Occurrence of carbapenemase-producing Klebsiella pneumoniae and Escherichia coli in Europe

ECDC comment

​​The global rise of carbapenemase-producing Enterobacteriaceae (CPE) is alarming and is an increasing threat to patient safety, in Europe and globally. It results in higher healthcare costs, prolonged hospital stays, treatment failures and sometimes death.

In 2012, the European Centre for Disease Prevention and Control (ECDC) launched the “European Survey on Carbapenamase-Producing Enterobacteriaceae''' (EuSCAPE) project with the aim to gather data on the occurrence of CPE in Europe and build laboratory capacity for their diagnosis and for surveillance.

On the occasion of the 9th European Antibiotic Awareness Day, on 18 November 2016, The Lancet Infectious Diseases published the results of characterisation, including carbapenemase production, of 1397 carbapenem-resistant Enterobacteriaceae isolates collected in 455 European hospitals from 36 countries during the EuSCAPE project, giving the first complete snapshot of carbapenemase-producing Klebsiella pneumoniae and Escherichia coli in Europe.

The surve​y showed that on average in Europe, 1.3 patients per 10 000 hospital admissions had a carbapenemase-producing K. pneumoniae or E. coli infection, with the highest incidence found in southern and southeastern Europe. In K. pneumoniae, the most frequently detected carbapenamases were KPC enzymes, followed by OXA-48-like, NDM and VIM, while in E. coli, there were OXA-48-like enzymes followed by NDM and KPC.

The EuSCAPE project contributed to the improvement of the capacity and ability to detect CPE in European countries by creating a European network of national reference/expert laboratories able to provide information for monitoring incidence and spread of carbapenemases and CPE. These results highlight the need to develop a system for public health surveillance of CPE across healthcare systems in Europe as a tool to inform risk assessment and control programmes.

Grundmann H, Glasner C, Albiger B et al.Occurrence of carbapenemase-producing Klebsiella pneumoniae and Escherichiacoli in the European survey of carbapenemase-producing Enterobacteriaceae(EuSCAPE): a prospective, multinational study. Lancet Infectious Diseases.