Carbapenem-non-susceptible Enterobacteriaceae in Europe: conclusions from a meeting of national experts

• DOI: 10.2807/ese.15.46.19711-en
• Publication Date: 2017-11-28T11:55:18Z
• Authors: H Grundmann; D M Livermore; C G Giske; R Cantón; G M Rossolini; J Campos; A Vatopoulos; M Gniadkowski; A Toth; Y Pfeifer; V Jarlier; Y Carmeli; Collective the CN...
• Keywords: Carbapenem-resistant enterobacteriaceae; Carbapenem; Indian subcontinent; Molecular Epidemiology

The emergence and global spread of carbapenemase-producing Enterobacteriaceae is great concern to health services worldwide. These bacteria are often resistant all beta-lactam antibiotics frequently co-resistant most other antibiotics, leaving very few treatment options. epidemiology compounded by the diversity carbapenem-hydrolysing enzymes ability their genes between different bacterial species. Difficulties also encountered laboratories when trying detect carbapenemase production during routine diagnostic procedures due an heterogeneous expression resistance. Some resistance associated with successful clonal lineages which have a selective advantage in those hospitals where antimicrobial use high opportunities for transmission exist; others more transmissible plasmids. A genetically distinct strain Klebsiella pneumoniae sequence type (ST) 258 harbouring K. carbapenemases (KPC) has been causing epidemics national international proportions. It follows pathways patient referrals, hospital outbreaks along way. Simultaneously, diverse strains New Delhi metallo-beta-lactamase (NDM-1) repeatedly being imported into Europe, commonly via patients prior medical exposure Indian subcontinent. Since nature scale carbapenem-non-susceptible Entrobacteriaceae as threat Europe remains unclear, consultation experts from 31 countries set out identify gaps response capacity, index magnitude carbapenem-non-susceptibility across using novel five-level staging system, provide elements strategy combat this public issue concerted manner.