Andrea Bartolini1, Monica Basso1, Elisa Franchin1, Nicola Menegotto1, Anna Ferrari1, Ettore De Canale2, Samantha Andreis1, Renzo Scaggiante3, Stefania Stefani4, Giorgio Palù1, Saverio Giuseppe Parisi5. 1. Department of Molecular Medicine, University of Padova, Via Gabelli 63, 35100 Padova, Italy. 2. Microbiology and Virology Unit, Padova Hospital, Via Giustiniani, 2, 35121 Padova, Italy. 3. Infectious Diseases Unit, Padova Hospital, Via Giustiniani, 2, 35128 Padova, Italy. 4. Department of Bio-Medical Sciences, University of Catania, Via Androne 81, 95124 Catania, Italy. 5. Department of Molecular Medicine, University of Padova, Via Gabelli 63, 35100 Padova, Italy. Electronic address: saverio.parisi@unipd.it.
Abstract
OBJECTIVES: We described Klebsiella pneumoniae producing carbapenemase (CPKP) spread from 01/01/2015 to 13/09/16 in a tertiary level hospital. METHODS: The first positive surveillance rectal swab (SRS) or clinical sample (CS) collected in the medical department (MD), surgical department (SD) and intensive care department (ICD) were included in the study. A validated in-house Real-Time PCR method was used to detect carbapenemases; multilocus sequence typing (MLST) was used for further characterization of the strains. RESULTS: 21535 patients were included: 213 CPKP strains from surveillance rectal swab (SRS) and 98 from clinical samples (CS) were collected. The percentage of CPKP detected in SRS with respect to CS increased in the medical MD from 2015 to 2016 (p=0.01) and in ICD from 2012 to 2015 (p=0.0001), while it decreased in SD from 2014 to 2016 (p=0.003); 68.5% of the positive SRS had a previous negative SRS; CPKP was more frequently identified in CS than in SRS in MD. Twelve strains harboured more than one carbapenemase gene. Many other species harbouring a carbapenemase gene were collected. CONCLUSIONS: MDs need more inclusive surveillance criteria. The late detection of positive SRS underlined the risk of colonization during hospitalization.
OBJECTIVES: We described Klebsiella pneumoniae producing carbapenemase (CPKP) spread from 01/01/2015 to 13/09/16 in a tertiary level hospital. METHODS: The first positive surveillance rectal swab (SRS) or clinical sample (CS) collected in the medical department (MD), surgical department (SD) and intensive care department (ICD) were included in the study. A validated in-house Real-Time PCR method was used to detect carbapenemases; multilocus sequence typing (MLST) was used for further characterization of the strains. RESULTS: 21535 patients were included: 213 CPKP strains from surveillance rectal swab (SRS) and 98 from clinical samples (CS) were collected. The percentage of CPKP detected in SRS with respect to CS increased in the medical MD from 2015 to 2016 (p=0.01) and in ICD from 2012 to 2015 (p=0.0001), while it decreased in SD from 2014 to 2016 (p=0.003); 68.5% of the positive SRS had a previous negative SRS; CPKP was more frequently identified in CS than in SRS in MD. Twelve strains harboured more than one carbapenemase gene. Many other species harbouring a carbapenemase gene were collected. CONCLUSIONS: MDs need more inclusive surveillance criteria. The late detection of positive SRS underlined the risk of colonization during hospitalization.
Authors: Sophia David; Sandra Reuter; Simon R Harris; Corinna Glasner; Theresa Feltwell; Silvia Argimon; Khalil Abudahab; Richard Goater; Tommaso Giani; Giulia Errico; Marianne Aspbury; Sara Sjunnebo; Edward J Feil; Gian Maria Rossolini; David M Aanensen; Hajo Grundmann Journal: Nat Microbiol Date: 2019-07-29 Impact factor: 17.745