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SDG 3: Antimicrobial resistance

Abstract

Background

Preliminary unpublished results of the survey of carbapenem- and/or colistin-resistant Enterobacterales (CCRE survey) showed the expansion of carbapenemase-producing (CPKP) sequence type (ST) 39 in 12 of 15 participating Greek hospitals in 2019.

Aim

We conducted a rapid survey to determine the extent of spread of CPKP high-risk clones in Greek hospitals in 2022 and compare the distribution of circulating CPKP clones in these hospitals since 2013.

Methods

We analysed whole genome sequences and epidemiological data of 310 isolates that were carbapenem-resistant or ‘susceptible, increased exposure’ from Greek hospitals that participated in the European survey of carbapenemase-producing (EuSCAPE, 2013–2014), in the CCRE survey (2019) and in a national follow-up survey (2022) including, for the latter, an estimation of transmission events.

Results

Five STs including ST258/512 (n = 101 isolates), ST11 (n = 93), ST39 (n = 56), ST147 (n = 21) and ST323 (n = 13) accounted for more than 90% of CPKP isolates in the dataset. While ST11, ST147 and ST258/512 have been detected in participating hospitals since 2013 and 2014, KPC-2-producing ST39 and ST323 emerged in 2019 and 2022, respectively. Based on the defined genetic relatedness cut-off, 44 within-hospital transmission events were identified in the 2022 survey dataset, with 12 of 15 participating hospitals having at least one within-hospital transmission event.

Conclusion

The recent emergence and rapid spread of new high-risk clones in the Greek healthcare system related to within-hospital transmission is of concern and highlights the need for molecular surveillance and enhanced infection prevention and control measures.

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2023-11-23
2024-04-27
http://instance.metastore.ingenta.com/content/10.2807/1560-7917.ES.2023.28.47.2300571
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Emergence and persistent spread of carbapenemase-producing Klebsiella pneumoniae high-risk clones in Greek hospitals, 2013 to 2022
<p class="citation"> <span>Citation style for this article:</span> <span class="meta-value authors"> <a href="/search?value1=Kyriaki+Tryfinopoulou&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Tryfinopoulou Kyriaki</a>, <a href="/search?value1=Marius+Linkevicius&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Linkevicius Marius</a>, <a href="/search?value1=Olga+Pappa&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Pappa Olga</a>, <a href="/search?value1=Erik+Alm&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Alm Erik</a>, <a href="/search?value1=Kleon+Karadimas&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Karadimas Kleon</a>, <a href="/search?value1=Olov+Svartstr%C3%B6m&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Svartström Olov</a>, <a href="/search?value1=Michalis+Polemis&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Polemis Michalis</a>, <a href="/search?value1=Kassiani+Mellou&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Mellou Kassiani</a>, <a href="/search?value1=Antonis+Maragkos&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Maragkos Antonis</a>, <a href="/search?value1=Alma+Brolund&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Brolund Alma</a>, <a href="/search?value1=Inga+Fr%C3%B6ding&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Fröding Inga</a>, <a href="/search?value1=Sophia+David&option1=author&noRedirect=true" class="nonDisambigAuthorLink">David Sophia</a>, <a href="/search?value1=Alkiviadis+Vatopoulos&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Vatopoulos Alkiviadis</a>, <a href="/search?value1=Daniel+Palm&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Palm Daniel</a>, <a href="/search?value1=Dominique+L+Monnet&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Monnet Dominique L</a>, <a href="/search?value1=Theoklis+Zaoutis&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Zaoutis Theoklis</a>, <a href="/search?value1=Anke+Kohlenberg&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Kohlenberg Anke</a>, <a href="/search?value1=Greek+CCRE+study+group&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Greek CCRE study group</a></span>. Emergence and persistent spread of carbapenemase-producing Klebsiella pneumoniae high-risk clones in Greek hospitals, 2013 to 2022. <a href="/content/ecdc">Euro Surveill.</a> 2023;28(47):pii=2300571. <a href="https://doi.org/10.2807/1560-7917.ES.2023.28.47.2300571" title="doi link" target="_blank">https://doi.org/10.2807/1560-7917.ES.2023.28.47.2300571</a> <span class="ES_Article_citation"> <span class="generated">Received</span>: 19 Oct 2023;&nbsp;&nbsp; <span class="generated">Accepted</span>: 17 Nov 2023 </span> </p>
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