Evolving beta-lactamase epidemiology in Enterobacteriaceae from Italian nationwide surveillance, October 2013: KPC-carbapenemase spreading among outpatients

This study investigated the presence of these resistance mechanisms in consecutive non-replicate isolates ofEscherichia coli (n?=?2,352),Klebsiella pneumoniae (n?=?697), andProteus mirabilis (n?=?275) from an Italian nationwide cross-sectional survey carried out in October 2013. Overall, 15.3% of isolates were non-susceptible to extended-spectrum cephalosporins but susceptible to carbapenems (ESCR-carbaS), while 4.3% were also non-susceptible to carbapenems (ESCR-carbaR). ESCR-carbaS isolates were contributed by all three species, with higher proportions among isolates from inpatients (20.3%) but remarkable proportions also among those from outpatients (11.1%). Most ESCR-carbaS isolates were ESBL-positive (90.5%), and most of them were contributed byE. coli carryingblaCTX-M group 1 genes. Acquired ACBLs were less common and mostly detected inP. mirabilis. ESCR-carbaR isolates were mostly contributed byK. pneumoniae (25.1% and 7.7% amongK. pneumoniae isolates from inpatients and outpatients, respectively), withblaKPC as the most common carbapenemase gene. Results showed an increasing trend for both ESBL and carbapenemase producers in comparison with previous Italian surveys, also among outpatients.
Source: Eurosurveillance - Category: Infectious Diseases Source Type: research