title: Incidence rates of carbapenemase-producing Enterobacteriaceae clinical isolates in France: a prospective nationwide study in 2011-12.
abstract: OBJECTIVE
  To determine proportions and incidence rates of Enterobacteriaceae producing carbapenemase among those non-susceptible (NS) to carbapenems in France.
  
  
  METHODS
  From November 2011 to April 2012, 71 laboratories recorded non-duplicate Enterobacteriaceae clinical isolates NS to at least one carbapenem and the total number of isolates of the different species. Carbapenem MICs were determined by broth microdilution and the β-lactamase content by DNA microarray.
  
  
  RESULTS
  During the study period, the 71 laboratories identified 133 244 Enterobacteriaceae isolates, of which 846 (0.63%) were NS to at least one carbapenem. Carbapenem-NS isolates accounted for 0.07% (61/90 148) among Escherichia coli isolates, 1.1% (111/10 436) among Klebsiella pneumoniae, 8.2% (492/5971) among Enterobacter cloacae and 4.0% (84/2104) among Enterobacter aerogenes. Among the 541 available carbapenem-NS isolates, 222 (including 63 randomly selected E. cloacae) were further analysed after confirmation of carbapenem non-susceptibility. None of the Enterobacter spp. isolates produced carbapenemase. Among the other species, 28 isolates produced carbapenemases (22 OXA-48, 4 KPC and 2 NDM), accounting for an estimated proportion of carbapenemase-producing isolates of 0.08% for all species, 0.01% for E. coli and 0.27% for K. pneumoniae. The incidence-density rate in the participating hospitals was 0.0041 per 1000 hospital-days and the incidence rate was 0.0027 per 100 admissions.
  
  
  CONCLUSIONS
  The incidence-density rate of carbapenemase-producing isolates per 1000 hospital-days was low and 30-fold lower than that of carbapenem-NS isolates (0.125) and almost 300-fold lower than that of ESBL-producing isolates (1.104) in these French hospitals.
authors.affiliation: Sorbonne Universités, UPMC Univ Paris 06, U1135, Centre d'Immunologie et des Maladies Infectieuses (CIMI), Eq 13, F-75013 Paris, France INSERM, U1135, Centre d'Immunologie et des Maladies Infectieuses (CIMI), Eq 13, F-75013 Paris, France Bactériologie-Hygiène, Hôpitaux Universitaires Pitié Salpêtrière-Charles Foix, APHP, F-75013 Paris, France jerome.robert@psl.aphp.fr.
authors.forename: Jérôme
authors.initials: J
authors.lastname: Robert
authors.affiliation: INSERM U1047, UFR de Médecine, Université Montpellier 1, Nîmes, France Service de Microbiologie, CHU Carémeau, Nîmes, France.
authors.forename: Alix
authors.initials: A
authors.lastname: Pantel
authors.affiliation: Laboratoire de Biologie, Hôpital d'Instruction des Armées Bégin, Saint-Mandé, France.
authors.forename: Audrey
authors.initials: A
authors.lastname: Mérens
authors.affiliation: INSERM U1047, UFR de Médecine, Université Montpellier 1, Nîmes, France Service de Microbiologie, CHU Carémeau, Nîmes, France.
authors.forename: Jean-Philippe
authors.initials: JP
authors.lastname: Lavigne
authors.affiliation: Service de Microbiologie, Hôpital Beaujon AP-HP, Clichy, France Faculté de Médecine D. Diderot-Paris 7, Paris, France INSERM UMR 1149, Université Paris 7, Paris, France.
authors.forename: Marie-Hélène
authors.initials: MH
authors.lastname: Nicolas-Chanoine
mesh_terms: D001426:Bacterial Proteins / Q000235:genetics*; D003428:Cross Infection; D004755:Enterobacteriaceae / Q000235:genetics* / Q000302:isolation & purification; D004756:Enterobacteriaceae Infections / Q000453:epidemiology* / Q000266:history / Q000382:microbiology*; D005602:France; D049674:History, 21st Century; D006801:Humans; D015994:Incidence; D011446:Prospective Studies; D062486:Public Health Surveillance; D001618:beta-Lactamases / Q000235:genetics*
chemical_list: D001426:Bacterial Proteins; D001618:beta-Lactamases; C063912:carbapenemase
keywords: carbapenem resistance; carbapenemase; epidemiology