BACKGROUND: Little is known about epidemiology of carbapenemase-producing Enterobacteriaceae (CPE) in children. Aim of this study was to describe CPE epidemiology in a tertiary care pediatric hospital in Italy that admits patients coming from geographic areas with high diffusion of CPE. METHODS: Prospective evaluation of the proportion and rates per 100,000 hospital discharges (D) or hospitalization-days (HD) of invasive infections due to CPE from 2013 to 2017 and of CPE infections and colonizations from 2014 to 2017. Disease-preventing strategies comprised patients' screening at admission, pre-emptive contact isolation precautions pending cultures results, and bundles for prevention of healthcare associated infections. RESULTS: From 2013 to 2017 CPE represented 3.5% of all invasive infections due to Enterobacteriaceae, with rates ranging 7.30-14.33 for D and 1.03-2.06 for HD, without major changes over time. On the contrary, overall rates of isolates increased from 83.03 to 191.34 for D and from 12.21 to 28.35 for HD. The intra-hospital diffusion consisted of 2 small outbreaks without invasive diseases in 2014-2015, and sporadic, not epidemiologically-related cases in 2016-2017. Globally, Escherichia coli and Klebsiella pneumoniae represented 64% of identified CPE, while 70% of carbapenemases identified were metallo-beta-lactamases (VIM or NDM), with changes over time. CONCLUSIONS: In our center metallo-beta lactamases were the most frequently identified carbapenemases in Enterobacteriaceae and E. coli and K. pneumoniae the most frequently isolated pathogens carrying these enzymes. A proactive management strategy was effective in containing in-hospital spreading.
BACKGROUND: Little is known about epidemiology of carbapenemase-producing Enterobacteriaceae (CPE) in children. Aim of this study was to describe CPE epidemiology in a tertiary care pediatric hospital in Italy that admits patients coming from geographic areas with high diffusion of CPE. METHODS: Prospective evaluation of the proportion and rates per 100,000 hospital discharges (D) or hospitalization-days (HD) of invasive infections due to CPE from 2013 to 2017 and of CPE infections and colonizations from 2014 to 2017. Disease-preventing strategies comprised patients' screening at admission, pre-emptive contact isolation precautions pending cultures results, and bundles for prevention of healthcare associated infections. RESULTS: From 2013 to 2017 CPE represented 3.5% of all invasive infections due to Enterobacteriaceae, with rates ranging 7.30-14.33 for D and 1.03-2.06 for HD, without major changes over time. On the contrary, overall rates of isolates increased from 83.03 to 191.34 for D and from 12.21 to 28.35 for HD. The intra-hospital diffusion consisted of 2 small outbreaks without invasive diseases in 2014-2015, and sporadic, not epidemiologically-related cases in 2016-2017. Globally, Escherichia coli and Klebsiella pneumoniae represented 64% of identified CPE, while 70% of carbapenemases identified were metallo-beta-lactamases (VIM or NDM), with changes over time. CONCLUSIONS: In our center metallo-beta lactamases were the most frequently identified carbapenemases in Enterobacteriaceae and E. coli and K. pneumoniae the most frequently isolated pathogens carrying these enzymes. A proactive management strategy was effective in containing in-hospital spreading.
Authors: Marilena Agosta; Daniela Bencardino; Marta Argentieri; Laura Pansani; Annamaria Sisto; Marta Luisa Ciofi Degli Atti; Carmen D'Amore; Lorenza Putignani; Pietro Bagolan; Barbara Daniela Iacobelli; Andrea Dotta; Ludovica Martini; Luca Di Chiara; Mauro Magnani; Carlo Federico Perno; Francesca Andreoni; Paola Bernaschi Journal: Antibiotics (Basel) Date: 2022-03-23
Authors: Ana I Cubas-Atienzar; Christopher T Williams; Abhilasha Karkey; Sabina Dongol; Manandhar Sulochana; Shrestha Rajendra; Glyn Hobbs; Katie Evans; Patrick Musicha; Nicholas Feasey; Luis E Cuevas; Emily R Adams; Thomas Edwards Journal: J Glob Antimicrob Resist Date: 2021-09-03 Impact factor: 4.035
Authors: Silvia Argimón; Sophia David; Anthony Underwood; Monica Abrudan; Nicole E Wheeler; Mihir Kekre; Khalil Abudahab; Corin A Yeats; Richard Goater; Ben Taylor; Harry Harste; Dawn Muddyman; Edward J Feil; Sylvain Brisse; Kathryn Holt; Pilar Donado-Godoy; K L Ravikumar; Iruka N Okeke; Celia Carlos; David M Aanensen Journal: Clin Infect Dis Date: 2021-12-01 Impact factor: 9.079
Authors: M Mariani; R Bandettini; D LA Masa; D Minghetti; I Baldelli; S Serveli; A Mesini; C Saffioti; L A Ramenghi; E Castagnola Journal: J Prev Med Hyg Date: 2020-07-04
Authors: Elio Castagnola; Francesca Bagnasco; Alessio Mesini; Philipp K A Agyeman; Roland A Ammann; Fabianne Carlesse; Maria Elena Santolaya de Pablo; Andreas H Groll; Gabrielle M Haeusler; Thomas Lehrnbecher; Arne Simon; Maria Rosaria D'Amico; Austin Duong; Evgeny A Idelevich; Marie Luckowitsch; Mariaclaudia Meli; Giuseppe Menna; Sasha Palmert; Giovanna Russo; Marco Sarno; Galina Solopova; Annalisa Tondo; Yona Traubici; Lillian Sung Journal: Antibiotics (Basel) Date: 2021-03-05