Prolonged outbreak of New Delhi metallo-beta-lactamase-producing carbapenem-resistant Enterobacterales (NDM-CRE), Tuscany, Italy, 2018 to 2019

Euro Surveill. 2020 Feb;25(6):2000085. doi: 10.2807/1560-7917.ES.2020.25.6.2000085.

Abstract

In Tuscany, Italy, New Delhi metallo-beta-lactamase-producing carbapenem-resistant Enterobacterales (NDM-CRE) have increased since November 2018. Between November 2018 and October 2019, 1,645 samples were NDM-CRE-positive: 1,270 (77.2%) cases of intestinal carriage, 129 (7.8%) bloodstream infections and 246 (14.9%) infections/colonisations at other sites. Klebsiella pneumoniae were prevalent (1,495; 90.9%), with ST147/NDM-1 the dominant clone. Delayed outbreak identification and response resulted in sustained NDM-CRE transmission in the North-West area of Tuscany, but successfully contained spread within the region.

Keywords: Enterobacterales; Italy; Klebsiella pneumoniae; New Delhi metallo-beta-lactamase; outbreak.

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Aged, 80 and over
  • Anti-Bacterial Agents / pharmacology*
  • Carbapenems / pharmacology*
  • Child
  • Child, Preschool
  • Disease Outbreaks*
  • Drug Resistance, Multiple, Bacterial / drug effects
  • Female
  • Humans
  • Infant
  • Infant, Newborn
  • Italy / epidemiology
  • Klebsiella Infections / drug therapy
  • Klebsiella Infections / epidemiology*
  • Klebsiella Infections / microbiology*
  • Klebsiella pneumoniae / drug effects*
  • Klebsiella pneumoniae / enzymology
  • Klebsiella pneumoniae / metabolism
  • Male
  • Microbial Sensitivity Tests
  • Middle Aged
  • Young Adult
  • beta-Lactamases / drug effects
  • beta-Lactamases / genetics
  • beta-Lactamases / metabolism*

Substances

  • Anti-Bacterial Agents
  • Carbapenems
  • beta-Lactamases
  • beta-lactamase NDM-1