Monica Basso1, Daniela Zago2, Irene Pozzetto3, Ettore De Canale4, Renzo Scaggiante5, Maria Angela Biasolo6, Marta Peracchi7, Francesco Onelia8, Elisa Baldasso9, Giorgio Palù10, Saverio Giuseppe Parisi11. 1. Department of Molecular Medicine, University of Padova, Via Gabelli 63, 35100 Padova, Italy. Electronic address: monica.basso@unipd.it. 2. Department of Molecular Medicine, University of Padova, Via Gabelli 63, 35100 Padova, Italy. Electronic address: daniela.zago.3@studenti.unipd.it. 3. Department of Molecular Medicine, University of Padova, Via Gabelli 63, 35100 Padova, Italy. Electronic address: irene_pozzetto@msn.com. 4. Microbiology and Virology Unit, Padova University Hospital, Via Giustiniani 2, 35128 Padova, Italy. Electronic address: ettore.decanale@aopd.veneto.it. 5. Infectious Diseases Unit, Padova University Hospital, Via Giustiniani 2, 35128 Padova, Italy. Electronic address: renzo.scaggiante@aopd.veneto.it. 6. Department of Molecular Medicine, University of Padova, Via Gabelli 63, 35100 Padova, Italy. Electronic address: mariaangela.biasolo@unipd.it. 7. Microbiology and Virology Unit, Padova University Hospital, Via Giustiniani 2, 35128 Padova, Italy. Electronic address: marta.peracchi@aopd.veneto.it. 8. Department of Molecular Medicine, University of Padova, Via Gabelli 63, 35100 Padova, Italy. Electronic address: francesco.onelia@studenti.unipd.it. 9. Department of Molecular Medicine, University of Padova, Via Gabelli 63, 35100 Padova, Italy. Electronic address: elisa.baldasso.1@studenti.unipd.it. 10. Department of Molecular Medicine, University of Padova, Via Gabelli 63, 35100 Padova, Italy. Electronic address: giorgio.palu@unipd.it. 11. Department of Molecular Medicine, University of Padova, Via Gabelli 63, 35100 Padova, Italy. Electronic address: saverio.parisi@unipd.it.
Abstract
OBJECTIVES: We present an updated picture (1/1/2017-31/08/2019) of the frequency of carbapenemase producing Klebsiella pneumoniae (CPKP) in surveillance rectal swabs (SRS) and in clinical samples (CS) of patients admitted to a tertiary level hospital, focusing on longitudinal evolution of CPKP detected in SRS and on colistin resistant strains. METHODS: Retrospective longitudinal analysis. Only the first positive CPKP strain isolated from each patient was included. RESULTS: 638 CPKP strains were identified (471 in SRS and 167 in CS). SRS frequency increased over time in the medical department, remained high in the surgical department (SD) and decreased in the intensive care department. Most SRS-71.3%-and 49.1% of CS had nosocomial origin; about half of the SRS were identified in the SD. Regarding SRS evolution, carriage was confirmed in 39.5% of patients, no more testing in 25.5%, clinical involvement in 24.8 %, and negative result in 10.2%. Rates of colistin resistance were 20.1% in 2017, 31.2% in 2018 and 26.9% in 2019. CONCLUSIONS: CPKP diffusion is still an important issue despite the surveillance program. It is vital to enhance medical staff's awareness on this because most CPKP first detections in SRS occurred during hospital stay due to a nosocomial acquisition with a comparable picture over time. Colistin resistance is increasing.
OBJECTIVES: We present an updated picture (1/1/2017-31/08/2019) of the frequency of carbapenemase producing Klebsiella pneumoniae (CPKP) in surveillance rectal swabs (SRS) and in clinical samples (CS) of patients admitted to a tertiary level hospital, focusing on longitudinal evolution of CPKP detected in SRS and on colistin resistant strains. METHODS: Retrospective longitudinal analysis. Only the first positive CPKP strain isolated from each patient was included. RESULTS: 638 CPKP strains were identified (471 in SRS and 167 in CS). SRS frequency increased over time in the medical department, remained high in the surgical department (SD) and decreased in the intensive care department. Most SRS-71.3%-and 49.1% of CS had nosocomial origin; about half of the SRS were identified in the SD. Regarding SRS evolution, carriage was confirmed in 39.5% of patients, no more testing in 25.5%, clinical involvement in 24.8 %, and negative result in 10.2%. Rates of colistin resistance were 20.1% in 2017, 31.2% in 2018 and 26.9% in 2019. CONCLUSIONS: CPKP diffusion is still an important issue despite the surveillance program. It is vital to enhance medical staff's awareness on this because most CPKP first detections in SRS occurred during hospital stay due to a nosocomial acquisition with a comparable picture over time. Colistin resistance is increasing.