10.3201/eid1710.110655  PMID: 22000347 
  2. Nordmann P, Cornaglia G. Carbapenemase-producing Enterobacteriaceae: a call for action! Clin Microbiol Infect. 2012;18(5):411-2.  https://doi.org/10.1111/j.1469-0691.2012.03795.x  PMID: 22507108 
  3. Cantón R, Akóva M, Carmeli Y, Giske CG, Glupczynski Y, Gniadkowski M, et al. , European Network on Carbapenemases. Rapid evolution and spread of carbapenemases among Enterobacteriaceae in Europe. Clin Microbiol Infect. 2012;18(5):413-31.  https://doi.org/10.1111/j.1469-0691.2012.03821.x  PMID: 22507109 
  4. Oteo J, Ortega A, Bartolomé R, Bou G, Conejo C, Fernández-Martínez M, et al. , GEIH-GEMARA (SEIMC) and REIPI. Prospective multicenter study of carbapenemase-producing Enterobacteriaceae from 83 hospitals in Spain reveals high in vitro susceptibility to colistin and meropenem. Antimicrob Agents Chemother. 2015;59(6):3406-12.  https://doi.org/10.1128/AAC.00086-15  PMID: 25824224 
  5. 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.ES2013.18.28.20525  PMID: 23870096 
  6. Huang TD, Berhin C, Bogaerts P, Glupczynski Y, multicentre study group. Prevalence and mechanisms of resistance to carbapenems in Enterobacteriaceae isolates from 24 hospitals in Belgium. J Antimicrob Chemother. 2013;68(8):1832-7.  https://doi.org/10.1093/jac/dkt096  PMID: 23557926 
  7. Clinical and Laboratory Standards Institute (CLSI). Performance standards for antimicrobial susceptibility testing: Twenty-Second Informational Supplement M100-S22. Wayne, PA: CLSI; 2012.
  8. Huang TD, Bogaerts P, Berhin C, Jans B, Denis O, Glupczynski Y, editors. National survey data of carbapenemase-producing Enterobacteriaceae in Belgium. In: Abstracts of the 25th European Congress of Clinical Microbiology and Infectious Diseases, Copenhagen; 2015. Abstract no O374.
  9. European Society of Clinical Microbiology and Infectious Diseases. Clinical breakpoints version 5.0. In European Committee on Antimicrobial Susceptibility Testing. Växjö: EUCAST; 2015. Available from: http://www.eucast.org
  10. European Society of Clinical Microbiology and Infectious Diseases. EUCAST guidelines for detection of resistance mechanisms and specific resistances of clinical and/or epidemiological importance. Version 1.0. Växjö: EUCAST; 2013. Available from: http://www.eucast.org
  11. Bogaerts P, Yunus S, Massart M, Huang TD, Glupczynski Y. Evaluation of the BYG Carba Test, a New Electrochemical Assay for Rapid Laboratory Detection of Carbapenemase-Producing Enterobacteriaceae. J Clin Microbiol. 2016;54(2):349-58.  https://doi.org/10.1128/JCM.02404-15  PMID: 26637378 
  12. Bogaerts P, Rezende de Castro R, de Mendonça R, Huang TD, Denis O, Glupczynski Y. Validation of carbapenemase and extended-spectrum β-lactamase multiplex endpoint PCR assays according to ISO 15189. J Antimicrob Chemother. 2013;68(7):1576-82.  https://doi.org/10.1093/jac/dkt065  PMID: 23508620 
  13. Lahey clinic. ß-Lactamase Classification and Amino Acid Sequences for TEM, SHV and OXA Extended-Spectrum and Inhibitor Resistant Enzymes. Available from: http://www.lahey.org/Studies/
  14. Fuchs PC, Barry AL, Thornsberry C, Jones RN. Interpretive criteria for temocillin disk diffusion susceptibility testing. Eur J Clin Microbiol. 1985;4(1):30-3.  https://doi.org/10.1007/BF02148656  PMID: 3872793 
  15. Liu YY, Wang Y, Walsh TR, Yi LX, Zhang R, Spencer J, et al. Emergence of plasmid-mediated colistin resistance mechanism MCR-1 in animals and human beings in China: a microbiological and molecular biological study. Lancet Infect Dis. 2016;16(2):161-8.  https://doi.org/10.1016/S1473-3099(15)00424-7  PMID: 26603172 
  16. Deplano A, Denis O, Rodriguez-Villalobos H, De Ryck R, Struelens MJ, Hallin M. Controlled performance evaluation of the DiversiLab repetitive-sequence-based genotyping system for typing multidrug-resistant health care-associated bacterial pathogens. J Clin Microbiol. 2011;49(10):3616-20.  https://doi.org/10.1128/JCM.00528-11  PMID: 21813717 
  17. Jans B, D Huang TD, Bauraing C, Berhin C, Bogaerts P, Deplano A, et al. Infection due to travel-related carbapenemase-producing Enterobacteriaceae, a largely underestimated phenomenon in Belgium. Acta Clin Belg. 2015;70(3):181-7.  https://doi.org/10.1179/2295333715Y.0000000001  PMID: 25825036 
  18. Parisi SG, Bartolini A, Santacatterina E, Castellani E, Ghirardo R, Berto A, et al. Prevalence of Klebsiella pneumoniae strains producing carbapenemases and increase of resistance to colistin in an Italian teaching hospital from January 2012 To December 2014. BMC Infect Dis. 2015;15(1):244.  https://doi.org/10.1186/s12879-015-0996-7  PMID: 26116560 
  19. Huang TD, Bogaerts P, Berhin C, Boucharhouf W, Glupczynski Y, editors. Susceptibility data of Enterobacteriaceae isolates referred to the national reference center in Belgium. In: Abstracts of the 35th Réunion Interdisciplinaire de Chimiothérapie Anti-Infectieuse, Paris; 2015. Abstract no O113.
  20. Poirel L, Kieffer N, Liassine N, Thanh D, Nordmann P. Plasmid-mediated carbapenem and colistin resistance in a clinical isolate of Escherichia coli. Lancet Infect Dis. 2016;16(3):281.  https://doi.org/10.1016/S1473-3099(16)00006-2  PMID: 26774246 
  21. Skov RL, Monnet DL. Plasmid-mediated colistin resistance (mcr-1 gene): three months later, the story unfolds. Euro Surveill. 2016;21(9):30155.  https://doi.org/10.2807/1560-7917.ES.2016.21.9.30155  PMID: 26967914 
  22. Yao X, Doi Y, Zeng L, Lv L, Liu JH. Carbapenem-resistant and colistin-resistant Escherichia coli co-producing NDM-9 and MCR-1. Lancet Infect Dis. 2016;16(3):288-9.  https://doi.org/10.1016/S1473-3099(16)00057-8  PMID: 26842777 
  23. Miró E, Agüero J, Larrosa MN, Fernández A, Conejo MC, Bou G, et al. Prevalence and molecular epidemiology of acquired AmpC β-lactamases and carbapenemases in Enterobacteriaceae isolates from 35 hospitals in Spain. Eur J Clin Microbiol Infect Dis. 2013;32(2):253-9. PMID: 22956023 
  24. Ruppé E, Armand-Lefèvre L, Estellat C, Consigny PH, El Mniai A, Boussadia Y, et al. High Rate of Acquisition but Short Duration of Carriage of Multidrug-Resistant Enterobacteriaceae After Travel to the Tropics. Clin Infect Dis. 2015;61(4):593-600.  https://doi.org/10.1093/cid/civ333  PMID: 25904368 
  25. Voulgari E, Poulou A, Dimitroulia E, Politi L, Ranellou K, Gennimata V, et al. Emergence of OXA-162 Carbapenemase- and DHA-1 AmpC Cephalosporinase-Producing Sequence Type 11 Klebsiella pneumoniae Causing Community-Onset Infection in Greece. Antimicrob Agents Chemother. 2015;60(3):1862-4.  https://doi.org/10.1128/AAC.01514-15  PMID: 26666930 
  26. Zurfluh K, Nüesch-Inderbinen MT, Poirel L, Nordmann P, Hächler H, Stephan R. Emergence of Escherichia coli producing OXA-48 β-lactamase in the community in Switzerland. Antimicrob Resist Infect Control. 2015;4(1):9.  https://doi.org/10.1186/s13756-015-0051-x  PMID: 25834728 
  27. Yusuf E, Huang TD, Schallier A, Trémérie JM, Mertens R, Jans B, et al. OXA-48 Producing Klebsiella pneumoniae in a Household Contact of a Previously Infected Patient: Person-to-Person Transmission or Coincidental Community Acquisition? Microb Drug Resist. 2016;22(2):134-6.  https://doi.org/10.1089/mdr.2015.0179  PMID: 26954370 
/content/10.2807/1560-7917.ES.2017.22.19.30530
Loading

Data & Media loading...

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