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Abstract

We report the findings of an active surveillance scheme for detection of asymptomatic carriers with carbapenemase-producing Gram-negative bacteria (CP-GNB) in Romanian hospitals. During a pilot study from December 2014 to May 2015, faecal cultures were screened in three hospitals (two large, one medium-size) for patients newly admitted to selected wards or inpatients transferred from other wards to an intensive-care unit. The study revealed a high prevalence of CP-GNB detected in 22/27 and 28/38 of the carbapenem non-susceptible isolates from Hospitals 1 and 3, respectively. CP-GNB identified through faecal screening included NDM-1-producing and , OXA-48-producing and OXA-23-producing The distribution of the CP-GNB varied between the hospitals, with NDM-1-producing and being prevalent in the north-central part of the country and OXA-23/24-producing , OXA-48-producing and VIM-2-producing / detected in the north-east of the country. Conjugation studies showed that carbapenem resistance was transferable and PCR-based replicon typing identified on IncFIIs in and from Hospital 1 and on IncL plasmids in all spp. isolates from Hospitals 1 and 3. Our findings underline the importance of active surveillance for detection of CP-GNB asymptomatic faecal carriers and suggest a likely endemic spread of CP-GNB in Romania.

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/content/10.2807/1560-7917.ES.2016.21.25.30262
2016-06-23
2019-06-19
http://instance.metastore.ingenta.com/content/10.2807/1560-7917.ES.2016.21.25.30262
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References

  1. Bakour S, Olaitan AO, Ammari H, Touati A, Saoudi S, Saoudi K, et al. Emergence of Colistin- and Carbapenem-Resistant Acinetobacter baumannii ST2 Clinical Isolate in Algeria: First Case Report. Microb Drug Resist. 2015;21(3):279-85.  https://doi.org/10.1089/mdr.2014.0214  PMID: 25588125 
  2. Glasner C, Albiger B, Buist G, Tambić Andrasević A, Canton R, Carmeli Y, et al. European Survey on Carbapenemase-Producing Enterobacteriaceae (EuSCAPE) Working Group. 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 
  3. European Centre for Disease Prevention and Control (ECDC). Antimicrobial resistance surveillance in Europe 2012. Annual report of the European Antimicrobial Resistance Surveillance Network (EARS-Net). Stockholm: ECDC; 2013. Available from: http://ecdc.europa.eu/en/publications/Publications/antimicrobial-resistance-surveillance-europe-2012.pdf
  4. European Committee on Antimicrobial Susceptibility Testing (EUCAST). Guidelines for detection of resistance mechanisms and specific resistances of clinical and/or epidemiological importance. Version 1.0. EUCAST. [Accessed 19 Jan 2016]. Available from: http://www.eucast.org/fileadmin/src/media/PDFs/EUCAST_files/Resistance_mechanisms/EUCAST_detection_of_resistance_mechanisms_v1.0_20131211.pdf
  5. Dallenne C, Da Costa A, Decré D, Favier C, Arlet G. Development of a set of multiplex PCR assays for the detection of genes encoding important beta-lactamases in Enterobacteriaceae. J Antimicrob Chemother. 2010;65(3):490-5.  https://doi.org/10.1093/jac/dkp498  PMID: 20071363 
  6. Corvec S, Caroff N, Espaze E, Giraudeau C, Drugeon H, Reynaud A. AmpC cephalosporinase hyperproduction in Acinetobacter baumannii clinical strains. J Antimicrob Chemother. 2003;52(4):629-35.  https://doi.org/10.1093/jac/dkg407  PMID: 12951337 
  7. Nordmann P, Poirel L, Carrër A, Toleman MA, Walsh TR. How to detect NDM-1 producers. J Clin Microbiol. 2011;49(2):718-21.  https://doi.org/10.1128/JCM.01773-10  PMID: 21123531 
  8. Woodford N, Ellington MJ, Coelho JM, Turton JF, Ward ME, Brown S, et al. Multiplex PCR for genes encoding prevalent OXA carbapenemases in Acinetobacter spp. Int J Antimicrob Agents. 2006;27(4):351-3.  https://doi.org/10.1016/j.ijantimicag.2006.01.004  PMID: 16564159 
  9. Antunes NT, Lamoureaux TL, Toth M, Stewart NK, Frase H, Vakulenko SB. Class D β-lactamases: are they all carbapenemases? Antimicrob Agents Chemother. 2014;58(4):2119-25.  https://doi.org/10.1128/AAC.02522-13  PMID: 24468778 
  10. European Committee on Antimicrobial Susceptibility Testing (EUCAST). Breakpoint tables for interpretation of MICs and zone diameters. Version 5.0, 2015. EUCAST; 2015. Available from: http://www.eucast.org/fileadmin/src/media/PDFs/EUCAST_files/Breakpoint_tables/v_5.0_Breakpoint_Table_01.pdf
  11. Clinical and Laboratory Standard Institute (CLSI). Performance standards for antimicrobial susceptibility testing. Twenty-first informational supplement. M100-S21. Vol. 31 No. 1. CLSI;2011.
  12. Oliver A, Weigel LM, Rasheed JK, McGowan JE Jr, Raney P, Tenover FC. Mechanisms of decreased susceptibility to cefpodoxime in Escherichia coli. Antimicrob Agents Chemother. 2002;46(12):3829-36.  https://doi.org/10.1128/AAC.46.12.3829-3836.2002  PMID: 12435684 
  13. McDaniels AE, Rice EW, Reyes AL, Johnson CH, Haugland RA, Stelma GN. Confirmational identification of Escherichia coli, a comparison of genotypic and phenotypic assays for glutamate decarboxylase and beta-D-glucuronidase. Appl Environ Microbiol. 1998;64(10):4113. PMID: 16349569 
  14. Carattoli A, Bertini A, Villa L, Falbo V, Hopkins KL, Threlfall EJ. Identification of plasmids by PCR-based replicon typing. J Microbiol Methods. 2005;63(3):219-28.  https://doi.org/10.1016/j.mimet.2005.03.018  PMID: 15935499 
  15. Carattoli A, Seiffert SN, Schwendener S, Perreten V, Endimiani A. Differentiation of IncL and IncM Plasmids Associated with the Spread of Clinically Relevant Antimicrobial Resistance. PLoS One. 2015;10(5):e0123063.  https://doi.org/10.1371/journal.pone.0123063  PMID: 25933288 
  16. Livermore DM, Walsh TR, Toleman M, Woodford N. Balkan NDM-1: escape or transplant? Lancet Infect Dis. 2011;11(3):164.  https://doi.org/10.1016/S1473-3099(11)70048-2  PMID: 21371654 
  17. Gruber TM, Göttig S, Mark L, Christ S, Kempf VAJ, Wichelhaus TA, et al. Pathogenicity of pan-drug-resistant Serratia marcescens harbouring blaNDM-1. J Antimicrob Chemother. 2015;70(4):1026-30. PMID: 25468904 
  18. Voelz A, Müller A, Gillen J, Le C, Dresbach T, Engelhart S, et al. Outbreaks of Serratia marcescens in neonatal and pediatric intensive care units: clinical aspects, risk factors and management. Int J Hyg Environ Health. 2010;213(2):79-87.  https://doi.org/10.1016/j.ijheh.2009.09.003  PMID: 19783209 
  19. Yoon HJ, Choi JY, Park YS, Kim CO, Kim JM, Yong DE, et al. Outbreaks of Serratia marcescens bacteriuria in a neurosurgical intensive care unit of a tertiary care teaching hospital: a clinical, epidemiologic, and laboratory perspective. Am J Infect Control. 2005;33(10):595-601.  https://doi.org/10.1016/j.ajic.2005.01.010  PMID: 16330308 
  20. Poirel L, Bonnin RA, Nordmann P. Genetic features of the widespread plasmid coding for the carbapenemase OXA-48. Antimicrob Agents Chemother. 2012;56(1):559-62.  https://doi.org/10.1128/AAC.05289-11  PMID: 22083465 
  21. Kaase M, Pfennigwerth N, Lange F, Anders A, Gatermann SG. Molecular epidemiology of VIM-1 producing Escherichia coli from Germany referred to the National Reference Laboratory. Int J Med Microbiol. 2015;305(7):784-9.  https://doi.org/10.1016/j.ijmm.2015.08.032  PMID: 26321009 
  22. Jamal WY, Albert MJ, Khodakhast F, Poirel L, Rotimi VO. Emergence of New Sequence Type OXA-48 Carbapenemase-Producing Enterobacteriaceae in Kuwait. Microb Drug Resist. 2015;21(3):329-34.  https://doi.org/10.1089/mdr.2014.0123  PMID: 25551428 
  23. Hammoudi D, Ayoub Moubareck C, Aires J, Adaime A, Barakat A, Fayad N, et al. Countrywide spread of OXA-48 carbapenemase in Lebanon: surveillance and genetic characterization of carbapenem-non-susceptible Enterobacteriaceae in 10 hospitals over a one-year period. Int J Infect Dis. 2014;29:139-44.  https://doi.org/10.1016/j.ijid.2014.07.017  PMID: 25449248 
  24. Towner KJ. Acinetobacter: an old friend, but a new enemy. J Hosp Infect. 2009;73(4):355-63.  https://doi.org/10.1016/j.jhin.2009.03.032  PMID: 19700220 
  25. Deshpande LM, Flonta M, Jones RN, Castanheira M. Detection of NDM-1-producing Enterobacteriaceae in Romania: report of the SENTRY Antimicrobial Surveillance Program. J Med Microbiol. 2014;63(Pt 3):483-4.  https://doi.org/10.1099/jmm.0.070334-0  PMID: 24346066 
  26. Gheorghe I, Novais Â, Grosso F, Rodrigues C, Chifiriuc MC, Lazar V, et al. Snapshot on carbapenemase-producing Pseudomonas aeruginosa and Acinetobacter baumannii in Bucharest hospitals reveals unusual clones and novel genetic surroundings for blaOXA-23. J Antimicrob Chemother. 2015;70(4):1016-20. PMID: 25630639 
  27. Székely E, Damjanova I, Jánvári L, Vas KE, Molnár S, Bilca DV, et al. First description of bla(NDM-1), bla(OXA-48), bla(OXA-181) producing Enterobacteriaceae strains in Romania. Int J Med Microbiol. 2013;303(8):697-700.  https://doi.org/10.1016/j.ijmm.2013.10.001  PMID: 24183483 
  28. Bonnin RA, Poirel L, Licker M, Nordmann P. Genetic diversity of carbapenem-hydrolysing β-lactamases in Acinetobacter baumannii from Romanian hospitals. Clin Microbiol Infect. 2011;17(10):1524-8.  https://doi.org/10.1111/j.1469-0691.2011.03622.x  PMID: 21883667 
  29. Mereuta AI, Badescu AC, Domeanu OS, Iancu LS, Tuchilus CG. Spread of VIM-2 metallo-beta-lactamase in Pseudomonas aeruginosa and Acinetobacter baumannii clinical isolates from Iasi, Romania. Rev Rom De Med De Laborator.2013;21(4):423-30. Available from: https://www.degruyter.com/dg/viewarticle.fullcontentlink:pdfeventlink/$002fj$002frrlm.2013.21.issue-4$002frrlm-2013-0035$002frrlm-2013-0035.pdf/rrlm-2013-0035.pdf?t:ac=j$002frrlm.2013.21.issue-4$002frrlm-2013-0035$002frrlm-2013-0035.xml
  30. Albiger B, Glasner C, Struelens MJ, Grundmann H, Monnet DLEuropean 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 
Active surveillance scheme in three Romanian hospitals reveals a high prevalence and variety of carbapenamase-producing Gram-negative bacteria: a pilot study, December 2014 to May 2015
<p class="citation"> <span>Citation style for this article:</span> <span class="meta-value authors"> <a href="/search?value1=Dorina+Timofte&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Timofte Dorina</a>, <a href="/search?value1=Carmen+Valentina+Panzaru&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Panzaru Carmen Valentina</a>, <a href="/search?value1=Iuliana+Elena+Maciuca&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Maciuca Iuliana Elena</a>, <a href="/search?value1=Maria+Dan&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Dan Maria</a>, <a href="/search?value1=Anca+Delia+Mare&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Mare Anca Delia</a>, <a href="/search?value1=Adrian+Man&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Man Adrian</a>, <a href="/search?value1=Felicia+Toma&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Toma Felicia</a></span>. Active surveillance scheme in three Romanian hospitals reveals a high prevalence and variety of carbapenamase-producing Gram-negative bacteria: a pilot study, December 2014 to May 2015. <a href="/content/ecdc">Euro Surveill.</a> 2016;21(25):pii=30262. <a href="https://doi.org/10.2807/1560-7917.ES.2016.21.25.30262" title="doi link" target="_blank">https://doi.org/10.2807/1560-7917.ES.2016.21.25.30262</a> <span class="ES_Article_citation"> <span class="generated">Received</span>: 30 Sep 2015;&nbsp;&nbsp; <span class="generated">Accepted</span>: 12 Feb 2016 </span> </p>
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