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In 2014, a total of 2,976 Enterobacteriaceae isolates with decreased susceptibility to carbapenems were received at the French Associated National Reference Center for Antibiotic Resistance (NRC) and were characterised for their molecular resistance mechanism to carbapenems and compared with results obtained during 2012 and 2013.The overall number of enterobacterial isolates with decreased susceptibility to carbapenems received at the NRC rapidly increased (more than twofold in two years) with a growing proportion of carbapenemase producers (23.1% in 2012 vs 28.6% in 2013 vs 36.2% in 2014). Between 2012 and 2014, the main carbapenemase type was OXA-48, with an increase in OXA-48 variants (mostly OXA-181) and NDM producers, whereas the number KPC producers decreased. We identified a potential spread of OXA-181 producers in the tropical region of Africa. Finally, OXA-48 and OXA-48-related enzymes remained the predominant carbapenemases in France. The number of carbapenemase-producing isolates was multiplied by fivefold between 2012 and 2014, suggesting a possible dissemination in the community.


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  1. 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 
  2. Potron A, Poirel L, Nordmann P. Emerging broad-spectrum resistance in Pseudomonas aeruginosa and Acinetobacter baumannii: Mechanisms and epidemiology. Int J Antimicrob Agents. 2015;45(6):568-85.  https://doi.org/10.1016/j.ijantimicag.2015.03.001  PMID: 25857949 
  3. Pitout JD, Nordmann P, Poirel L. Carbapenemase-producing Klebsiella pneumoniae, a key pathogen set for global nosocomial dominance. Antimicrob Agents Chemother. 2015;59(10):5873-84.  https://doi.org/10.1128/AAC.01019-15  PMID: 26169401 
  4. Dortet L, Poirel L and Nordmann P. Worldwide dissemination of the NDM-type carbapenemases in Gram-negative bacteria. Biomed Res Int. 2014: 249856.
  5. 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 
  6. 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 
  7. Nordmann P, Poirel L. The difficult-to-control spread of carbapenemase producers among Enterobacteriaceae worldwide. Clin Microbiol Infect. 2014;20(9):821-30.  https://doi.org/10.1111/1469-0691.12719  PMID: 24930781 
  8. Dortet L, Cuzon G, Plésiat P, Naas T. Prospective evaluation of an algorithm for the phenotypic screening of carbapenemase-producing Enterobacteriaceae. J Antimicrob Chemother. 2016;71(1):135-40.  https://doi.org/10.1093/jac/dkv308  PMID: 26462984 
  9. Société Française de Microbiologie (SFM). Comité de l'Antibiogramme de la Société Française de Microbiologie. Recommendations 2015. [2015 Recommendations]. Paris: SFM. 2015. French. Available from http://www.sfm-microbiologie.org/UserFiles/files/casfm/CASFM_EUCAST_V1_2015.pdf
  10. Dortet L, Bréchard L, Poirel L, Nordmann P. Impact of the isolation medium for detection of carbapenemase-producing Enterobacteriaceae using an updated version of the Carba NP test. J Med Microbiol. 2014;63(Pt 5):772-6.  https://doi.org/10.1099/jmm.0.071340-0  PMID: 24591705 
  11. Dortet L, Bréchard L, Cuzon G, Poirel L, Nordmann P. Strategy for rapid detection of carbapenemase-producing Enterobacteriaceae. Antimicrob Agents Chemother. 2014;58(4):2441-5.  https://doi.org/10.1128/AAC.01239-13  PMID: 24468779 
  12. Dortet L, Cuzon G, Nordmann P. Dissemination of carbapenemase-producing Enterobacteriaceae in France, 2012. J Antimicrob Chemother. 2014;69(3):623-7.  https://doi.org/10.1093/jac/dkt433  PMID: 24275115 
  13. The European Committee on Antimicrobial Susceptibility Testing (EUCAST). Breakpoint tables for interpretation of MICs and zone diameters. Version 7.0, valid from 2017-01-01. Växjö: EUCAST. [Accessed 3 Feb 2017]. Available from: http://www.eucast.org/fileadmin/src/media/PDFs/EUCAST_files/Breakpoint_tables/v_7.0_Breakpoint_Tables.pdf
  14. Dortet L, Oueslati S, Jeannot K, Tandé D, Naas T, Nordmann P. Genetic and biochemical characterization of OXA-405, an OXA-48-type extended-spectrum β-lactamase without significant carbapenemase activity. Antimicrob Agents Chemother. 2015;59(7):3823-8.  https://doi.org/10.1128/AAC.05058-14  PMID: 25870062 
  15. Potron A, Poirel L, Nordmann P. Derepressed transfer properties leading to the efficient spread of the plasmid encoding carbapenemase OXA-48. Antimicrob Agents Chemother. 2014;58(1):467-71.  https://doi.org/10.1128/AAC.01344-13  PMID: 24189247 
  16. Fournier S, Monteil C, Lepainteur M, Richard C, Brun-Buisson C, Jarlier V, et al. Long-term control of carbapenemase-producing Enterobacteriaceae at the scale of a large French multihospital institution: a nine-year experience, France, 2004 to 2012. Euro Surveill. 2014;19(19):20802.  https://doi.org/10.2807/1560-7917.ES2014.19.19.20802  PMID: 24852956 
  17. Santé Publique France. Enterobacteries-productrices-de-carbapenemases-EPC. [Carbapenemase-producing Enterobacteriaceae]. Paris: Santé Publique France. [Accessed 3 Feb 2017]. French. Available from: http://invs.santepubliquefrance.fr/Dossiers-thematiques/Maladies-infectieuses/Infections-associees-aux-soins/Surveillance-des-infections-associees-aux-soins-IAS/Enterobacteries-productrices-de-carbapenemases-EPC
  18. Cuzon G, Bentchouala C, Vogel A, Héry M, Lezzar A, Smati F, et al. First outbreak of OXA-48-positive carbapenem-resistant Klebsiella pneumoniae isolates in Constantine, Algeria. Int J Antimicrob Agents. 2015;46(6):725-7.  https://doi.org/10.1016/j.ijantimicag.2015.08.005  PMID: 26453148 
  19. Cuzon G, Ouanich J, Gondret R, Naas T, Nordmann P. Outbreak of OXA-48-positive carbapenem-resistant Klebsiella pneumoniae isolates in France. Antimicrob Agents Chemother. 2011;55(5):2420-3.  https://doi.org/10.1128/AAC.01452-10  PMID: 21343451 
  20. Hays C, Benouda A, Poirel L, Elouennass M, Nordmann P. Nosocomial occurrence of OXA-48-producing enterobacterial isolates in a Moroccan hospital. Int J Antimicrob Agents. 2012;39(6):545-7.  https://doi.org/10.1016/j.ijantimicag.2012.03.002  PMID: 22521525 
  21. Potron A, Poirel L, Bussy F, Nordmann P. Occurrence of the carbapenem-hydrolyzing β-lactamase gene blaOXA-48 in the environment in Morocco. Antimicrob Agents Chemother. 2011;55(11):5413-4.  https://doi.org/10.1128/AAC.05120-11  PMID: 21876064 
  22. Semin-Pelletier B, Cazet L, Bourigault C, Juvin ME, Boutoille D, Raffi F, et al. Challenges of controlling a large outbreak of OXA-48 carbapenemase-producing Klebsiella pneumoniae in a French university hospital. J Hosp Infect. 2015;89(4):248-53.  https://doi.org/10.1016/j.jhin.2014.11.018  PMID: 25601745 
  23. Decousser JW, Poirel L, Desroches M, Jayol A, Denamur E, Nordmann P. Failure to detect carbapenem-resistant Escherichia coli producing OXA-48-like using the Xpert Carba-R assay®. Clin Microbiol Infect. 2015;21(2):e9-10.  https://doi.org/10.1016/j.cmi.2014.09.006  PMID: 25682281 
  24. Lafeuille E, Laouira S, Sougakoff W, Soulier-Escrihuela O, Leconte J, Garrec H, et al. Detection of OXA-48-like carbapenemase genes by the Xpert® Carba-R test: room for improvement. Int J Antimicrob Agents. 2015;45(4):441-2.  https://doi.org/10.1016/j.ijantimicag.2014.12.009  PMID: 25601530 
  25. Dortet L, Fusaro M, Naas T. Improvement of the Xpert Carba-R kit for the detection of carbapenemase-producing Enterobacteriaceae. Antimicrob Agents Chemother. 2016;60(6):3832-7.  https://doi.org/10.1128/AAC.00517-16  PMID: 27021332 
  26. Findlay J, Hopkins KL, Meunier D, Woodford N. Evaluation of three commercial assays for rapid detection of genes encoding clinically relevant carbapenemases in cultured bacteria. J Antimicrob Chemother. 2015;70(5):1338-42.  https://doi.org/10.1093/jac/dku571  PMID: 25630646 
  27. Dortet L, Agathine A, Naas T, Cuzon G, Poirel L, Nordmann P. Evaluation of the RAPIDEC® CARBA NP, the Rapid CARB Screen® and the Carba NP test for biochemical detection of carbapenemase-producing Enterobacteriaceae. J Antimicrob Chemother. 2015;70(11):3014-22.  https://doi.org/10.1093/jac/dkv213  PMID: 26260131 
  28. Pires J, Novais A, Peixe L. Blue-carba, an easy biochemical test for detection of diverse carbapenemase producers directly from bacterial cultures. J Clin Microbiol. 2013;51(12):4281-3.  https://doi.org/10.1128/JCM.01634-13  PMID: 24108615 
  29. Hrabák J, Chudácková E, Walková R. Matrix-assisted laser desorption ionization-time of flight (maldi-tof) mass spectrometry for detection of antibiotic resistance mechanisms: from research to routine diagnosis. Clin Microbiol Rev. 2013;26(1):103-14.  https://doi.org/10.1128/CMR.00058-12  PMID: 23297261 
  30. 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 
  31. Tsakris A, Poulou A, Bogaerts P, Dimitroulia E, Pournaras S, Glupczynski Y. Evaluation of a new phenotypic OXA-48 disk test for differentiation of OXA-48 carbapenemase-producing Enterobacteriaceae clinical isolates. J Clin Microbiol. 2015;53(4):1245-51.  https://doi.org/10.1128/JCM.03318-14  PMID: 25653401 
  32. Dortet L, Jousset A, Sainte-Rose V, Cuzon G, Naas T. Prospective evaluation of the OXA-48 K-SeT assay, an immunochromatographic test for the rapid detection of OXA-48-type carbapenemases. J Antimicrob Chemother. 2016;71(7):1834-40.  https://doi.org/10.1093/jac/dkw058  PMID: 26968882 
  33. Nordmann P, Poirel L, Walsh TR, Livermore DM. The emerging NDM carbapenemases. Trends Microbiol. 2011;19(12):588-95.  https://doi.org/10.1016/j.tim.2011.09.005  PMID: 22078325 
  34. Woodford N, Turton JF, Livermore DM. Multiresistant Gram-negative bacteria: the role of high-risk clones in the dissemination of antibiotic resistance. FEMS Microbiol Rev. 2011;35(5):736-55.  https://doi.org/10.1111/j.1574-6976.2011.00268.x  PMID: 21303394 

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