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|Title: ||Carbapenem-non-susceptible Enterobacteriaceae in Europe: conclusions from a meeting of national experts|
|Authors: ||Grundmann, H.|
Livermore, D. M.
Giske, C. G.
Rossolini, G. M.
The CNSE Working Group
Resistência aos Antimicrobianos
|Issue Date: ||18-Nov-2010|
|Publisher: ||European Centre for Disease Prevention and Control|
|Citation: ||Euro Surveill. 2010 Nov 18;15(46). pii: 19711|
|Abstract: ||The emergence and global spread of carbapenemase-producing Enterobacteriaceae is of great concern to health services worldwide. These bacteria are often resistant to all beta-lactam antibiotics and frequently co-resistant to most other antibiotics, leaving very few treatment options. The epidemiology is compounded by the diversity of carbapenem-hydrolysing enzymes and the ability of their genes to spread between different bacterial species. Difficulties are also encountered by laboratories when trying to detect carbapenemase production during routine diagnostic procedures due to an often heterogeneous expression of resistance. Some of the resistance genes are associated with successful clonal lineages which have a selective advantage in those hospitals where antimicrobial use is high and opportunities for transmission exist; others are more often associated with transmissible plasmids. A genetically distinct strain of Klebsiella pneumoniae sequence type (ST) 258 harbouring the K. pneumoniae carbapenemases (KPC) has been causing epidemics of national and international proportions. It follows the pathways of patient referrals, causing hospital outbreaks along the way. Simultaneously, diverse strains harbouring New Delhi metallo-beta-lactamase (NDM-1) are repeatedly being imported into Europe, commonly via patients with prior medical exposure in the Indian subcontinent. Since the nature and scale of carbapenem-non-susceptible Entrobacteriaceae as a threat to hospital patients in Europe remains unclear, a consultation of experts from 31 countries set out to identify the gaps in diagnostic and response capacity, to index the magnitude of carbapenem-non-susceptibility across Europe using a novel five-level staging system, and to provide elements of a strategy to combat this public health issue in a concerted manner.|
|Description: ||The CNSE Working Group: Manuela Caniça (Departamento de Doenças Infecciosas do INSA)|
Euro Surveill. 2011;16(5). pii: 19781.
Euro Surveill. 2011;16(3). pii: 19766. Garcia Fernandez, Aurora [corrected to Garcia-Fernandez, Aurora]; Leverstein, Maurine [corrected to Leverstein-van Hall, Maurine A].
Euro Surveill. 2010 Nov 25;15(47)pii: 19726.
Euro Surveill. 2010;15(50). pii: 19755.
Euro Surveill. 2010;15(50). pii: 19752
|Peer Reviewed: ||yes|
|Publisher version: ||http://www.eurosurveillance.org/ViewArticle.aspx?ArticleId=19711|
|Appears in Collections:||DDI - Artigos em revistas internacionais|
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