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1. Multicenter prospective study on the prevalence of colistin resistance in Escherichia coli: relevance of mcr-1-positive clinical isolates in Lombardy, Northern Italy

Author

Principe L, Piazza A, Mauri C, Anesi A, Bracco S, Brigante G, Casari E, Agrappi C, Caltagirone M, Novazzi F, Migliavacca R, Pagani L, and Luzzaro F

Subjects
MCR-1, colistin, Escherichia coli, prevalence, surveillance, epidemiology, Infectious and parasitic diseases, RC109-216
Abstract

Luigi Principe,1 Aurora Piazza,2,3 Carola Mauri,1 Adriano Anesi,4 Silvia Bracco,5 Gioconda Brigante,6 Erminia Casari,7 Carlo Agrappi,8 Mariasofia Caltagirone,2 Federica Novazzi,2 Roberta Migliavacca,2 Laura Pagani,2 Francesco Luzzaro1 1Microbiology and Virology Unit, A. Manzoni Hospital, Lecco, Italy; 2Clinical-Surgical, Diagnostic and Pediatric Sciences Department, Unit of Microbiology and Clinical Microbiology, University of Pavia, Pavia, Italy; 3Romeo and Enrica Invernizzi Pediatric Research Center, Department of Biomedical and Clinical Sciences, University of Milan, Milan, Italy; 4Clinical Pathology Laboratory, ASST Lodi, Lodi, Italy; 5Clinical Pathology Laboratory, ASST Vimercate, Vimercate, Italy; 6Clinical Pathology Laboratory, ASST Valle Olona, Busto Arsizio, Italy; 7Clinical Pathology Laboratory, IRCCS “Humanitas,” Rozzano, Italy; 8Microbiology and Virology Unit, ASST Ovest Milanese, Legnano, Italy Background: The emergence of the plasmid-mediated colistin resistance mechanism in Escherichia coli has raised concern among public health experts as colistin is a last-line antimicrobial resort. The primary aim of the study was to investigate the prevalence of this resistance trait in E. coli isolates circulating in the Lombardy region, Northern Italy. The presence of mcr-type genes and their genetic relationship were also studied.Materials and methods: A prospective study was performed during a 4-month period (May to August, 2016) in six acute care Hospitals. Consecutive nonduplicate clinical isolates of E. coli from any type of clinical specimen, with the exception of rectal swabs, were included in the study. Isolates that exhibited MIC values for colistin >2 mg/L were further investigated. Bacterial identification was obtained by matrix-assisted laser desorption ionization-time of flight mass spectrometry. Amplification of mcr-type genes (−1 to −5 variants) and microarray analysis were accomplished. Repetitive sequence-based PCR (Rep-PCR) and multilocus sequence typing (MLST) analysis were used for genotyping.Results: Overall, 3,902 consecutive E. coli isolates (2,342 from outpatients, 1,560 from inpatients) were evaluated during the study period. Of them, 18/3,902 (0.5%), collected from 4/6 centers, showed resistance to colistin. These isolates were mostly obtained from urine of both outpatients (n=12) and inpatients (n=6). Colistin MIC values ranged from 4 to 8 mg/L. The mcr-1 gene was detected in 10/18 isolates (7 from outpatients, 3 from inpatients). Rep-PCR and MLST analysis revealed the presence of nine different clusters. Further mcr-type genes were not detected.Conclusion: Resistance to colistin in E. coli clinical isolates appears low in our geographic area. With regard to mcr-1-positive isolates, they accounted for approximately 50% of colistin-resistant E. coli isolates, thus representing a relevant resistance mechanism in this context. Although overall limited, the presence of mcr-1 determinant in our region should not be ignored and great concern should be given to the continuous surveillance. Keywords: MCR-1, colistin, Escherichia coli, prevalence, surveillance, epidemiology

Published
2018

2. Diagnosis and management of infections caused by multidrug-resistant bacteria: guideline endorsed by the Italian Society of Infection and Tropical Diseases (SIMIT), the Italian Society of Anti-Infective Therapy (SITA), the Italian Group for Antimicrobial Stewardship (GISA), the Italian Association of Clinical Microbiologists (AMCLI) and the Italian Society of Microbiology (SIM)

Author

Tiseo, G., Brigante, G., Giacobbe, D. R., Maraolo, A. E., Gona, F., Falcone, Marco, Giannella, M., Grossi, Paolo, Pea, Federico, Rossolini, G. M., Sanguinetti, Maurizio, Sarti, Daniela Maria, Scarparo, C., Tumbarello, Mario, Venditti, Mario, Viale, P., Bassetti, M., Luzzaro, F., Menichetti, F., Stefani, S., Tinelli, M., Falcone M., Grossi P., Pea F., Sanguinetti M. (ORCID:0000-0002-9780-7059), Sarti M., Tumbarello M. (ORCID:0000-0002-9519-8552), Venditti M., Tiseo, G., Brigante, G., Giacobbe, D. R., Maraolo, A. E., Gona, F., Falcone, Marco, Giannella, M., Grossi, Paolo, Pea, Federico, Rossolini, G. M., Sanguinetti, Maurizio, Sarti, Daniela Maria, Scarparo, C., Tumbarello, Mario, Venditti, Mario, Viale, P., Bassetti, M., Luzzaro, F., Menichetti, F., Stefani, S., Tinelli, M., Falcone M., Grossi P., Pea F., Sanguinetti M. (ORCID:0000-0002-9780-7059), Sarti M., Tumbarello M. (ORCID:0000-0002-9519-8552), and Venditti M.

Abstract

Management of patients with infections caused by multidrug-resistant organisms is challenging and requires a multidisciplinary approach to achieve successful clinical outcomes. The aim of this paper is to provide recommendations for the diagnosis and optimal management of these infections, with a focus on targeted antibiotic therapy. The document was produced by a panel of experts nominated by the five endorsing Italian societies, namely the Italian Association of Clinical Microbiologists (AMCLI), the Italian Group for Antimicrobial Stewardship (GISA), the Italian Society of Microbiology (SIM), the Italian Society of Infectious and Tropical Diseases (SIMIT) and the Italian Society of Anti-Infective Therapy (SITA). Population, Intervention, Comparison and Outcomes (PICO) questions about microbiological diagnosis, pharmacological strategies and targeted antibiotic therapy were addressed for the following pathogens: carbapenem-resistant Enterobacterales; carbapenem-resistant Pseudomonas aeruginosa; carbapenem-resistant Acinetobacter baumannii; and methicillin-resistant Staphylococcus aureus. A systematic review of the literature published from January 2011 to November 2020 was guided by the PICO strategy. As data from randomised controlled trials (RCTs) were expected to be limited, observational studies were also reviewed. The certainty of evidence was classified using the GRADE approach. Recommendations were classified as strong or conditional. Detailed recommendations were formulated for each pathogen. The majority of available RCTs have serious risk of bias, and many observational studies have several limitations, including small sample size, retrospective design and presence of confounders. Thus, some recommendations are based on low or very-low certainty of evidence. Importantly, these recommendations should be continually updated to reflect emerging evidence from clinical studies and real-world experience.

Published
2022

3. Incidence of SARS-CoV-2 infection in health care workers from Northern Italy based on antibody status: immune protection from secondary infection- A retrospective observational case-control study

Author

Rovida, F, Cassaniti, I, Percivalle, E, Sarasini, A, Paolucci, S, Klersy, C, Cutti, S, Novelli, V, Marena, C, Luzzaro, F, De Vito, G, Schiavo, R, Cascio, G, Lilleri, D, Baldanti, F, Rovida, Francesca, Cassaniti, Irene, Percivalle, Elena, Sarasini, Antonella, Paolucci, Stefania, Klersy, Catherine, Cutti, Sara, Novelli, Viola, Marena, Carlo, Luzzaro, Francesco, De Vito, Giovanni, Schiavo, Roberta, Cascio, Giuliana Lo, Lilleri, Daniele, Baldanti, Fausto, Rovida, F, Cassaniti, I, Percivalle, E, Sarasini, A, Paolucci, S, Klersy, C, Cutti, S, Novelli, V, Marena, C, Luzzaro, F, De Vito, G, Schiavo, R, Cascio, G, Lilleri, D, Baldanti, F, Rovida, Francesca, Cassaniti, Irene, Percivalle, Elena, Sarasini, Antonella, Paolucci, Stefania, Klersy, Catherine, Cutti, Sara, Novelli, Viola, Marena, Carlo, Luzzaro, Francesco, De Vito, Giovanni, Schiavo, Roberta, Cascio, Giuliana Lo, Lilleri, Daniele, and Baldanti, Fausto

Abstract

Objective: The protection from SARS-CoV-2 infection induced by SARS-CoV-2 anti-S1 and anti-S2 IgG antibody positivity resulting from natural infection was evaluated. Methods: The frequency of SARS-CoV-2 infection (as determined by virus RNA detection) was evaluated in a group of 1,460 seropositive and a control group of 8,150 seronegative healthcare workers in three Centres of Northern Italy in the period June-November 2020. Neutralizing serum titers were analyzed in seropositive subjects with or without secondary SARS-CoV-2 infection. Results: During the 6-month survey, 1.78% seropositive subjects developed secondary SARS-CoV-2 infection while 6.63% seronegative controls developed primary infection (odds ratio: 0.26; 95% confidence interval: 0.17-0.38). Secondary infection was associated with low or absent serum neutralizing titer (p<0.01) and was mildly symptomatic in 45.8% cases vs 71.4% symptomatic primary infections (odds ratio: 0.34; 95% confidence interval: 0.16-0.78). Conclusions: Immunity from natural infection appears protective from secondary infection; therefore, vaccination of seronegative subjects might be prioritized.

Published
2021

4. Comparing BioFire FilmArray BCID2 and BCID panels for direct detection of bacterial pathogens and antimicrobial resistance genes from positive blood cultures

Author

Cortazzo, Venere, D'Inzeo, Tiziana, Giordano, Liliana, Menchinelli, Giulia, Liotti, Flora Marzia, Fiori, Barbara, Demaio, F., Luzzaro, F., Sanguinetti, Maurizio, Posteraro, Brunella, Spanu Pennestri, Teresa, Cortazzo V., D'Inzeo T. (ORCID:0000-0003-1508-3518), Giordano L., Menchinelli G., Liotti F. M., Fiori B. (ORCID:0000-0003-3318-5809), Sanguinetti M. (ORCID:0000-0002-9780-7059), Posteraro B. (ORCID:0000-0002-1663-7546), Spanu T. (ORCID:0000-0003-1864-5184), Cortazzo, Venere, D'Inzeo, Tiziana, Giordano, Liliana, Menchinelli, Giulia, Liotti, Flora Marzia, Fiori, Barbara, Demaio, F., Luzzaro, F., Sanguinetti, Maurizio, Posteraro, Brunella, Spanu Pennestri, Teresa, Cortazzo V., D'Inzeo T. (ORCID:0000-0003-1508-3518), Giordano L., Menchinelli G., Liotti F. M., Fiori B. (ORCID:0000-0003-3318-5809), Sanguinetti M. (ORCID:0000-0002-9780-7059), Posteraro B. (ORCID:0000-0002-1663-7546), and Spanu T. (ORCID:0000-0003-1864-5184)

Abstract

This study evaluated and compared the accuracy of BCID2 with that of BCID to identify bacterial species and relative antimicrobial resistance genes directly from positive BCs. We used archived samples from positive BCs (1.5 ml thereof mixed with 100 ml of dimethyl sulfoxide and stored at 280°C), which had prospectively been processed with the BD Bactec 9240 (BD Diagnostic Systems, Sparks, MD), BacTAlert 3D (bioMérieux), or BacTAlert Virtuo (bioMérieux) system at two hospital microbiology laboratories from January 2018 to August 2020.

Published
2021

5. EUCAST rapid antimicrobial susceptibility testing of blood cultures positive for Escherichia coli or Klebsiella pneumoniae: experience of three laboratories in Italy

Author

Cortazzo, Venere, Giordano, Liliana, D'Inzeo, Tiziana, Fiori, B., Brigante, G., Luzzaro, F., Liotti, Flora Marzia, Menchinelli, Giulia, Sanguinetti, Maurizio, Spanu, Teresa, Posteraro, Brunella, Cortazzo V., Giordano L., D'Inzeo T. (ORCID:0000-0003-1508-3518), Liotti F. M., Menchinelli G., Sanguinetti M. (ORCID:0000-0002-9780-7059), Spanu T. (ORCID:0000-0003-1864-5184), Posteraro B. (ORCID:0000-0002-1663-7546), Cortazzo, Venere, Giordano, Liliana, D'Inzeo, Tiziana, Fiori, B., Brigante, G., Luzzaro, F., Liotti, Flora Marzia, Menchinelli, Giulia, Sanguinetti, Maurizio, Spanu, Teresa, Posteraro, Brunella, Cortazzo V., Giordano L., D'Inzeo T. (ORCID:0000-0003-1508-3518), Liotti F. M., Menchinelli G., Sanguinetti M. (ORCID:0000-0002-9780-7059), Spanu T. (ORCID:0000-0003-1864-5184), and Posteraro B. (ORCID:0000-0002-1663-7546)

Abstract

Sir, Recently, EUCAST developed a rapid antimicrobial susceptibility testing (RAST) method for direct use on positive blood culture (BC) samples, which relies on EUCAST standard disc diffusion (DD) methodology and allows inhibition zone reading within 4–8 h of BC positivity.We herein report on EUCAST RAST results for BCs consecutively collected between June 2019 and December 2019 that contained E. coli (n = 134)or K. pneumoniae (n = 66) isolates.

Published
2021

6. Mother-to-child transmission of KPC-producing Klebsiella pneumoniae: potential relevance of a low microbial urinary load for screening purposes

Author

Principe, L, Meroni, E, Conte, V, Mauri, C, Di Pilato, V, Giani, T, Bonfanti, P, Rossolini, G, Luzzaro, F, Principe L., Meroni E., Conte V., Mauri C., Di Pilato V., Giani T., Bonfanti P., Rossolini G. M., Luzzaro F., Principe, L, Meroni, E, Conte, V, Mauri, C, Di Pilato, V, Giani, T, Bonfanti, P, Rossolini, G, Luzzaro, F, Principe L., Meroni E., Conte V., Mauri C., Di Pilato V., Giani T., Bonfanti P., Rossolini G. M., and Luzzaro F.

Published
2018

7. Results of the Italian infection-Carbapenem Resistance Evaluation Surveillance Trial (iCREST-IT): activity of ceftazidime/avibactam against Enterobacterales isolated from urine

Author

Giani, T, Antonelli, A, Sennati, S, Di Pilato, V, Chiarelli, A, Cannatelli, A, Gatsch, C, Luzzaro, F, Spanu, Teresa, Stefani, S, Rossolini, Gm, Spanu T (ORCID:0000-0003-1864-5184), Giani, T, Antonelli, A, Sennati, S, Di Pilato, V, Chiarelli, A, Cannatelli, A, Gatsch, C, Luzzaro, F, Spanu, Teresa, Stefani, S, Rossolini, Gm, and Spanu T (ORCID:0000-0003-1864-5184)

Abstract

Objectives: To assess the in vitro antibacterial activity of ceftazidime/avibactam against a recent Italian collection of carbapenem-resistant Enterobacterales (CRE) isolated from urine specimens. Methods: Consecutive Gram-negative isolates from urine specimens, collected from inpatients in five Italian hospitals during the period October 2016 to February 2017, were screened for CRE phenotype using chromogenic selective medium and identified using MALDI-TOF MS. Antimicrobial susceptibility testing was performed by reference broth microdilution (BMD) and, for ceftazidime/avibactam, also by EtestVR CZA. Results were interpreted according to the EUCAST breakpoints. All confirmed CRE were subjected to real-time PCR targeting blaKPC-type, blaVIM-type, blaNDM-type and blaOXA-48-type carbapenemase genes. Non-MBL-producing isolates resistant to ceftazidime/ avibactam were subjected toWGS and their resistome and clonality were analysed. Results: Overall, 318 non-replicate presumptive CRE were collected following screening of 9405 isolates of Enterobacterales (3.4%) on chromogenic selective medium. Molecular analysis revealed that 216 isolates were positive for a carbapenemase gene (of which 92.1%, 2.8%, 1.4% and 1.4% were positive for blaKPC-type, blaOXA-48-type, blaNDM-type and blaVIM-type, respectively). Against the confirmed carbapenemase-producing Enterobacterales (CPE), ceftazidime/avibactam was the most active compound, followed by colistin (susceptibility rates 91.6% and 69.4%, respectively). Compared with BMD, EtestVR for ceftazidime/avibactam yielded consistent results (100% category agreement). All class B b-lactamase producers were resistant to ceftazidime/ avibactam, while OXA-48 and KPC producers were susceptible, with the exception of seven KPC-producing isolates (4.2%). The latter exhibited an MIC of 16 to >32 mg/L, belonged to ST512, produced KPC-3 and showed alterations in the OmpK35 and Ompk36 porins. Conclusions: Ceftazidime/avibactam showed potent in v

Published
2020

16. Mother-to-child transmission of KPC carbapenemase-producing Klebsiella pneumoniae at birth

Author

Bonfanti, P, Bellu, R, Principe, L, Caramma, I, Condo, M, Giani, T, Rossolini, G, Luzzaro, F, Bonfanti P., Bellu R., Principe L., Caramma I., Condo M., Giani T., Rossolini G. M., Luzzaro F., Bonfanti, P, Bellu, R, Principe, L, Caramma, I, Condo, M, Giani, T, Rossolini, G, Luzzaro, F, Bonfanti P., Bellu R., Principe L., Caramma I., Condo M., Giani T., Rossolini G. M., and Luzzaro F.

Abstract

We report on a mother-to-child transmission of KPC carbapenemase-producing Klebsiella pneumoniae at birth followed by subsequent cases in the neonatal intensive care unit. Molecular analysis of isolates showed production of KPC-3 enzyme. The only potential risk factor identified for the mother was previous activity as a caregiver. Present findings suggest consideration of proactive surveillance in pregnant women with risk factors for colonization.

Published
2017

23. Simplified Testing Method for Direct Detection of Carbapenemase-Producing Organisms from Positive Blood Cultures Using the NG-Test Carba 5 Assay

Author

Giordano, Liliana, Fiori, Barbara, D'Inzeo, Tiziana, Parisi, G, Liotti, Flora Marzia, Menchinelli, Giulia, De Angelis, Giulia, De Maio, Flavio, Luzzaro, F, Sanguinetti, Maurizio, Posteraro, Brunella, Spanu, Teresa, Giordano L, Fiori B (ORCID:0000-0003-3318-5809), D'Inzeo T (ORCID:0000-0003-1508-3518), Liotti FM, Menchinelli G, De Angelis G (ORCID:0000-0002-7087-7399), De Maio F, Sanguinetti M (ORCID:0000-0002-9780-7059), Posteraro B (ORCID:0000-0002-1663-7546), Spanu T (ORCID:0000-0003-1864-5184), Giordano, Liliana, Fiori, Barbara, D'Inzeo, Tiziana, Parisi, G, Liotti, Flora Marzia, Menchinelli, Giulia, De Angelis, Giulia, De Maio, Flavio, Luzzaro, F, Sanguinetti, Maurizio, Posteraro, Brunella, Spanu, Teresa, Giordano L, Fiori B (ORCID:0000-0003-3318-5809), D'Inzeo T (ORCID:0000-0003-1508-3518), Liotti FM, Menchinelli G, De Angelis G (ORCID:0000-0002-7087-7399), De Maio F, Sanguinetti M (ORCID:0000-0002-9780-7059), Posteraro B (ORCID:0000-0002-1663-7546), and Spanu T (ORCID:0000-0003-1864-5184)

Abstract

We directly tested 484 organisms from clinical (n = 310) and simulated (n = 174) positive blood cultures using the NG-Test Carba 5 assay for carbapenemase-producing Enterobacterales detection. The assay identified all but 4 of the KPC (170/171), OXA-48-like (22/22), VIM (19/21), and NDM (14/15) producers with no false positives. Among the clinical Klebsiella pneumoniae organisms tested, 122 of 123 KPC, 1 of 1 OXA-48-like, and 1 of 2 VIM producers were detected by the assay. Some VIM and NDM producers yielded scant but still-readable bands with the assay. No organisms produced the IMPS that the assay was designed to detect.

Published
2019

32. Strategies for preventing group B streptococcal infections in newborns: A nation-wide survey of Italian policies

Author

Tzialla, C, berardi, A, farina, C, clerici, P, borghesi, A, viora, E, scollo, P, stronati, M, Task Force for group B streptococcal infections for the Italian Society of Neonatology including Stival, G, barbaglia, Ma, guala, A, giunta, E, parola, L, grossignani, Mr, perri, P, tubaldi, L, alletto, G, daidone, S, flacco, V, dani, C, sterpa, A, rapisardi, G, elicio, Mr, faldella, G, capretti, Mg, messner, H, bandiera, M, achille, C, azzali, A, montrasio, G, mariani, S, galvagno, G, giacosa, E, de Angelis, F, spandrio, M, serra, A, garofalo, F, perona, A, porcelli, F, ferrero, F, De Franco, S, paollilo, P, picone, S, besana, R, varisco, T, farina, M, memo, L, nicolini, G, lietti, D, Di Chiara, G, rottoli, A, Bonabitacola, T, Cortis, E, Neri, E, Martinelli, S, Ilardi, L, Rondanini, Gf, Calzi, P, Gatta, A, Quntadamo, Pa, Ivaldi, M, Terenzani, L, Di Lascio, N, Travaglio, Md, Vetrano, G, Furcolo, G, Vitacco, V, Intini, C, Frigerio, M, Stroppiana, P, Policicchio, G, Mesirca, P, Gianino, P, Audenio, E, Paludetto, R, Raimondi, F, Pugliese, A, Valentino, L, Nosari, N, Marchesano, G, Chirico, G, Bellù, R, Menchini, M, Poletti, A, E T, Vacchiano, Pinto, L, E D, Perri, Coppola, R, Perini, R, Vetrella, A, De Luca, G, Lista, G, Cavigioli, F, Bettinelli, A, Massironi, E, Franco, C, Bernardo, L, Poli, S, Palladini, M, Tota, V, Spadavecchia, F, Zuccotti, Gv, Pogliani, L, Bracaglia, G, Mancini, Al, Zocco, F, Iozzia, G, Auriemma, A, Teani, M, Mangilli, G, Tempra, Am, Di Terlizi, L, Bottino, R, Salvi, C, Fortunato, V, Musaico, R, Gargantini, G, Carrera, G, Magaldi, R, Taurino, L, D'Onofrio, Am, Buffone, E, Tempera, A, Agosti, M, Garzia, P, Mosca, F, Pugni, L, Tagliabue, P, Colombo, C, Demi, M, Picco, G, Carlucci, A, Zorzi, G, Padula, D, Cardone, Ml, Buonocore, G, Muraca, Mc, Boldrini, A, Ciantelli, M, Lanari, M, Serra, L, Felici, L, Banderalli, G, Brambilla, C, Dall'Agnola, A, Viviani, E, Zonca, Mc, Licardi, G, Chiara, A, Ancora, G, Papa, I, Gancia, P, Pomero, G, Deloglu, A, Villani, P, Mussini, P, Canidio, E, Migliavacca, D, Di Fabio, S, Cipollone, I, Biasucci, G, Rubbi, P, Piepoli, M, Guastaferro, N, Infriccioli, F, Bertino, E, Perathoner, C, Parmigiani, S, Suriano, G, Ianniello, C, Biasini, A, Azzalli, M, Timpani, G, Barresi, S, Caoci, G, Ciccotti, R, De Curtis, M, Natale, F, Finocchi, M, Haass, C, Milillo, F, Lucieri, S, Guercio, E, Canepa, Sa, Scozia, G, Antonucci, R, Limongelli, O, Macciò, S, Mongelli, F, Colonna, F, Dragovic, D, Calipa, Mt, Cohen, A, Moresco, L, Italian Society of Obstetricians and Gynecologists including La Spina, R, Ruggeri, R, Luehwink, A, Brattoli, M, Fedi, A, Lacchi, L, Ettore, G, Pappalardo, E, Conoscenti, G, Zeni, B, Spellecchia, D, Favretti, L, Spagna, L, Zaglio, S, Bresciani, D, Bandini, A, Mancini, R, Mustoni, P, Dodero, D, Grimaldi, M, Di Mario, M, Migliorini, P, Kemeny, A, Anastasio, Ps, Riccardi, T, Maggino, T, Cerri, G, Puggina, P, Marconi, Am, Morgia, S, Bellia, G, D'Anna, Mr, Catania, M, Bacchi Modena, A, Franchi, L, Calonaci, N, Schettini, S, Paradiso, R, Saccucci, P, Ioppi, M, Zorzi, M, Stellin, G, Patacchiola, F, Carrata, L, Bassini, D, San Marco, L, Todros, T, Tibadi, C, Liborio, M, Italian Association of Clinical Microbiologists including Laricchia, R, Tauro, L, Ferrara, F, Nuara, C, Ghiraldi, E, Molinari, F, Comessatti, A, Rocchetti, A, Di Matteo, L, Miconi, V, Calvi, P, Pernigotti, A, Fabozzi, F, Micca, G, Monticone, G, Sarti, M, Da Rin, G, Zoppelletto, M, Modolo, E, Landini, Mp, Furlini, G, Galluppi, E, Pagani, E, Aschbacher, R, Innocenti, P, Bresolin, N, Raggi, Me, Bonfanti, C, De Francesco, M, Santer, P, Griessmaier, A, De Francesco, D, Pirali, A, Prasciolu, C, Usai, F, Cuzzone, G, Scutellà, M, Tramacere, P, Fossati, D, Piaserico, G, Bordignon, G, Sciacca, A, Di Vincenzo, F, Imbriani, A, Melotti, D, Catanoso, G, Rivetti, I, Neri, G, Bruno, R, Bacelle, L, Sartore, P, Giana, G, Sala, E, Giraldi, C, Cavalcanti, P, Perugini, M, Perugini, A, Ginardi, C, Maritano, D, Ferrini, A, Bonettini, A, Avanzini, A, Gasperoni, S, Pieretti, B, Montanari, E, Carillo, C, Rossi, Mr, Laureti, A, Baldoni, Ml, Serra, D, Melioli, G, Bandettini, R, Oneto, F, Colla, R, Storchi Incerti, S, Lanzini, F, Pauri, P, Tili, E, Leone, Ra, Verdastro, G, Megha, M, Luzzaro, F, Conti, A, Busulini, L, Mirri, P, Diodati, R, Vettori, C, Pittalis, S, Anesi, A, Fiore, A, Goglia, L, Vitullo, E, Sinno, A, Platzgummer, S, Spitaler, C, Trabucchi, Mc, Besozzi, M, Cesana, E, Inghilleri, G, Grosso, S, D'Angelo, R, Fogato, E, Lavarda, F, Ortisi, G, Clementi, M, Cichero, P, Rumpianesi, F, Venturelli, C, Mortillaro, F, Daffara, S, Catania, Mr, Iula, D, Andreoni, S, Politi, A, Agostinelli, C, Paparella, C, Capozzi, D, Notaris, P, Bistoni, F, Mencacci, A, Valentini, M, Filippetti, A, Confalonieri, M, Novarese, O, Bonini, F, Salamone, D, Camporese, A, De Rosa, R, Casprini, P, Degl'Innocenti, R, Giordano, R, Allù, Mt, Zanella, D, Malandrino, M, Tronci, M, Valmarin, M, Leonetti, G, Falco, S, Meledandri, M, Ballardini, M, Spanò, A, Cava, Mc, Mascellino, Mt, Schinella, M, Gualdi, P, Casari, E, Scattolo, N, Motta, C, Perfetti, C, Bassano, M, Cera, G, Iafisco, P, Mura, I, Palmieri, A, Migliardi, M, Ferlini, M, Grandi, G, Giardini, F, Albano, F, Latino, M, Ferrero, Mp, Bellizia, L, Russolo, M, Russolo, S, Pesenti, A, Fasano, Ma, Previato, S, Radillo, O, Busetti, M, Ferrari, P, Siderini, V, Puzzolante, L, Scarparo, C, Arzese, A, Cappuccia, N, Lodolo, L, Delledonne, L, Gramoni, A, Maiolo, V, Gheller, A, Spadaro, S, Balzaretti, M, Tzialla, C., Berardi, A., Farina, C., Clerici, P., Borghesi, A., Viora, E., Scollo, P., Stronati, M., Stival, G., Barbaglia, M. A., Guala, A., Giunta, E., Parola, L., Grossignani, M. R., Perri, P., Tubaldi, L., Alletto, G., Daidone, S., Flacco, V., Dani, C., Sterpa, A., Rapisardi, G., Elicio, M. R., Faldella, G., Capretti, M. G., Messner, H., Bandiera, M., Achille, C., Azzali, A., Montrasio, G., Mariani, S., Galvagno, G., Giacosa, E., de Angelis, F., Spandrio, M., Serra, A., Garofalo, F., Perona, A., Porcelli, F., Ferrero, F., De Franco, S., Paollilo, P., Picone, S., Besana, R., Varisco, T., Farina, M., Memo, L., Nicolini, G., Lietti, D., Di Chiara, G., Rottoli, A., Bonabitacola, T., Cortis, E., Neri, E., Martinelli, S., Ilardi, L., Rondanini, G. F., Calzi, P., Gatta, A., Quntadamo, P. A., Ivaldi, M., Terenzani, L., Di Lascio, N., Travaglio, M. D., Vetrano, G., Furcolo, G., Vitacco, V., Intini, C., Frigerio, M., Stroppiana, P., Policicchio, G., Mesirca, P., Gianino, P., Audenio, E., Paludetto, R., Raimondi, F., Pugliese, A., Valentino, L., Nosari, N., Marchesano, G., Chirico, G., Bell(`u), R., Menchini, M., Poletti, A., Vacchiano, T., Pinto, L., Perri, D., Coppola, R., Perini, R., Vetrella, A., De Luca, G., Lista, G., Cavigioli, F., Bettinelli, A., Massironi, E., Franco, C., Bernardo, L., Poli, S., Palladini, M., Tota, V., Spadavecchia, F., Zuccotti, G. V., Pogliani, L., Bracaglia, G., Mancini, A. L., Zocco, F., Iozzia, G., Auriemma, A., Teani, M., Mangilli, G., Tempra, A. M., Di Terlizi, L., Bottino, R., Salvi, C., Fortunato, V., Musaico, R., Gargantini, G., Carrera, G., Magaldi, R., Taurino, L., D?onofrio, A. M., Buffone, E., Tempera, A., Agosti, M., Garzia, P., Mosca, F., Pugni, L., Tagliabue, P., Colombo, C., Demi, M., Picco, G., Carlucci, A., Zorzi, G., Padula, D., Cardone, M. L., Buonocore, G., Muraca, M. C., Boldrini, A., Ciantelli, M., Lanari, M., Serra, L., Felici, L., Banderalli, G., Brambilla, C., Dall?agnola, A., Viviani, E., Zonca, M. C., Licardi, G., Chiara, A., Ancora, G., Papa, I., Gancia, P., Pomero, G., Deloglu, A., Villani, P., Mussini, P., Canidio, E., Migliavacca, D., Di Fabio, S., Cipollone, I., Biasucci, G., Rubbi, P., Piepoli, M., Guastaferro, N., Infriccioli, F., Bertino, E., Perathoner, C., Parmigiani, S., Suriano, G., Ianniello, C., Biasini, A., Azzalli, M., Timpani, G., Barresi, S., Caoci, G., Ciccotti, R., De Curtis, M., Natale, F., Finocchi, M., Haass, C., Milillo, F., Lucieri, S., Guercio, E., Canepa, S. A., Scozia, G., Antonucci, R., Limongelli, O., Macci(`o), S., Mongelli, F., Colonna, F., Dragovic, D., Calipa, M. T., Cohen, A., Moresco, L., La Spina, R., Ruggeri, R., Luehwink, A., Brattoli, M., Fedi, A., Lacchi, L., Ettore, G., Pappalardo, E., Conoscenti, G., Zeni, B., Spellecchia, D., Favretti, L., Spagna, L., Zaglio, S., Bresciani, D., Bandini, A., Mancini, R., Mustoni, P., Dodero, D., Grimaldi, M., Di Mario, M., Migliorini, P., Kemeny, A., Anastasio, P. S., Riccardi, T., Maggino, T., Cerri, G., Puggina, P., Marconi, A. M., Morgia, S., Bellia, G., D?anna, M. R., Catania, M., Bacchi Modena, A., Franchi, L., Calonaci, N., Schettini, S., Paradiso, R., Saccucci, P., Ioppi, M., Zorzi, M., Stellin, G., Patacchiola, F., Carrata, L., Bassini, D., San Marco, L., Todros, T., Tibadi, C., Liborio, M., Laricchia, R., Tauro, L., Ferrara, F., Nuara, C., Ghiraldi, E., Molinari, F., Comessatti, A., Rocchetti, A., Di Matteo, L., Miconi, V., Calvi, P., Pernigotti, A., Fabozzi, F., Micca, G., Monticone, G., Sarti, M., Da Rin, G., Zoppelletto, M., Modolo, E., Landini, M. P., Furlini, G., Galluppi, E., Pagani, E., Aschbacher, R., Innocenti, P., Bresolin, N., Raggi, M. E., Bonfanti, C., De Francesco, M., Santer, P., Griessmaier, A., De Francesco, D., Pirali, A., Prasciolu, C., Usai, F., Cuzzone, G., Scutell(`a), M., Tramacere, P., Fossati, D., Piaserico, G., Bordignon, G., Sciacca, A., Di Vincenzo, F., Imbriani, A., Melotti, D., Catanoso, G., Rivetti, I., Neri, G., Bruno, R., Bacelle, L., Sartore, P., Giana, G., Sala, E., Giraldi, C., Cavalcanti, P., Perugini, M., Perugini, A., Ginardi, C., Maritano, D., Ferrini, A., Bonettini, A., Avanzini, A., Gasperoni, S., Pieretti, B., Montanari, E., Carillo, C., Rossi, M. R., Laureti, A., Baldoni, M. L., Serra, D., Melioli, G., Bandettini, R., Oneto, F., Colla, R., Storchi Incerti, S., Lanzini, F., Pauri, P., Tili, E., Leone, R. A., Verdastro, G., Megha, M., Luzzaro, F., Conti, A., Busulini, L., Mirri, P., Diodati, R., Vettori, C., Pittalis, S., Anesi, A., Fiore, A., Goglia, L., Vitullo, E., Sinno, A., Platzgummer, S., Spitaler, C., Trabucchi, M. C., Besozzi, M., Cesana, E., Inghilleri, G., Grosso, S., D?angelo, R., Fogato, E., Lavarda, F., Ortisi, G., Clementi, M., Cichero, P., Rumpianesi, F., Venturelli, C., Mortillaro, F., Daffara, S., Catania, M. R., Iula, D., Andreoni, S., Politi, A., Agostinelli, C., Paparella, C., Capozzi, D., Notaris, P., Bistoni, F., Mencacci, A., Valentini, M., Filippetti, A., Confalonieri, M., Novarese, O., Bonini, F., Salamone, D., Camporese, A., De Rosa, R., Casprini, P., Degl?innocenti, R., Giordano, R., All(`u), M. T., Zanella, D., Malandrino, M., Tronci, M., Valmarin, M., Leonetti, G., Falco, S., Meledandri, M., Ballardini, M., Span(`o), A., Cava, M. C., Mascellino, M. T., Schinella, M., Gualdi, P., Casari, E., Scattolo, N., Motta, C., Perfetti, C., Bassano, M., Cera, G., Iafisco, P., Mura, I., Palmieri, A., Migliardi, M., Ferlini, M., Grandi, G., Giardini, F., Albano, F., Latino, M., Ferrero, M. P., Bellizia, L., Russolo, M., Russolo, S., Pesenti, A., Fasano, M. A., Previato, S., Radillo, O., Busetti, M., Ferrari, P., Siderini, V., Puzzolante, L., Scarparo, C., Arzese, A., Cappuccia, N., Lodolo, L., Delledonne, L., Gramoni, A., Maiolo, V., Gheller, A., Spadaro, S., Balzaretti, M., Tzialla, Chryssoula, Berardi, Alberto, Farina, Claudio, Clerici, Pierangelo, Borghesi, Alessandro, Viora, Elsa, Scollo, Paolo, Stronati, Mauro, [.., Lanari, Marcello, Faldella, Giacomo, and ]

Subjects
Male, Pediatrics, Group B, 0302 clinical medicine, Neonate, Pregnancy, Surveys and Questionnaires, Prevalence, Mass Screening, Blood culture, 030212 general & internal medicine, Antibiotic prophylaxis, Survey, GBS, Group B streptococcus, Infection, Newborn infant, Adult, Antibiotic Prophylaxis, Female, Health Surveys, Humans, Infant, Newborn, Italy, Neonatal Screening, Pregnancy Complications, Infectious, Prenatal Care, Primary Prevention, Risk Assessment, Streptococcal Infections, Streptococcus agalactiae, reproductive and urinary physiology, Group B streptococcu, medicine.diagnostic_test, lcsh:RJ1-570, Infectious, Perinatology and Child Health, Pediatrics, Perinatology and Child Health, medicine.medical_specialty, Antibiotic sensitivity, Group B Streptococcal Infection, Prenatal care, 03 medical and health sciences, 030225 pediatrics, medicine, Intensive care medicine, Mass screening, business.industry, Public health, Infant, lcsh:Pediatrics, Newborn, Pregnancy Complications, business
Abstract

Background There are no Italian data regarding the strategies for preventing neonatal group B streptococcal (GBS) infection. We conducted a national survey in order to explore obstetrical, neonatal and microbiological practices for the GBS prevention. Methods Three distinct questionnaires were sent to obstetricians, neonatologists and microbiologists. Questionnaires included data on prenatal GBS screening, maternal risk factors, intrapartum antibiotic prophylaxis, microbiological information concerning specimen processing and GBS antimicrobial susceptibility. Results All respondent obstetrical units used the culture-based screening approach to identify women who should receive intrapartum antibiotic prophylaxis, and more than half of the microbiological laboratories (58%) reported using specimen processing consistent with CDC guidelines. Most neonatal units (89 out of 107, 82%) reported using protocols for preventing GBS early-onset sepsis consistent with CDC guidelines. Conclusions The screening-based strategy is largely prevalent in Italy, and most protocols for preventing GBS early-onset sepsis are consistent with CDC guidelines. However, we found discrepancies in practices among centers that may reflect the lack of Italian guidelines issued by public health organizations.

Published
2017

33. Microbiologia clinica

Author

Abbate, I., Amendola, A., Andreoni, S., Cagliotti, C., Capobianchi, M. R., Carozzi, F., Castello, E., Crovatto, M., De Maria, A. F., Debbia, E. A., Delogu, G., Di caro, A., Farina, C. F., Fazii, P., Gauldiero, M., Gava, G., Giraldi, C., Giusto, G. R., Goletti, D., Greco, F., Iester, M., Luzzaro, F., Marchese, A., Mauro, M. V., Melioli, G., Morelli, P., Pagani, L., Perotti, M., Rassu, M., Smeraglia, R., Stevan, M., and Vagge, A.

Published
2018

36. Italian nationwide survey on Pseudomonas aeruginosa from invasive infections: activity of ceftolozane/tazobactam and comparators, and molecular epidemiology of carbapenemase producers

Author

Giani, T, Arena, F, Pollini, S, Di Pilato, V, D'Andrea, Mm, Henrici De Angelis, L, Bassetti, M, Rossolini, Gm, Vismara, C, Luzzaro, F, Cavallo, R, Dusi, Pa, Pagani, E, Sarti, M, Farina, C, Rigoli, R, Scarparo, C, Pecile, P, Cusi, Mg, Mencacci, A, Manso, E, Spanu, Teresa, Labonia, M, Tassi, V, Amato, G, Stefani, S, Giraldi, C, Rassu, M, Spanu T (ORCID:0000-0003-1864-5184), Giani, T, Arena, F, Pollini, S, Di Pilato, V, D'Andrea, Mm, Henrici De Angelis, L, Bassetti, M, Rossolini, Gm, Vismara, C, Luzzaro, F, Cavallo, R, Dusi, Pa, Pagani, E, Sarti, M, Farina, C, Rigoli, R, Scarparo, C, Pecile, P, Cusi, Mg, Mencacci, A, Manso, E, Spanu, Teresa, Labonia, M, Tassi, V, Amato, G, Stefani, S, Giraldi, C, Rassu, M, and Spanu T (ORCID:0000-0003-1864-5184)

Abstract

Objectives: Pseudomonas aeruginosa is a major cause of severe healthcare-associated infections and often shows MDR phenotypes. Ceftolozane/tazobactam is a new cephalosporin/b-lactamase inhibitor combination with potent activity against P. aeruginosa. This survey was carried out to evaluate the susceptibility of P. aeruginosa, circulating in Italy, to ceftolozane/tazobactam and comparators and to investigate the molecular epidemiology of carbapenemase-producing strains. Methods: Consecutive non-replicate P. aeruginosa clinical isolates (935) from bloodstream infections and lower respiratory tract infections were collected from 20 centres distributed across Italy from September 2013 to November 2014. Antimicrobial susceptibility testing was performed by broth microdilution and results were interpreted according to the EUCAST breakpoints. Isolates resistant to ceftolozane/tazobactam were investigated for carbapenemase genes by PCR, and for carbapenemase activity by spectrophotometric assay. WGS using an Illumina platform was performed on carbapenemase-producing isolates. Results: Ceftolozane/tazobactam was the most active molecule, retaining activity against 90.9% of P. aeruginosa isolates, followed by amikacin (88.0% susceptibility) and colistin (84.7% susceptibility). Overall, 48 isolates (5.1%) were positive for carbapenemase genes, including blaVIM (n"32), blaIMP (n"12) and blaGES-5 (n"4), while the remaining ceftolozane/tazobactam-resistant isolates tested negative for carbapenemase production. Carbapenemase producers belonged to 10 different STs, with ST175 (n"12) and ST621 (n"11) being the most common lineages. Genome analysis revealed different trajectories of spread for the different carbapenemase genes. Conclusions: Ceftolozane/tazobactam exhibited potent in vitro activity against P. aeruginosa causing invasive infections in Italy. Carbapenemase production was the most common mechanism of resistance to ceftolozane/ tazobactam.

Published
2018

37. Evolving beta-lactamase epidemiology in Enterobacteriaceae from Italian nationwide surveillance, October 2013: KPC-carbapenemase spreading among outpatients

Author

Giani, T., Antonelli, A., Caltagirone, M., Mauri, C., Nicchi, J., Arena, F., Nucleo, E., Bracco, S., Pantosti, A., Vismara, C., Pini, B., Andreoni, S., Dusi, P. A., Aschbacher, R., Scarparo, C., Sarti, M., Venturelli, C., Pecile, P., Manso, E., Spanu, T., Labonia, M., Buonopane, G., Giraldi, C., Luzzaro, F., Pagani, L., and Rossolini, Gian Maria

Subjects
Male, 0301 basic medicine, medicine.medical_specialty, Epidemiology, medicine.drug_class, Klebsiella pneumoniae, medicine.medical_treatment, 030106 microbiology, Cephalosporin, Class C beta-lactamases, ESBL, Enterobacteriaceae, carbapenemase, epidemiology, outpatients, Public Health, Environmental and Occupational Health, Virology, Microbial Sensitivity Tests, beta-Lactamases, Microbiology, 03 medical and health sciences, Bacterial Proteins, Outpatients, Escherichia coli, medicine, Humans, Proteus mirabilis, Escherichia coli Infections, Molecular Epidemiology, biology, Enterobacteriaceae Infections, biology.organism_classification, Anti-Bacterial Agents, Cephalosporins, 3. Good health, Cross-Sectional Studies, Italy, Beta-lactamase, Female, Erratum, Proteus Infections
Abstract

Extended-spectrum beta-lactamases (ESBLs), AmpC-type beta-lactamases (ACBLs) and carbapenemases are among the most important resistance mechanisms in Enterobacteriaceae. This study investigated the presence of these resistance mechanisms in consecutive non-replicate isolates of Escherichia coli (n = 2,352), Klebsiella pneumoniae (n = 697), and Proteus mirabilis (n = 275) from an Italian nationwide cross-sectional survey carried out in October 2013. Overall, 15.3% of isolates were non-susceptible to extended-spectrum cephalosporins but susceptible to carbapenems (ESCR-carbaS), while 4.3% were also non-susceptible to carbapenems (ESCR-carbaR). ESCR-carbaS isolates were contributed by all three species, with higher proportions among isolates from inpatients (20.3%) but remarkable proportions also among those from outpatients (11.1%). Most ESCR-carbaS isolates were ESBL-positive (90.5%), and most of them were contributed by E. coli carrying bla CTX-M group 1 genes. Acquired ACBLs were less common and mostly detected in P. mirabilis. ESCR-carbaR isolates were mostly contributed by K. pneumoniae (25.1% and 7.7% among K. pneumoniae isolates from inpatients and outpatients, respectively), with bla KPC as the most common carbapenemase gene. Results showed an increasing trend for both ESBL and carbapenemase producers in comparison with previous Italian surveys, also among outpatients.

Published
2017

39. Colistin resistance superimposed to endemic carbapenem-resistant Klebsiella pneumoniae: a rapidly evolving problem in Italy, November 2013 to April 2014

Author

Monaco, M, Giani, T, Raffone, M, Arena, F, Garcia Fernandez, A, Pollini, S, Network EuSCAPE Italy, Grundmann, H, Pantosti, A, Rossolini, Gm, Collaborators, Barbaro, A, Campion, L, Catania, M, De Bernochi, A, Di Taranto AM, Dusi, P, Grandesso, S, Luzzaro, F, Manso, E, Meledandri, M, Mencacci, A, Milano, F, Parisi, G, Pecile, P, Restelli, A, Rocchetti, A, Arrigo, C, Rossi, M, Santino, Iolanda, Sarti, M, and Sartor, A.

Subjects
Carbapenem, Endemic Diseases, Epidemiology, Carbapenem resistant Klebsiella pneumoniae, Microbial Sensitivity Tests, Drug resistance, Polymerase Chain Reaction, beta-Lactamases, Microbiology, Colistin resistance, Bacterial Proteins, Drug Resistance, Multiple, Bacterial, Virology, polycyclic compounds, medicine, Humans, biology, Colistin, Public Health, Environmental and Occupational Health, Outbreak, biochemical phenomena, metabolism, and nutrition, Laboratories, Hospital, bacterial infections and mycoses, medicine.disease, biology.organism_classification, Health Surveys, Enterobacteriaceae, Anti-Bacterial Agents, Klebsiella Infections, Klebsiella pneumoniae, Carbapenems, Italy, Klebsiella pneumonia, Sentinel Surveillance, medicine.drug
Abstract

Consecutive non-replicate clinical isolates (n=191) of carbapenem non-susceptible Enterobacteriaceae were collected from 21 hospital laboratories across Italy from November 2013 to April 2014 as part of the European Survey on Carbapenemase-producing Enterobacteriaceae (EuSCAPE) project. Klebsiella pneumoniae carbapenemase-producing K. pneumoniae (KPC-KP) represented 178 (93%) isolates with 76 (43%) respectively resistant to colistin, a key drug for treating carbapenamase-producing Enterobacteriaceae. KPC-KP colistin-resistant isolates were detected in all participating laboratories. This underscores a concerning evolution of colistin resistance in a setting of high KPC-KP endemicity.

Published
2014

40. Management of carbapenem resistant Klebsiella pneumoniae infections in stem cell transplant recipients: An italian multidisciplinary consensus statement

Author

Girmenia, C., Viscoli, C., Piciocchi, A., Cudillo, L., Botti, S., Errico, A., Sarmati, L., Ciceri, F., Locatelli, Franco, Giannella, M., Bassetti, M., Tascini, C., Lombardini, L., Majolino, I., Farina, C., Luzzaro, F., Rossolini, G. M., Rambaldi, A., Locatelli F. (ORCID:0000-0002-7976-3654), Girmenia, C., Viscoli, C., Piciocchi, A., Cudillo, L., Botti, S., Errico, A., Sarmati, L., Ciceri, F., Locatelli, Franco, Giannella, M., Bassetti, M., Tascini, C., Lombardini, L., Majolino, I., Farina, C., Luzzaro, F., Rossolini, G. M., Rambaldi, A., and Locatelli F. (ORCID:0000-0002-7976-3654)

Abstract

NO ABSTRACT

Published
2015

41. Epidemic diffusion of KPC carbapenemase-producing Klebsiella pneumoniae in Italy: results of the first countrywide survey, 15 May to 30 June 2011

Author

Giani, T, Pini, B, Arena, F, Conte, V, Bracco, S, Migliavacca, R, Pantosti, A, Pagani, L, Luzzaro, F, M Rossolini, G, Vismara, C, Colombo, A, Serra, R, Kroumova, V, Mori, M, A Dusi, P, Mazzariol, A, Pagani, E, Gargiulo, R, Venturelli, C, Pecile, P, Mencacci, A, Manso, E, Tronci, M, Fazii, P, Labonia, M, Pizzolante, M, Amato, G, Buonopane, G, Cavalcanti, P, G Conaldi, P, Stefani, S, and F Di Vincenzo

Subjects
Infection Control, KPC carbapenemase, Colony Count, Microbial, Microbial Sensitivity Tests, Laboratories, Hospital, beta-Lactamases, Klebsiella Infections, Specimen Handling, Klebsiella pneumoniae, Cross-Sectional Studies, Bacterial Proteins, Carbapenems, Italy, Drug Resistance, Multiple, Bacterial, Humans
Abstract

Carbapenem-resistant Enterobacteriaceae (CRE) are emerging as a public health problem in various settings. In Italy, a rapid and remarkable increase of carbapenem-non-susceptible Klebsiella pneumoniae has been reported since 2010. Here we report on the results of a countrywide cross-sectional survey, carried out from 15 May to 30 June 2011 to investigate the diffusion of CRE in Italy and to characterise the most prevalent resistance mechanisms and their dissemination patterns. CRE were reported from most (23 of 25) participating laboratories, with an overall proportion of 3.5% and 0.3% among consecutive non-duplicate clinical isolates of Enterobacteriaceae from inpatients (n=7,154) and outpatients (n=6,595), respectively. K. pneumoniae was the most frequent species (proportion of carbapenem-non-susceptible isolates: 11.9%), while a minority of CRE of other species were detected. Carbapenemase production was detected in the majority (85%) of CRE. KPC-type enzymes were by far the most common (89.5% of carbapenemase producers), followed by VIM-1 (9.2%) and OXA-48 (1.3%). KPC-producing K. pneumoniae (KPC-KP) were detected in most centres and contributed majorly to the epidemic dissemination of CRE recently observed in our country. Dissemination of KPC-KP was mostly sustained by strains of clonal complex 258 (ST-258 producing KPC-2 or KPC-3, and ST-512 producing KPC-3), while a minority belonged to ST-101.

Published
2013

43. Management of carbapenem resistant Klebsiella pneumoniae infections in stem cell transplant recipients: an Italian multidisciplinary consensus statement

Author

Girmenia, C., primary, Viscoli, C., additional, Piciocchi, A., additional, Cudillo, L., additional, Botti, S., additional, Errico, A., additional, Sarmati, L., additional, Ciceri, F., additional, Locatelli, F., additional, Giannella, M., additional, Bassetti, M., additional, Tascini, C., additional, Lombardini, L., additional, Majolino, I., additional, Farina, C., additional, Luzzaro, F., additional, Rossolini, G. M., additional, and Rambaldi, A., additional

Published
2015
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50. Metallo-beta-lactamases as emerging resistance determinants in Gram-negative pathogens: open issues

Author

Cornaglia, Giuseppe, Akova, M., Amicosante, G., Canton, R., Cauda, R., Docquier, J. D., Edelstein, M., Frére, J. M., Fuzi, M., Galleni, M., Giamarellou, H., Gniadkowski, M., Koncan, Raffaella, Libisch, B., Luzzaro, F., Miriagou, V., Navarro, F., Nordmann, P., Pagani, L., Peixe, L., Poirel, L., Souli, M., Tacconelli, E., Vatopoulos, A., Rossolini, G. M., and on behalf of the ESGARS

Subjects
Microbiology (medical), metallo-beta-lactamases, Drug Resistance, Drug resistance, Microbial Sensitivity Tests, Biology, Antimicrobial resistance, Settore MED/17 - MALATTIE INFETTIVE, Metallo-β-lactamases, Applied Microbiology and Biotechnology, Microbiology, Metallo β lactamase, beta-Lactam Resistance, beta-Lactamases, Antibiotic resistance, Virology, Drug Resistance, Multiple, Bacterial, Development economics, Antimicrobial chemotherapy, Gram-Negative Bacteria, Immunology and Allergy, Infection control, media_common.cataloged_instance, Humans, Pharmacology (medical), European Union, European union, media_common, Parasitology, Infectious Diseases, Resistance (ecology), Gram-negative bacterial infections, business.industry, antimicrobial resistance, Bacterial, General Medicine, Biotechnology, Anti-Bacterial Agents, Gram-Negative Bacterial Infections, business, Multiple
Abstract

The rapid spread of acquired metallo-beta-lactamases (MBLs) among major Gram-negative pathogens is a matter of particular concern worldwide and primarily in Europe, one of first continents where the emergence of acquired MBLs has been reported and possibly the geographical area where the increasing diversity of these enzymes and the number of bacterial species affected are most impressive. This spread has not been paralleled by accuracy/standardisation of detection methods, completeness of epidemiological knowledge or a clear understanding of what MBL production entails in terms of clinical impact, hospital infection control and antimicrobial chemotherapy. A number of European experts in the field met to review the current knowledge on this phenomenon, to point out open issues and to reinforce and relate to one another the existing activities set forth by research institutes, scientific societies and European Union-driven networks.

Published
2007

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