New Delhi metallo-beta-lactamase 1-producing Enterobacteriaceae: Emergence and response in Europe

M. J. Struelens, D. L. Monnet, A. P. Magiorakos, F. Santos O'Connor, J. Giesecke, A. Grisold, G. Zarfel, B. Jans, T. Velinov, T. Kantardjiev, M. Alexandrou, H. Zemlickova, J. Hrabak, N. Frimodt-Møller, A. M. Hammerum, M. Maimets, M. Ivanova, J. Jalava, M. Rummukainen, T. EckmannsM. Kaase, X. Dedoukou, A. Vatopoulos, K. Böröcz, K. G. Kristinsson, O. Gudlaugsson, R. Cunney, G. M. Rossolini, A. Pantosti, U. Dumpis, A. Balode, R. Valinteliene, P. Weicherding, M. Borg, M. Leverstein-van Hall, X. Huijsdens, Samuelsen, G. S. Simonsen, W. Hryniewicz, M. Gniadkowski, A. C. Costa, M. Caniça, I. Codita, R. Serban, L. Siegfried, M. Stefkovicova, J. Kolman, M. Pirš, J. Oteo, J. Campos, K. Tegmark-Wisell, P. Edquist, D. Livermore, N. Woodford

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    118 Citations (Scopus)


    Acquired carbapenemases confer extensive antibiotic resistance to Enterobacteriaceae and represent a public health threat. A novel acquired carbapenemase, New Delhi metallo-beta-lactamase 1 (NDM-1), has recently been described in the United Kingdom and Sweden, mostly in patients who had received care on the Indian subcontinent. We conducted a survey among 29 European countries (the European Union Member States, Iceland and Norway) to gather information on the spread of NDM-1-producing Enterobacteriaceae in Europe, on public health responses and on available national guidance on detection, surveillance and control. A total of 77 cases were reported from 13 countries from 2008 to 2010. Klebsiella pneumoniae was the most frequently reported species with 54%. Among 55 cases with recorded travel history, 31 had previously travelled or been admitted to a hospital in India or Pakistan and five had been hospitalised in the Balkan region. Possible nosocomial acquisition accounted for 13 of 77 cases. National guidance on NDM-1 detection was available in 14 countries and on NDM-1 control in 11 countries. In conclusion, NDM-1 is spreading across Europe, where it is frequently linked to a history of healthcare abroad, but also to emerging nosocomial transmission. National guidance in response to the threat of carbapenemase-producing Enterobacteriaceae is available in approximately half of the surveyed European countries. Surveillance of carbapenemase- producing Enterobacteriaceae must be enhanced in Europe and effective control measures identified and implemented.

    Original languageEnglish
    Issue number46
    Publication statusPublished - 18 Nov 2010


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