title: Burden of carbapenem-resistant organisms in the Frankfurt/Main Metropolitan Area in Germany 2012/2013 - first results and experiences after the introduction of legally mandated reporting.
abstract: BACKGROUND
  The federal state of Hesse, Germany, introduced a laboratory-based reporting scheme for carbapenem-resistant organisms (CROs).
  
  
  METHODS
  The results of the first year of mandated reporting of CROs from April 2012 through March 2013 to the Public Health Authority of Frankfurt/Main, responsible for a population of 700,000 inhabitants, are described.
  
  
  RESULTS
  Within a period of 12 months 243 CROs were notified to the health authority. Of these 213 isolates had been reported from 16 of the 17 hospitals in Frankfurt/Main, 6 from ambulatory settings and 24 from clinics outside of Frankfurt/Main. Mean incidence rate per 1,000 patient days in hospitals was 0.138 (range 0.02-0.28).
  
  
  CONCLUSIONS
  In Frankfurt/Main almost all hospitals have reported CROs in the study period though the frequency of isolation varies strongly and many facilities only report CROs sporadically. Molecular data indicate a high diversity of different carbapenemases. Autochthonous transmission must be assumed despite the absence of major outbreaks. Rapid and coordinated efforts by clinicians and health departments are crucial to control the spread of CRO infections. The mandatory reporting scheme provides important data to guide the implementation of preventive measures.
authors.affiliation: Public Health Authority of Frankfurt/Main, Breite Gasse 28, D- 60313 Frankfurt, Germany. niels.kleinkauf@stadt-frankfurt.de.
authors.forename: Niels
authors.initials: N
authors.lastname: Kleinkauf
authors.forename: Angelika
authors.initials: A
authors.lastname: Hausemann
authors.forename: Volkhard A J
authors.initials: VA
authors.lastname: Kempf
authors.forename: René
authors.initials: R
authors.lastname: Gottschalk
authors.forename: Ursel
authors.initials: U
authors.lastname: Heudorf
mesh_terms: D000328:Adult; D000368:Aged; D001424:Bacterial Infections / Q000175:diagnosis / Q000453:epidemiology*; D015780:Carbapenems / Q000494:pharmacology*; D003140:Communicable Disease Control; D003625:Data Collection; D004196:Disease Outbreaks; D024901:Drug Resistance, Multiple, Bacterial; D005260:Female; D005858:Germany / Q000453:epidemiology; D006761:Hospitals; D006801:Humans; D008297:Male; D008875:Middle Aged; D015995:Prevalence
chemical_list: D015780:Carbapenems