title: Rapid evolution and spread of carbapenemases among Enterobacteriaceae in Europe.
abstract: Plasmid-acquired carbapenemases in Enterobacteriaceae, which were first discovered in Europe in the 1990s, are now increasingly being identified at an alarming rate. Although their hydrolysis spectrum may vary, they hydrolyse most β-lactams, including carbapenems. They are mostly of the KPC, VIM, NDM and OXA-48 types. Their prevalence in Europe as reported in 2011 varies significantly from high (Greece and Italy) to low (Nordic countries). The types of carbapenemase vary among countries, partially depending on the cultural/population exchange relationship between the European countries and the possible reservoirs of each carbapenemase. Carbapenemase producers are mainly identified among Klebsiella pneumoniae and Escherichia coli, and still mostly in hospital settings and rarely in the community. Although important nosocomial outbreaks with carbapenemase-producing Enterobacteriaceae have been extensively reported, many new cases are still related to importation from a foreign country. Rapid identification of colonized or infected patients and screening of carriers is possible, and will probably be effective for prevention of a scenario of endemicity, as now reported for extended-spectrum β-lactamase (mainly CTX-M) producers in all European countries.
authors.affiliation: Servicio de Microbiología and CIBER en Epidemiología y Salud Pública, Instituto Ramón y Cajal de Investigación Sanitaria and Hospital Universitario Ramón y Cajal, Madrid, Spain.
authors.forename: R
authors.initials: R
authors.lastname: Cantón
authors.forename: M
authors.initials: M
authors.lastname: Akóva
authors.forename: Y
authors.initials: Y
authors.lastname: Carmeli
authors.forename: C G
authors.initials: CG
authors.lastname: Giske
authors.forename: Y
authors.initials: Y
authors.lastname: Glupczynski
authors.forename: M
authors.initials: M
authors.lastname: Gniadkowski
authors.forename: D M
authors.initials: DM
authors.lastname: Livermore
authors.forename: V
authors.initials: V
authors.lastname: Miriagou
authors.forename: T
authors.initials: T
authors.lastname: Naas
authors.forename: G M
authors.initials: GM
authors.lastname: Rossolini
authors.forename: Ø
authors.initials: Ø
authors.lastname: Samuelsen
authors.forename: H
authors.initials: H
authors.lastname: Seifert
authors.forename: N
authors.initials: N
authors.lastname: Woodford
authors.forename: P
authors.initials: P
authors.lastname: Nordmann
mesh_terms: D000900:Anti-Bacterial Agents / Q000494:pharmacology; D001426:Bacterial Proteins / Q000096:biosynthesis / Q000235:genetics*; D015780:Carbapenems / Q000494:pharmacology; D003428:Cross Infection / Q000453:epidemiology / Q000382:microbiology / Q000635:transmission*; D024881:Drug Resistance, Bacterial; D004755:Enterobacteriaceae / Q000187:drug effects / Q000201:enzymology* / Q000235:genetics; D004756:Enterobacteriaceae Infections / Q000453:epidemiology / Q000382:microbiology / Q000635:transmission*; D005060:Europe / Q000453:epidemiology; D019143:Evolution, Molecular; D005260:Female; D006801:Humans; D008297:Male; D015995:Prevalence; D013997:Time Factors; D001618:beta-Lactamases / Q000096:biosynthesis / Q000235:genetics*
chemical_list: D000900:Anti-Bacterial Agents; D001426:Bacterial Proteins; D015780:Carbapenems; D001618:beta-Lactamases; C063912:carbapenemase