title: New Delhi metallo-beta-lactamase 1-producing Enterobacteriaceae: emergence and response in Europe.
abstract: 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.
authors.affiliation: European Centre for Disease Prevention and Control (ECDC), Stockholm, Sweden. marc.struelens@ecdc.europa.eu
authors.forename: M J
authors.initials: MJ
authors.lastname: Struelens
authors.forename: D L
authors.initials: DL
authors.lastname: Monnet
authors.forename: A P
authors.initials: AP
authors.lastname: Magiorakos
authors.forename: F
authors.initials: F
authors.lastname: Santos O'Connor
authors.forename: J
authors.initials: J
authors.lastname: Giesecke
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015780:Carbapenems / Q000494:pharmacology*; D002648:Child; D002675:Child, Preschool; D018563:Disease Notification; D004755:Enterobacteriaceae / Q000187:drug effects / Q000201:enzymology / Q000235:genetics / Q000302:isolation & purification*; D004756:Enterobacteriaceae Infections / Q000175:diagnosis / Q000188:drug therapy* / Q000453:epidemiology / Q000382:microbiology; D005060:Europe / Q000453:epidemiology; D017408:Guidelines as Topic; D006801:Humans; D015994:Incidence; D008297:Male; D008826:Microbial Sensitivity Tests; D008875:Middle Aged; D010641:Phenotype; D016133:Polymerase Chain Reaction; D011159:Population Surveillance; D018570:Risk Assessment; D011795:Surveys and Questionnaires; D055815:Young Adult; D001618:beta-Lactamases / Q000378:metabolism*
chemical_list: D015780:Carbapenems; D001618:beta-Lactamases; C552864:beta-lactamase NDM-1