Rise of carbapenem-resistant Enterobactericaeae

June 14, 2018, European Centre for Disease Prevention and Control (ECDC)

Infections with bacteria resistant to carbapenems, a group of highly effective antibiotics, pose a significant threat to patients and healthcare systems in all EU/EEA countries, warns ECDC in a Rapid Risk Assessment.

Resistance to carbapenems has been reported with increasing frequency and geographical spread since the beginning of the 1990s. The global rise of carbapenem in a certain family of bacteria called Enterobacteriaceae, or carbapenem-resistant Enterobactericaeae (CRE), represents a threat to healthcare delivery and patient safety.

"We should be very concerned about the rise in carbapenem resistance in the EU/EEA as there are very few options for the of patients with CRE infections" says Dominique Monnet, Head of ECDC's Antimicrobial Resistance and Healthcare-Associated Infections Programme. "In recent years, the proportions of carbapenem resistance in Klebsiella pneumoniae - a type of Enterobacteriaceae—rapidly increased to high levels in Greece, Italy and Romania. The same could happen to other EU/EEA countries if appropriate measures are not taken. But the spread of CRE can likely be controlled in most countries through the implementation of appropriate prevention and control measures in hospitals and other healthcare settings."

CRE are often a cause of and in hospital settings. Such infections are associated with prolonged hospital stays, high treatment costs, treatment failures and high mortality, primarily due to delays in the administration of effective treatment and the limited availability of treatment options.

Data from the European Antimicrobial Resistance Surveillance Network (EARS-Net) for 2016 show large differences in the national percentages of resistant bloodstream infections caused by Klebsiella pneumonia, ranging from 0% to as high as 67%, depending on the country. Although prevalence is still low in most European countries, Romania, Italy and Greece, with 31%, 34% and 67%, respectively, are among the countries reporting the highest prevalences worldwide.

In general, if the frequency of resistance to an antibiotic is high, it cannot be recommended for empiric treatment anymore due to the risk of failure. In case of CRE infection, there is no good antibiotic alternative for empiric treatment that does not carry serious side effects or other complications.

Introduction of CRE into low-prevalence EU/EEA countries can happen when patients are transferred from an EU Member State with a high level of CRE, or from other countries or regions of the world with high reported levels of CRE, e.g. countries in the eastern and southern Mediterranean regions, the Indian subcontinent and south-east Asia.

Timely and appropriate laboratory investigation and reporting is essential to avoid delays in appropriate treatment and in the implementation of appropriate infection control measures. Strict adherence to control measures and implementation of comprehensive antimicrobial stewardship programmes are key to prevent and control the emergence and spread of CRE, as highlighted in the ECDC rapid risk assessment.

Explore further: Efforts needed to stop the spread of carbapenem-resistant Acinetobacter baumannii

More information: ecdc.europa.eu/en/publications … riaceae-first-update

Related Stories

Efforts needed to stop the spread of carbapenem-resistant Acinetobacter baumannii

December 14, 2016
ECDC's latest risk assessment highlights the need of increased efforts to face this significant threat to patients and healthcare systems in all EU/EEA countries and outlines options to reduce risks through clinical management, ...

Combined resistance to multiple antibiotics: A growing problem in the EU

November 15, 2017
On the occasion of the 10th European Antibiotic Awareness Day, the European Centre for Disease Prevention and Control (ECDC) is releasing its latest EU-wide data on antibiotic resistance, as well as its guidance on prevention ...

Drug resistance genes shared among bacteria in hospitals can be deadly

June 10, 2018
A hospital outbreak of carbapenem-resistant Enterobacteriaceae (CRE) became more worrisome when researchers found resistance genes being shared among unrelated bacteria via plasmids and other mobile genetic elements. This ...

Antibiotic-resistant bacteria found in the US presents a triple threat

June 9, 2018
Researchers from the Emory Antibiotic Resistance Center describe the first strain of carbapenem-resistant, hypermucoviscous Klebsiella pneumoniae exhibiting colistin heteroresistance and enhanced virulence isolated from a ...

Antimicrobial resistance in zoonotic bacteria still high in humans, animals and food

February 27, 2018
Bacteria from humans and animals continue to show resistance to antimicrobials, according to a new report published today by the European Food Safety Authority (EFSA) and the European Centre for Disease Prevention and Control ...

Avoid piperacillin-tazobactam when treating BSI cause by ceftriaxone-resistant pathogens

April 22, 2018
The antibiotic combination treatment piperacillin-tazobactam was significantly less effective than meropenem when treating potentially fatal bloodstream infections (BSI) caused by ceftriaxone-resistant Escherichia coli and ...

Recommended for you

Study reveals new therapeutic target for slowing the spread of flu virus

June 22, 2018
Influenza A (flu A) hijacks host proteins for viral RNA splicing and blocking these interactions caused replication of the virus to slow, according to new research published in Nature Communications by Kristin W. Lynch, Ph.D., ...

First ancient syphilis genomes decoded

June 21, 2018
An international research team, including scientists from the Max Planck Institute for the Science of Human History, the University of Tübingen, the National School of Anthropology and History in Mexico City, and the University ...

Rhesus macaque model offers route to study Zika brain pathology

June 21, 2018
Rhesus macaque monkeys infected in utero with Zika virus develop similar brain pathology to human infants, according to a report by researchers at the California National Primate Research Center and School of Veterinary Medicine ...

California Aedes mosquitoes capable of spreading Zika

June 21, 2018
Over the last five years, Zika virus has emerged as a significant global human health threat following outbreaks in South and Central America. Now, researchers reporting in PLOS Neglected Tropical Diseases have shown that ...

Breakthrough treatment for crippling jaw disease created

June 20, 2018
A first-ever tissue implant to safely treat a common jaw defect, known as temporomandibular joint dysfunction, has been successfully tested by UCI-led researchers in a large animal model, according to new findings.

Cell-free DNA profiling informative way to monitor urinary tract infections

June 20, 2018
Using shotgun DNA sequencing, Cornell University researchers have demonstrated a new method for monitoring urinary tract infections (UTIs) that surpasses traditional methods in providing valuable information about the dynamics ...

0 comments

Please sign in to add a comment. Registration is free, and takes less than a minute. Read more

Click here to reset your password.
Sign in to get notified via email when new comments are made.