TY - JOUR
T1 - Carbapenemase-producing Enterobacteriaceae in the UK
T2 - A national study (EuSCAPE-UK) on prevalence, incidence, laboratory detection methods and infection control measures
AU - Trepanier, Pascale
AU - Mallard, Kim
AU - Meunier, Daniele
AU - Pike, Rachel
AU - Brown, Derek
AU - Ashby, Janet P.
AU - Donaldson, Hugo
AU - Awad-El-Kariem, F. Mustafa
AU - Balakrishnan, Indran
AU - Cubbon, Marc
AU - Chadwick, Paul R.
AU - Doughton, Michael
AU - Doughton, Rachael
AU - Hardiman, Fiona
AU - Harvey, Graham
AU - Horner, Carolyne
AU - Lee, John
AU - Lewis, Jonathan
AU - Loughrey, Anne
AU - Manuel, Rohini
AU - Parsons, Helena
AU - Perry, John D.
AU - Vanstone, Gemma
AU - White, Graham
AU - Shetty, Nandini
AU - Coia, John
AU - Wiuff, Camilla
AU - Hopkins, Katie L.
AU - Woodford, Neil
N1 - Publisher Copyright:
© The Author 2016.
PY - 2017/2
Y1 - 2017/2
N2 - Objectives: To estimate UK prevalence and incidence of clinically significant carbapenemase-producing Enterobacteriaceae (CPE), and to determine epidemiological characteristics, laboratory methods and infection prevention and control (IPC) measures in acute care facilities. Methods: A 6 month survey was undertaken in November 2013-April 2014 in 21 sentinel UK laboratories as part of the European Survey on Carbapenemase-Producing Enterobacteriaceae (EuSCAPE) project. Up to 10 consecutive, non-duplicate, clinically significant and carbapenem-non-susceptible isolates of Escherichia coli or Klebsiella pneumoniaewere submitted to a reference laboratory. Participants answered a questionnaire on relevant laboratory methods and IPC measures. Results: Of 102 isolates submitted, 89 (87%) were non-susceptible to ≥1 carbapenem, and 32 (36%) were confirmed as CPE. CPE were resistant to most antibiotics, except colistin (94% susceptible), gentamicin (63%), tigecycline (56%) and amikacin (53%). The prevalence of CPE was 0.02% (95% CI=0.01%-0.03%). The incidence of CPEwas 0.007 per 1000 patient-days (95% CI=0.005-0.010), with north-west England the most affected region at 0.033 per 1000 patient-days (95% CI=0.012-0.072). Recommended IPC measures were not universally followed, notably screening high-risk patients on admission (applied by 86%), using a CPE 'flag' on patients' records (70%) and alerting neighbouring hospitals when transferring affected patients (only 30%). Most sites (86%) had a laboratory protocol for CPE screening, most frequently using chromogenic agar (52%) or MacConkey/CLED agars with carbapenem discs (38%). Conclusions: The UK prevalence and incidence of clinically significant CPE is currently low, but these MDR bacteria affect most UK regions. Improved IPC measures, vigilance and monitoring are required.
AB - Objectives: To estimate UK prevalence and incidence of clinically significant carbapenemase-producing Enterobacteriaceae (CPE), and to determine epidemiological characteristics, laboratory methods and infection prevention and control (IPC) measures in acute care facilities. Methods: A 6 month survey was undertaken in November 2013-April 2014 in 21 sentinel UK laboratories as part of the European Survey on Carbapenemase-Producing Enterobacteriaceae (EuSCAPE) project. Up to 10 consecutive, non-duplicate, clinically significant and carbapenem-non-susceptible isolates of Escherichia coli or Klebsiella pneumoniaewere submitted to a reference laboratory. Participants answered a questionnaire on relevant laboratory methods and IPC measures. Results: Of 102 isolates submitted, 89 (87%) were non-susceptible to ≥1 carbapenem, and 32 (36%) were confirmed as CPE. CPE were resistant to most antibiotics, except colistin (94% susceptible), gentamicin (63%), tigecycline (56%) and amikacin (53%). The prevalence of CPE was 0.02% (95% CI=0.01%-0.03%). The incidence of CPEwas 0.007 per 1000 patient-days (95% CI=0.005-0.010), with north-west England the most affected region at 0.033 per 1000 patient-days (95% CI=0.012-0.072). Recommended IPC measures were not universally followed, notably screening high-risk patients on admission (applied by 86%), using a CPE 'flag' on patients' records (70%) and alerting neighbouring hospitals when transferring affected patients (only 30%). Most sites (86%) had a laboratory protocol for CPE screening, most frequently using chromogenic agar (52%) or MacConkey/CLED agars with carbapenem discs (38%). Conclusions: The UK prevalence and incidence of clinically significant CPE is currently low, but these MDR bacteria affect most UK regions. Improved IPC measures, vigilance and monitoring are required.
UR - http://www.scopus.com/inward/record.url?scp=85014575172&partnerID=8YFLogxK
U2 - 10.1093/jac/dkw414
DO - 10.1093/jac/dkw414
M3 - Article
C2 - 27687074
AN - SCOPUS:85014575172
SN - 0305-7453
VL - 72
SP - 596
EP - 603
JO - Journal of Antimicrobial Chemotherapy
JF - Journal of Antimicrobial Chemotherapy
IS - 2
ER -