Carbapenemase-producing Enterobacteriaceae in Europe: Assessment by national experts from 38 countries, May 2015

Eurosurveillance

Volumn 20, Issue 45, 2015, Pages

  Albiger, B ^a   Glasner, C ^b,c   Struelens, M J ^a   Grundmann, H ^b   Monnet, D L ^a   Koraqi, Andi ^d   Bino, Silvia ^d   Hartl, Rainer ^d   Apfalter, Petra ^d   Glupczynski, Youri ^d   Jans, Beatrice ^d   Marković, Tatjana ^d   Dedeić Ljubović, Amela ^d   Kojić, Dušan ^d   Strateva, Tanya ^d   Sabtcheva, Stefana ^d   Butić, Iva ^d   Tambić Andrašević, Arjana ^d   Pieridou Bagatzouni, Despo ^d   Panayiota, Maikanti Charalampous ^d   Hrabak, Jaroslav ^d   Žemličkova, Helena ^d   Hammerum, Anette M ^d   Skov, Robert ^d   Ivanova, Marina ^d   Jalava, Jari ^d   Dortet, Laurent ^d   Vaux, Sophie ^d   Kaase, Martin ^d   Eckmanns, Tim ^d   Vatopoulos, Alkiviadis ^d   Giamarellou, Helen ^d   Tóth, Ákos ^d   Kurcz, Andrea ^d   Hardarson, Hordur ^d   Kristinsson, Karl ^d   Boo, Teck Wee ^d   Burns, Karen ^d   Carmeli, Yehuda ^d   Pantosti, Annalisa ^d   Kurti, Arsim ^d   Raka, Lul ^d   Balode, Arta ^d   Miciulevičienė, Jolanta ^d   Valintėlienė, Rolanda ^d   Perrin Weniger, Monique ^d   Nestorova, Nina ^d   Borg, Michael ^d   Mijović, Gordana ^d   Mugosa, Boban ^d   Meessen, Nico ^d   de Greeff, Sabine ^d   Samuelsen, Ørjan ^d   Simonsen, Gunnar Skov ^d   Żabicka, Dorota ^d   Hryniewicz, Waleria ^d   Caniça, Manuela ^d   Paiva, Jose Artur ^d   Kaftandzieva, Ana ^d   Memeti, Shaban ^d   Damian, Maria ^d   Codita, Irina ^d   Jelesić, Zora ^d   Stevanovic, Goran ^d   Nikš, Milan ^d   Schreterova, Eva ^d   Pirš, Mateja ^d   Kolman, Jana ^d   Oteo, Jesús ^d   Campos, José ^d   Giske, Christian G ^d   Sjöström, Karin ^d   Gür, Deniz ^d   Ekmekci, Elif ^d   Wiuff, Camilla ^d   Hopkins, Kathie ^d   Woodford, Neil ^d   Canton, Rafael ^d   Friedrich, Alexander W ^d   Gniadkowski, Marek ^d   Poirel, Laurent ^d   Rossolini, Gian Maria ^d   Seifert, Harald ^d   Walsh, Timothy ^d   Livermore, David ^d   Nordmann, Patrice ^d   more..

^a EUROPEAN CENTRE FOR DISEASE PREVENTION AND CONTROL ECDC   (Sweden)

^b UNIVERSITY MEDICAL CENTER GRONINGEN   (Netherlands)

^c Wellcome Genome Campus   (United Kingdom)

^d NONE

Author keywords

[No Author keywords available]

Indexed keywords

KLEBSIELLA PNEUMONIAE CARBAPENEMASE; METALLO BETA LACTAMASE; NEW DELHI METALLO BETA LACTAMASE; OXACILLINASE 48; UNCLASSIFIED DRUG; VERONA INTEGRON ENCODED METALLO BETA LACTAMASE; ANTIINFECTIVE AGENT; BACTERIAL PROTEIN; BETA LACTAMASE; CARBAPENEM DERIVATIVE; CARBAPENEMASE;

ARTICLE; BACTERIAL STRAIN; CARBAPENEMASE PRODUCING ENTEROBACTERIACEAE; COMPARATIVE STUDY; DISEASE SURVEILLANCE; ESCHERICHIA COLI; EUROPE; GEOGRAPHIC DISTRIBUTION; GRAM NEGATIVE INFECTION; HEALTH SURVEY; HUMAN; KLEBSIELLA PNEUMONIAE; QUESTIONNAIRE; ENTEROBACTERIACEAE; ENTEROBACTERIACEAE INFECTIONS; ENZYMOLOGY; METABOLISM; MICROBIAL SENSITIVITY TEST; MICROBIOLOGY;

ANTI-BACTERIAL AGENTS; BACTERIAL PROTEINS; BETA-LACTAMASES; CARBAPENEMS; ENTEROBACTERIACEAE; ENTEROBACTERIACEAE INFECTIONS; EUROPE; HUMANS; MICROBIAL SENSITIVITY TESTS; SURVEYS AND QUESTIONNAIRES;

EID: 84966355051     PISSN: 1025496X     EISSN: 15607917     Source Type: Journal    
DOI: 10.2807/1560-7917.ES.2015.20.45.30062     Document Type: Article

References (79)

1. European Survey on Carbapenemase-Producing Enterobacteriaceae (EuSCAPE) Working Group, Glasner C, Albiger B, Buist G, Tambić Andrasević A, Canton R, Carmeli Y, et al. Carbapenemase-producing Enterobacteriaceae in Europe: a survey among national experts from 39 countries, February 2013. Euro Surveill. 2013;18(28):20525. DOI: 10.2807/1560-7917.ES2013.18.28.20525 PMID: 23870096
2. European Centre for Disease Prevention and Control (ECDC). Carbapenemase-producing bacteria in Europe: interim results from the European Survey on carbapenemase-producing Enterobacteriaceae (EuSCAPE) project 2013. Stockholm: ECDC. 2014. Available from: http://ecdc.europa.eu/en/publications/Publications/antimicrobial-resistance-carbapenemase-producing-bacteria-europe.pdf
3. CNSE Working Group, Grundmann H, Livermore DM, Giske CG, Canton R, Rossolini GM, Campos J, et al. Carbapenem-non-susceptible Enterobacteriaceae in Europe: conclusions from a meeting of national experts. Euro Surveill. 2010;15(46).PMID: 21144429
4. Jakobsen L, Hansen F, Stegger M, Andersen PS, Hammerum AM, Fuglsang-Damgaard D. Use of whole-genome sequencing for detection of the spread of VIM-4-producing Escherichia coli between two patients in Denmark. Int J Antimicrob Agents. 2015;45(3):327-9. DOI: 10.1016/j.ijantimicag.2014.12.003 PMID: 25595952
5. Jakobsen L, Hammerum AM, Hansen F, Fuglsang-Damgaard D. An ST405 NDM-4-producing Escherichia coli isolated from a Danish patient previously hospitalized in Vietnam. J Antimicrob Chemother. 2014;69(2):559-60. DOI: 10.1093/jac/dkt356 PMID: 24013194
6. Hammerum AMHF, Olesen B, Struve C, Holzknecht BJ, Andersen PS, Thye A-M, et al. Investigation of a possible outbreak of NDM-5-producing ST16 Klebsiella pneumoniae among patients in Denmark with no history of recent travel using whole-genome sequencing. J Glob Antimicrob Resist. 2015;3(3):219-21. DOI: 10.1016/j.jgar.2015.05.003
7. Österblad M, Kirveskari J, Hakanen AJ, Tissari P, Vaara M, Jalava J. Carbapenemase-producing Enterobacteriaceae in Finland: the first years (2008-11). J Antimicrob Chemother. 2012;67(12):2860-4. DOI: 10.1093/jac/dks299 PMID: 22855858
8. Kanerva M, Skogberg K, Ryynänen K, Pahkamäki A, Jalava J, Ollgren J, et al. Coincidental detection of the first outbreak of carbapenemase-producing Klebsiella pneumonia colonisation in a primary care hospital, Finland, 2013. Euro Surveill. 2015;20(26):21172. DOI: 10.2807/1560-7917. ES2015.20.26.21172 PMID: 26159309
9. Löfmark S, Sjöström K, Mäkitalo B, Edquist P, Tegmark Wisell K, Giske CG. Carbapenemase-producing Enterobacteriaceae in Sweden 2007-2013: Experiences from seven years of systematic surveillance and mandatory reporting. Drug Resist Updat. 2015;20:29-38. DOI: 10.1016/j.drup.2015.05.001 PMID: 26004211
10. Dautzenberg MJ, Ossewaarde JM, de Kraker ME, van der Zee A, van Burgh S, de Greeff SC, et al. Successful control of a hospital-wide outbreak of OXA-48 producing Enterobacteriaceae in the Netherlands, 2009 to 2011. Euro Surveill. 2014;19(9):20723. DOI: 10.2807/1560-7917. ES2014.19.9.20723 PMID: 24626209
11. Bathoorn E, Friedrich AW, Zhou K, Arends JP, Borst DM, Grundmann H, et al. Latent introduction to the Netherlands of multiple antibiotic resistance including NDM-1 after hospitalisation in Egypt, August 2013. Euro Surveill. 2013;18(42):20610. DOI: 10.2807/1560-7917. ES2013.18.42.20610 PMID: 24176580
12. European Centre for Disease Prevention and Control (ECDC), Antimicrobial resistance surveillance in Europe 2014. Annual Report of the European Antimicrobial Resistance Surveillance Network (EARS-Net). Stockholm: ECDC. 2015; (Forthcoming).
13. Pavelkovich A, Balode A, Edquist P, Egorova S, Ivanova M, Kaftyreva L, et al. Detection of carbapenemase-producing enterobacteriaceae in the baltic countries and st. Petersburg area. Biomed Res Int. 2014;2014:548960.
14. Prior AR, Roche C, Lynch M, Kelly S, O’Rourke K, Crowley B. First identified case of VIM-producing carbapenem-resistant Klebsiella pneumoniae in the Republic of Ireland associated with fatal outcome. Euro Surveill. 2010;15(50).PMID: 21172170
15. Roche C, Cotter M, O Connell N, Crowley B. First identification of class A carbapenemase-producing Klebsiella pneumoniae in the Republic of Ireland. Euro Surveill. 2009;14(13).PMID: 19341609
16. McDermott H, Morris D, McArdle E, O’Mahony G, Kelly S, Cormican M, et al. Isolation of NDM-1-producing Klebsiella pnemoniae in Ireland, July 2011. Euro Surveill. 2012;17(7). PMID: 22370013
17. Morris D, Boyle F, Morris C, Condon I, Delannoy-Vieillard AS, Power L, et al. Inter-hospital outbreak of Klebsiella pneumoniae producing KPC-2 carbapenemase in Ireland. J Antimicrob Chemother. 2012;67(10):2367-72. DOI: 10.1093/jac/dks239 PMID: 22744760
18. Wrenn C, O’Brien D, Keating D, Roche C, Rose L, Ronayne A, et al. Investigation of the first outbreak of OXA-48-producing Klebsiella pneumoniae in Ireland. J Hosp Infect. 2014;87(1):41-6. DOI: 10.1016/j.jhin.2014.03.001 PMID: 24746608
19. Yong D, Toleman MA, Giske CG, Cho HS, Sundman K, Lee K, et al. Characterization of a new metallo-beta-lactamase gene, bla(NDM-1), and a novel erythromycin esterase gene carried on a unique genetic structure in Klebsiella pneumoniae sequence type 14 from India. Antimicrob Agents Chemother. 2009;53(12):5046-54. DOI: 10.1128/AAC.00774-09 PMID: 19770275
20. Kumarasamy KK, Toleman MA, Walsh TR, Bagaria J, Butt F, Balakrishnan R, et al. Emergence of a new antibiotic resistance mechanism in India, Pakistan, and the UK: a molecular, biological, and epidemiological study. Lancet Infect Dis. 2010;10(9):597-602. DOI: 10.1016/S1473-3099(10)70143-2 PMID: 20705517
21. Zarfel G, Hoenigl M, Würstl B, Leitner E, Salzer HJ, Valentin T, et al. Emergence of carbapenem-resistant Enterobacteriaceae in Austria, 2001-2010. Clin Microbiol Infect. 2011;17(11):E5-8. DOI: 10.1111/j.1469-0691.2011.03659.x PMID: 21939472
22. Grisold AJ, Hoenigl M, Ovcina I, Valentin T, Fruhwald S. Ventilator-associated pneumonia caused by OXA-48-producing Escherichia coli complicated by ciprofloxacin-associated rhabdomyolysis. Journal of infection and chemotherapy: official journal of the Japan Society of Chemotherapy. 2013;19(6):1214-7.
23. Leitner E, Zarfel G, Luxner J, Herzog K, Pekard-Amenitsch S, Hoenigl M, et al. Contaminated handwashing sinks as the source of a clonal outbreak of KPC-2-producing Klebsiella oxytoca on a hematology ward. Antimicrob Agents Chemother. 2015;59(1):714-6. DOI: 10.1128/AAC.04306-14 PMID: 25348541
24. Heller I, Grif K, Orth D. Emergence of VIM-1-carbapenemase-producing Enterobacter cloacae in Tyrol, Austria.J Med Microbiol. 2012;61(Pt 4):567-71. DOI: 10.1099/jmm.0.038646-0 PMID: 22194339
25. Czech Participants of European Antimicrobial Resistance Surveillance Network, Hrabák J, Papagiannitsis CC, Študentová V, Jakubu V, Fridrichová M, Zemlickova H, et al. Carbapenemase-producing Klebsiella pneumoniae in the Czech Republic in 2011. Euro Surveill. 2013;18(45):20626. DOI: 10.2807/1560-7917.ES2013.18.45.20626 PMID: 24229789
26. Studentova V, Dobiasova H, Hedlova D, Dolejska M, Papagiannitsis CC, Hrabak J. Complete nucleotide sequences of two NDM-1-encoding plasmids from the same sequence type 11 Klebsiella pneumoniae strain. Antimicrob Agents Chemother. 2015;59(2):1325-8. DOI: 10.1128/AAC.04095-14 PMID: 25421477
27. Hrabák J, Študentová V, Jakubů V, Adámková V, Dvořáková L, Balejova M, et al. Prevalence study on carbapenemase- producing Escherichia coli and Klebsiella pneumoniae isolates in Czech hospitals--results from Czech Part of European Survey on Carbapenemase--Producing Enterobacteriaceae (EuSCAPE). Epidemiol Mikrobiol Imunol. 2015;64(2):87-91.PMID: 26099612
28. Ducomble T, Faucheux S, Helbig U, Kaisers UX, König B, Knaust A, et al. Large hospital outbreak of KPC-2-producing Klebsiella pneumoniae: investigating mortality and the impact of screening for KPC-2 with polymerase chain reaction. J Hosp Infect. 2015;89(3):179-85. DOI: 10.1016/j.jhin.2014.11.012 PMID: 25623204
29. Bogaerts P, de Castro RR, Deplano A, Bouchahrouf W, Tsobo C, Denis O, et al. Detection of a VIM-27-producing Klebsiella pneumoniae isolate in a patient following surgical tourism in Greece. Antimicrob Agents Chemother. 2011;55(9):4488-9. DOI: 10.1128/AAC.00688-11 PMID: 21746946
30. Pirš M, Andlovic A, Cerar T, Žohar-Čretnik T, Kobola L, Kolman J, et al. A case of OXA-48 carbapenemase-producing Klebsiella pneumoniae in a patient transferred to Slovenia from Libya, November 2011. Euro Surveill. 2011;16(50):20042.PMID: 22221496
31. Tóth A, Damjanova I, Puskás E, Jánvári L, Farkas M, Dobák A, et al. Emergence of a colistin-resistant KPC-2-producing Klebsiella pneumoniae ST258 clone in Hungary. Eur J Clin Microbiol Infect Dis. 2010;29(7):765-9. Error! Hyperlink reference not valid. DOI: 10.1007/s10096-010-0921-3 PMID: 20401676
32. Jánvári L, Damjanova I, Lázár A, Rácz K, Kocsis B, Urbán E, et al. Emergence of OXA-162-producing Klebsiella pneumonia in Hungary. Scand J Infect Dis. 2014;46(4):320-4. DOI: 10.3109/00365548.2013.879993 PMID: 24552581
33. KPC-PL Study Group, Baraniak A, Grabowska A, Izdebski R, Fiett J, Herda M, Bojarska K, et al. Molecular characteristics of KPC-producing Enterobacteriaceae at the early stage of www.eurosurveillance.org their dissemination in Poland, 2008-2009. Antimicrob Agents Chemother. 2011;55(12):5493-9. DOI: 10.1128/AAC.05118-11 PMID: 21930889
34. Munoz-Price LS, Poirel L, Bonomo RA, Schwaber MJ, Daikos GL, Cormican M, et al. Clinical epidemiology of the global expansion of Klebsiella pneumoniae carbapenemases. Lancet Infect Dis. 2013;13(9):785-96. DOI: 10.1016/S1473- 3099(13)70190-7 PMID: 23969216
35. Baraniak A, Izdebski R, Fiett J, Gawryszewska I, Bojarska K, Herda M, et al. NDM-producing Enterobacteriaceae in Poland, 2012-14: inter-regional outbreak of Klebsiella pneumoniae ST11 and sporadic cases. J Antimicrob Chemother. 2015;dkv282. [Epub ahead of print].
36. Fiett J, Baraniak A, Izdebski R, Sitkiewicz I, Żabicka D, Meler A, et al. The first NDM metallo-β-lactamase-producing Enterobacteriaceae isolate in Poland: evolution of IncFII-type plasmids carrying the bla(NDM-1) gene. Antimicrob Agents Chemother. 2014;58(2):1203-7. DOI: 10.1128/AAC.01197-13 PMID: 24247128
37. Székely E, Damjanova I, Jánvári L, Vas KE, Molnár S, Bilca DV, et al. First description of bla(NDM-1), bla(OXA-48), bla(OXA-181) producing Enterobacteriaceae strains in Romania. Int J Med Microbiol. 2013;303(8):697-700. DOI: 10.1016/j.ijmm.2013.10.001 PMID: 24183483
38. Dortet L, Flonta M, Boudehen YM, Creton E, Bernabeu S, Vogel A, et al. Dissemination of Carbapenemase-Producing Enterobacteriaceae and Pseudomonas aeruginosa in Romania. Antimicrob Agents Chemother. 2015;59(11):7100-3. DOI: 10.1128/AAC.01512-15 PMID: 26303798
39. Gheorghe I, Czobor I, Chifiriuc MC, Borcan E, Ghiţă C, Banu O, et al. Molecular screening of carbapenemase-producing Gram-negative strains in Romanian intensive care units during a one year survey. J Med Microbiol. 2014;63(Pt 10):1303-10. DOI: 10.1099/jmm.0.074039-0 PMID: 25060972
40. Schréterová E, Takáčová V, Nikš M, Pastvová L, Tomčo L, Siegfried L. [Methods of phenotypic determination of New Delhi metallo-beta-lactamase (NDM-1) in Klebsiella penumoniae isolated in Slovakia]. Klin Mikrobiol Infekc Lek. 2014;20(3):79-84.PMID: 25702288
41. Kostyanev T, Tafaj S, Skenduli I, Bardhi D, Kapisyzi P, Bino S, et al. First detection of KPC-3-producing Klebsiella pneumonia in Albania. New Microbes New Infect. 2015;4:11-2. DOI: 10.1016/j.nmni.2015.01.001 PMID: 25830029
42. Mazzariol A, Bošnjak Z, Ballarini P, Budimir A, Bedenić B, Kalenić S, et al. NDM-1-producing Klebsiella pneumoniae, Croatia. Emerg Infect Dis. 2012;18(3):532-4. DOI: 10.3201/ eid1803.1103890 PMID: 22377049
43. Meletis G, Oustas E, Bagkeri M. Carbapenemase reports from the Balkans: a systematic review. Infez Med. 2014;22(2):85-106. PMID: 24955795
44. Markovska R, Schneider I, Stoeva T, Bojkova K, Boyanova L, Bauernfeind A, et al. First identification of KPC-2 and VIM-1 producing Klebsiella pneumoniae in Bulgaria. Diagn Microbiol Infect Dis. 2013;77(3):252-3. DOI: 10.1016/j.diagmicrobio.2013.07.019 PMID: 24041551
45. Poirel L, Savov E, Nazli A, Trifonova A, Todorova I, Gergova I, et al. Outbreak caused by NDM-1- and RmtB-producing Escherichia coli in Bulgaria. Antimicrob Agents Chemother. 2014;58(4):2472-4. DOI: 10.1128/AAC.02571-13 PMID: 24514099
46. Bedenić B, Mazzariol A, Plečko V, Bošnjak Z, Barl P, Vraneš J, et al. First report of KPC-producing Klebsiella pneumoniae in Croatia. J Chemother. 2012;24(4):237-9. DOI: 10.1179/1973947812Y.0000000017 PMID: 23040691
47. Zujić Atalić V, Bedenić B, Kocsis E, Mazzariol A, Sardelić S, Barišić M, et al. Diversity of carbapenemases in clinical isolates of Enterobacteriaceae in Croatia--the results of a multicentre study. Clin Microbiol Infect. 2014;20(11):0894-903. DOI: 10.1111/1469-0691.12635 PMID: 24674100
48. Bogaerts P, Bouchahrouf W, de Castro RR, Deplano A, Berhin C, Piérard D, et al. Emergence of NDM-1-producing Enterobacteriaceae in Belgium. Antimicrob Agents Chemother. 2011;55(6):3036-8. DOI: 10.1128/AAC.00049-11 PMID:21444697
49. Zarfel G, Hoenigl M, Leitner E, Salzer HJ, Feierl G, Masoud L, et al. Emergence of New Delhi metallo-β-lactamase, Austria. Emerg Infect Dis. 2011;17(1):129-30. DOI: 10.3201/eid1701.101331 PMID: 21192874
50. Seiffert SN, Marschall J, Perreten V, Carattoli A, Furrer H, Endimiani A. Emergence of Klebsiella pneumoniae coproducing NDM-1, OXA-48, CTX-M-15, CMY-16, QnrA and ArmA in Switzerland. Int J Antimicrob Agents. 2014;44(3):260-2. DOI: 10.1016/j.ijantimicag.2014.05.008 PMID: 25123809
51. Oteo J, Miró E, Pérez-Vázquez M, Navarro F. Evolution of carbapenemase-producing Enterobacteriaceae at the global and national level: what should be expected in the www.eurosurveillance.orgfuture?Enferm. Infecc Microbiol Clin. 2014;32(Suppl 4):17-23. DOI: 10.1016/S0213-005X(14)70170-3 PMID: 25542048
52. GEIH-GEMARA (SEIMC) and REIPI, Oteo J, Ortega A, Bartolomé R, Bou G, Conejo C, Fernández-Martínez M, et al. Prospective multicenter study of carbapenemase-producing Enterobacteriaceae from 83 hospitals in Spain reveals high in vitro susceptibility to colistin and meropenem. Antimicrob Agents Chemother. 2015;59(6):3406-12. DOI: 10.1128/AAC.00086-15 PMID: 25824224
53. Spanish Collaborating Group for the Antibiotic Resistance Surveillance Program, Oteo J, Saez D, Bautista V, Fernández-Romero S, Hernández-Molina JM, Pérez-Vázquez M, et al. Carbapenemase-producing enterobacteriaceae in Spain in 2012. Antimicrob Agents Chemother. 2013;57(12):6344-7. DOI: 10.1128/AAC.01513-13 PMID: 24041898
54. Seara N, Oteo J, Carrillo R, Pérez-Blanco V, Mingorance J, Gómez-Gil R, et al. Interhospital spread of NDM-7-producing Klebsiella pneumoniae belonging to ST437 in Spain. Int J Antimicrob Agents. 2015;46(2):169-73. DOI: 10.1016/j.ijantimicag.2015.04.001 PMID: 25982912
55. Antibiotic Resistance Surveillance Program in Portugal (ARSIP), Manageiro V, Ferreira E, Almeida J, Barbosa S, Simões C, Bonomo RA, et al. Predominance of KPC-3 in a survey for carbapenemase-producing Enterobacteriaceae in Portugal. Antimicrob Agents Chemother. 2015;59(6):3588-92. DOI: 10.1128/AAC.05065-14 PMID: 25779587
56. Manageiro V, Ferreira E, Pinto M, Caniça M. First description of OXA-48 carbapenemase harbored by Escherichia coliand Enterobacter cloacae from a single patient in Portugal. Antimicrob Agents Chemother. 2014;58(12):7613-4. DOI: 10.1128/AAC.02961-14 PMID: 25246399
57. EARS-Net Coordination Group and EARS-Net participants, Magiorakos AP, Suetens C, Monnet DL, Gagliotti C, Heuer OE. The rise of carbapenem resistance in Europe: just the tip of the iceberg?Antimicrob Resist Infect Control. 2013;2(1):6. DOI: 10.1186/2047-2994-2-6 PMID: 23410479
58. Voulgari E, Zarkotou O, Ranellou K, Karageorgopoulos DE, Vrioni G, Mamali V, et al. Outbreak of OXA-48 carbapenemase- producing Klebsiella pneumoniae in Greece involving an ST11 clone. J Antimicrob Chemother. 2013;68(1):84-8. DOI: 10.1093/jac/dks356 PMID: 22945916
59. Giakkoupi P, Tryfinopoulou K, Kontopidou F, Tsonou P, Golegou T, Souki H, et al. Emergence of NDM-producing Klebsiella pneumoniae in Greece. Diagn Microbiol Infect Dis. 2013;77(4):382-4. DOI: 10.1016/j.diagmicrobio.2013.09.001 PMID: 24135413
60. Schwaber MJ, Carmeli Y. An ongoing national intervention to contain the spread of carbapenem-resistant enterobacteriaceae. Clin Infect Dis. 2014;58(5):697-703. DOI:10.1093/cid/cit795 PMID: 24304707
61. Gefen-Halevi S, Hindiyeh MY, Ben-David D, Smollan G, Gal-Mor O, Azar R, et al. Isolation of genetically unrelated bla(NDM-1)-positive Providencia rettgeri strains in Israel. J Clin Microbiol. 2013;51(5):1642-3. DOI: 10.1128/JCM.00381-13 PMID: 23486709
62. Adler A, Shklyar M, Schwaber MJ, Navon-Venezia S, Dhaher Y, Edgar R, et al. Introduction of OXA-48-producing Enterobacteriaceae to Israeli hospitals by medical tourism. J Antimicrob Chemother. 2011;66(12):2763-6. DOI: 10.1093/jac/dkr382 PMID: 22191089
63. Adler A, Solter E, Masarwa S, Miller-Roll T, Abu-Libdeh B, Khammash H, et al. Epidemiological and microbiological characteristics of an outbreak caused by OXA-48-producing Enterobacteriaceae in a neonatal intensive care unit in Jerusalem, Israel. J Clin Microbiol. 2013;51(9):2926-30. DOI:10.1128/JCM.01049-13 PMID: 23804390
64. AMCLI-CRE Survey Participants, Giani T, Pini B, Arena F, Conte V, Bracco S, Migliavacca R, et al. Epidemic diffusion of KPC carbapenemase-producing Klebsiella pneumoniae in Italy: results of the first countrywide survey, 15 May to 30 June 2011. Euro Surveill. 2013;18(22).PMID: 23787077
65. Gaibani P, Ambretti S, Berlingeri A, Cordovana M, Farruggia P, Panico M, et al. Outbreak of NDM-1-producing Enterobacteriaceae in northern Italy, July to August 2011. Euro Surveill. 2011;16(47):20027.PMID: 22152705
66. Giani T, Conte V, Di Pilato V, Aschbacher R, Weber C, Larcher C, et al. Escherichia coli from Italy producing OXA-48 carbapenemase encoded by a novel Tn1999 transposon derivative. Antimicrob Agents Chemother. 2012;56(4):2211-3. DOI: 10.1128/AAC.00035-12 PMID: 22290939
67. D’Andrea MM, Venturelli C, Giani T, Arena F, Conte V, Bresciani P, et al. Persistent carriage and infection by multidrug-resistant Escherichia coli ST405 producing NDM-1 carbapenemase: report on the first Italian cases. J Clin Microbiol. 2011;49(7):2755-8. DOI: 10.1128/JCM.00016-11 PMID: 21525229
68. Network EuSCAPE-Italy, Monaco M, Giani T, Raffone M, Arena F, Garcia-Fernandez A, Pollini S, et al. Colistin resistance 17 superimposed to endemic carbapenem-resistant Klebsiella pneumoniae: a rapidly evolving problem in Italy, November 2013 to April 2014. Euro Surveill. 2014;19(42):20939. DOI: 10.2807/1560-7917.ES2014.19.42.20939 PMID: 25358041
69. European Centre for Disease Prevention and Control (ECDC). Annual Epidemiological Report 2012. Reporting on 2010 surveillance data and 2011 epidemic intelligence data. Stockholm: ECDC. 2013. Available from: http://ecdc.europa.eu/en/publications/Publications/Annual-Epidemiological-Report-2012.pdf
70. Labarca J, Poirel L, Ozdamar M, Turkoglü S, Hakko E, Nordmann P. KPC-producing Klebsiella pneumoniae, finally targeting Turkey. New Microbes New Infect. 2014;2(2):50-1. DOI: 10.1002/ nmi2.42 PMID: 25356342
71. Poirel L, Ozdamar M, Ocampo-Sosa AA, Türkoglu S, Ozer UG, Nordmann P. NDM-1-producing Klebsiella pneumoniae now in Turkey. Antimicrob Agents Chemother. 2012;56(5):2784-5. DOI: 10.1128/AAC.00150-12 PMID: 22391536
72. Poirel L, Yilmaz M, Istanbullu A, Arslan F, Mert A, Bernabeu S, et al. Spread of NDM-1-producing Enterobacteriaceae in a neonatal intensive care unit in Istanbul, Turkey. Antimicrob Agents Chemother. 2014;58(5):2929-33. DOI: 10.1128/ AAC.02047-13 PMID: 24550328
73. Kilic A, Baysallar M. The First Klebsiella pneumoniae Isolate Co-Producing OXA-48 and NDM-1 in Turkey. Ann Lab Med. 2015;35(3):382-3. DOI: 10.3343/alm.2015.35.3.382 PMID: 25932453
74. World Health Organization, Regional Office for Europe. (WHO/ Europe). Central Asian and Eastern European Surveillance of Antimicrobial Resistance. Annual report 2014. Copenhagen: WHO/Europe. 2015. Available from: http://www.euro.who.int/data/assets/pdf_file/0006/285405/CAESAR-Surveillance-Antimicrobial-Resistance2014.pdf?ua=1
75. European Centre for Disease Prevention and Control (ECDC). Directory of available online guidance documents on prevention and control of carbapenem-resistant Enterobaceriaceae. Stockholm: ECDC. 2014. Available from: http://ecdc.europa.eu/en/healthtopics/Healthcare-associated_infections/guidance-infection-prevention-control/Pages/ guidance-prevention-control-infections-CRE.aspx
76. European Centre for Disease Prevention and Control (ECDC). Systematic review of the effectiveness of infection control measures to prevent the transmission of carbapenemase-producing Enterobacteriaceae through cross-border transfer of patients. Stockholm: ECDC. 2014. Available from: http://ecdc.europa.eu/en/publications/Publications/CPE-systematic-review-effectiveness-infection-control-measures-to-prevent- transmission-2014.pdf
77. European Centre for Disease Prevention and Control (ECDC). Summary of the latest data on antibiotic consumption in the European Union. November 2014. Stockholm: ECDC. 2014. Available from: http://ecdc.europa.eu/en/eaad/antibiotics-get-informed/antibiotics-resistance-consumption/Pages/data- reports.aspx
78. Weterings V, Zhou K, Rossen JW, van Stenis D, Thewessen E, Kluytmans J, et al. An outbreak of colistin-resistant Klebsiella pneumoniae carbapenemase-producing Klebsiella pneumoniae in the Netherlands (July to December 2013), with inter-institutional spread. Eur J Clin Microbiol Infect Dis. 2015;34(8):1647-55. DOI: 10.1007/s10096-015-2401-2 PMID: 26067658
79. Douka E, Perivolioti E, Kraniotaki E, Fountoulis K, Economidou F, Tsakris A, et al. Emergence of a pandrug-resistant VIM- 1-producing Providencia stuartii clonal strain causing an outbreak in a Greek intensive care unit. Int J Antimicrob Agents. 2015;45(5):533-6. DOI: 10.1016/j.ijantimicag.2014.12.030 PMID: 25749199