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Increasing proportion of carbapenemase-producing Enterobacteriaceae and emergence of a MCR-1 producer through a multicentric study among hospital-based and private laboratories in Belgium from September to November 2015

(2017) EUROSURVEILLANCE. 22(19). p.17-25
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Abstract
Carbapenemase-producing Enterobacteriaceae (CPE) strains have been increasingly reported in Belgium. We aimed to determine the proportion of CPE among Enterobacteriaceae isolated from hospitalised patients and community outpatients in Belgium in 2015. For the hospitalised patients, the results were compared to a previous similar survey performed in the same hospitals in 2012. Twenty-four hospital-based and 10 private laboratories collected prospectively 200 non-duplicated Enterobacteriaceae isolates from clinical specimens. All isolates were screened locally by carbapenem disk diffusion using European Committee on Antimicrobial Susceptibility Testing methodology. Putative CPE strains with inhibition zone diameters below the screening breakpoints were referred centrally for confirmation of carbapenemase production. From September to November 2015, we found a proportion of clinical CPE of 0.55% (26/4,705) and of 0.60% (12/1,991) among hospitalised patients and among ambulatory outpatients respectively. Klebsiella pneumoniae (26/38) and OXA-48-like carbapenemase (28/38) were the predominant species and enzyme among CPE. One OXA-48-producing Escherichia coli isolated from a hospital was found carrying plasmid-mediated MCR-1 colistin resistance. Compared with the 2012 survey, we found a significant increased proportion of clinical CPE (0.55% in 2015 vs 0.25% in 2012; p = 0.02) and an increased proportion of hospitals (13/24 in 2015 vs 8/24 in 2012) with at least one CPE detected. The study results confirmed the concerning spread of CPE including a colistin-resistant MCR-1 producer in hospitals and the establishment of CPE in the community in Belgium.
Keywords
ESCHERICHIA-COLI, KLEBSIELLA-PNEUMONIAE, RESISTANCE, PREVALENCE, SUSCEPTIBILITY, ACQUISITION, LACTAMASE, COMMUNITY, SPREAD, TRAVEL

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Chicago
Huang, Te Din, Pierre Bogaerts, Catherine Berhin, Martin Hoebeke, Caroline Bauraing, Youri Glupczynski, on behalf of a multicentre study group, Jerina Boelens, and Geert Claeys. 2017. “Increasing Proportion of Carbapenemase-producing Enterobacteriaceae and Emergence of a MCR-1 Producer Through a Multicentric Study Among Hospital-based and Private Laboratories in Belgium from September to November 2015.” Eurosurveillance 22 (19): 17–25.
APA
Huang, T. D., Bogaerts, P., Berhin, C., Hoebeke, M., Bauraing, C., Glupczynski, Y., multicentre study group, on behalf of a, et al. (2017). Increasing proportion of carbapenemase-producing Enterobacteriaceae and emergence of a MCR-1 producer through a multicentric study among hospital-based and private laboratories in Belgium from September to November 2015. EUROSURVEILLANCE, 22(19), 17–25.
Vancouver
1.
Huang TD, Bogaerts P, Berhin C, Hoebeke M, Bauraing C, Glupczynski Y, et al. Increasing proportion of carbapenemase-producing Enterobacteriaceae and emergence of a MCR-1 producer through a multicentric study among hospital-based and private laboratories in Belgium from September to November 2015. EUROSURVEILLANCE. 2017;22(19):17–25.
MLA
Huang, Te Din, Pierre Bogaerts, Catherine Berhin, et al. “Increasing Proportion of Carbapenemase-producing Enterobacteriaceae and Emergence of a MCR-1 Producer Through a Multicentric Study Among Hospital-based and Private Laboratories in Belgium from September to November 2015.” EUROSURVEILLANCE 22.19 (2017): 17–25. Print.
@article{8561921,
  abstract     = {Carbapenemase-producing Enterobacteriaceae (CPE) strains have been increasingly reported in Belgium. We aimed to determine the proportion of CPE among Enterobacteriaceae isolated from hospitalised patients and community outpatients in Belgium in 2015. For the hospitalised patients, the results were compared to a previous similar survey performed in the same hospitals in 2012. Twenty-four hospital-based and 10 private laboratories collected prospectively 200 non-duplicated Enterobacteriaceae isolates from clinical specimens. All isolates were screened locally by carbapenem disk diffusion using European Committee on Antimicrobial Susceptibility Testing methodology. Putative CPE strains with inhibition zone diameters below the screening breakpoints were referred centrally for confirmation of carbapenemase production. From September to November 2015, we found a proportion of clinical CPE of 0.55\% (26/4,705) and of 0.60\% (12/1,991) among hospitalised patients and among ambulatory outpatients respectively. Klebsiella pneumoniae (26/38) and OXA-48-like carbapenemase (28/38) were the predominant species and enzyme among CPE. One OXA-48-producing Escherichia coli isolated from a hospital was found carrying plasmid-mediated MCR-1 colistin resistance. Compared with the 2012 survey, we found a significant increased proportion of clinical CPE (0.55\% in 2015 vs 0.25\% in 2012; p = 0.02) and an increased proportion of hospitals (13/24 in 2015 vs 8/24 in 2012) with at least one CPE detected. The study results confirmed the concerning spread of CPE including a colistin-resistant MCR-1 producer in hospitals and the establishment of CPE in the community in Belgium.},
  author       = {Huang, Te Din and Bogaerts, Pierre and Berhin, Catherine and Hoebeke, Martin and Bauraing, Caroline and Glupczynski, Youri and multicentre study group, on behalf of a and Boelens, Jerina and Claeys, Geert},
  issn         = {1560-7917},
  journal      = {EUROSURVEILLANCE},
  keyword      = {ESCHERICHIA-COLI,KLEBSIELLA-PNEUMONIAE,RESISTANCE,PREVALENCE,SUSCEPTIBILITY,ACQUISITION,LACTAMASE,COMMUNITY,SPREAD,TRAVEL},
  language     = {eng},
  number       = {19},
  pages        = {17--25},
  title        = {Increasing proportion of carbapenemase-producing Enterobacteriaceae and emergence of a MCR-1 producer through a multicentric study among hospital-based and private laboratories in Belgium from September to November 2015},
  url          = {http://dx.doi.org/10.2807/1560-7917.es.2017.22.19.30530},
  volume       = {22},
  year         = {2017},
}

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