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Statewide surveillance of carbapenemase-producing carbapenem-resistant Escherichia coli and Klebsiella species in Washington state, October 2012–December 2017

Published online by Cambridge University Press:  20 March 2020

Mimi R. Precit Open the ORCID record for Mimi R. Precit [Opens in a new window] ,
Kelly Kauber ,
William A. Glover ,
Scott J. Weissman ,
Tashina Robinson ,
Michael Tran  and
Marisa D’Angeli
Mimi R. Precit
Affiliation:
Washington State Public Health Laboratories, Shoreline, Washington
Kelly Kauber
Affiliation:
Washington State Public Health Laboratories, Shoreline, Washington
William A. Glover
Affiliation:
Washington State Public Health Laboratories, Shoreline, Washington
Scott J. Weissman
Affiliation:
Seattle Children’s Research Institute, Seattle, Washington
Tashina Robinson
Affiliation:
Washington State Public Health Laboratories, Shoreline, Washington
Michael Tran
Affiliation:
Washington State Public Health Laboratories, Shoreline, Washington
Marisa D’Angeli*
Affiliation:
Washington State Public Health Laboratories, Shoreline, Washington
*
Author for correspondence: Marisa D’Angeli, E-mail: [email protected]
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Abstract

Background:

Carbapenem-resistant Enterobacterales (CRE) are common causes of healthcare-associated infections and are often multidrug resistant with limited therapeutic options. Additionally, CRE can spread within and between healthcare facilities, amplifying potential harms.

Objective:

To better understand the burden, risk factors, and source of acquisition of carbapenemase genes in clinical Escherichia coli and Klebsiella spp isolates from patients in Washington to guide prevention efforts.

Design:

Multicenter prospective surveillance study.

Methods:

Escherichia coli and Klebsiella spp isolates meeting the Washington state CRE surveillance case definition were solicited from clinical laboratories and tested at Washington Public Health Laboratories using polymerase chain reaction (PCR) for the 5 most common carbapenemase genes: blaKPC, blaNDM, blaIMP, blaVIM, and blaOXA-48. Case patients positive by PCR were investigated by the public health department.

Results:

From October 2012 through December 2017, 363 carbapenem-resistant E. coli and Klebsiella spp isolates were tested. Overall, 45 of 115 carbapenem-resistant K. pneumoniae (39%), 1 of 8 K. oxytoca (12.5%), and 28 of 239 carbapenem-resistant E. coli (11.7%) were carbapenemase positive. Of 74 carbapenemase-positive isolates, blaKPC was most common (47%), followed by blaNDM (30%), blaOXA-48 (22%), and blaIMP (1%). Although all cases had healthcare exposure, blaKPC acquisition was associated with US health care, whereas non-blaKPC acquisition was associated with international health care or travel.

Conclusions:

We report that blaKPC, the most prevalent carbapenemase in the United States, accounts for nearly half of carbapenemase cases in Washington state and that most KPC-cases are likely acquired through in-state health care.

Type
Original Article
Information
Infection Control & Hospital Epidemiology , Volume 41 , Issue 6 , June 2020 , pp. 716 - 722
Copyright
© 2020 by The Society for Healthcare Epidemiology of America. All rights reserved.

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Footnotes

a

Present affiliations: Children’s Hospital of Los Angeles, Los Angeles, California [M.R.P.] and North Carolina State Laboratory of Public Health, Raleigh, North Carolina [W.A.G.].

PREVIOUS PRESENTATION. Some of the data reported here were included in a poster presentation at the Association of Public Health Laboratories 2018 Annual Meeting on June 4 2018, in Pasadena, California and a presentation at the 2018 SHEA Conference on April 19 2018 in Portland, Oregon.

References

Centers for Disease Control and Prevention. Antibiotic Resistance Threats in the United States. Atlanta: CDC; 2013.Google Scholar
Sievert, DM, Ricks, P, Edwards, JR, et al.Antimicrobial-resistant pathogens associated with healthcare-associated infections: summary of data reported to the National Healthcare Safety Network at the Centers for Disease Control and Prevention, 2009–2010. Infect Control Hosp Epidemiol 2013;34:1–14.CrossRefGoogle ScholarPubMed
Centers for Disease Control and Prevention. Vital signs: carbapenem-resistant Enterobacteriaceae. Morb Mortal Wkly Rep 2013;62:165–170.Google Scholar
Patel, G, Huprikar, S, Factor, SH, Jenkins, SG, Calfee, DP. Outcomes of carbapenem-resistant Klebsiella pneumoniae infection and the impact of antimicrobial and adjunctive therapies. Infect Control Hosp Epidemiol. 2008;29:1099–1106.CrossRefGoogle ScholarPubMed
Queenan, AM, Bush, K.Carbapenemases: the versatile lactamases. Clin Microbiol Rev 2007;20:440–458.CrossRefGoogle ScholarPubMed
Molton, JS, Tambyah, PA, P Ang, BS, Lin Ling, M, Fisher, DA.The global spread of healthcare-associated multidrug-resistant bacteria: a perspective from Asia. Clin Infect Dis 2013;56:1310–1318.Google ScholarPubMed
Yigit, H, Queenan, AM, Anderson, GJ, et al.Novel carbapenem-hydrolyzing-lactamase, KPC-1, from a carbapenem-resistant strain of Klebsiella pneumoniae. Antimicrob Agents Chemother 2001;45:1151–1161.10.1128/AAC.45.4.1151-1161.2001CrossRefGoogle ScholarPubMed
Lascols, C, Hackel, M, Marshall, SH, et al.Increasing prevalence and dissemination of NDM-1 metallo-β-lactamase in India: data from the SMART study (2009). J Antimicrob Chemother 2011;66:1992–1997.10.1093/jac/dkr240CrossRefGoogle Scholar
Codjoe, F, Donkor, E.Carbapenem resistance: a review. Med Sci 2017;6(1):1.Google ScholarPubMed
Nordmann, P, Naas, T, Poirel, L.Global spread of carbapenemase-producing Enterobacteriaceae. Emerg Infect Dis 2011;17:1791–1798.CrossRefGoogle ScholarPubMed
Schwaber, MJ, Lev, B, Israeli, A, et al.Containment of a country-wide outbreak of carbapenem-resistant Klebsiella pneumoniae in Israeli hospitals via a nationally implemented intervention. Clin Infect Dis 2011;52:848–855.CrossRefGoogle Scholar
Tängdén, T, Giske, CG. Global dissemination of extensively drug-resistant carbapenemase-producing Enterobacteriaceae: clinical perspectives on detection, treatment and infection control. J Intern Med 2015;277:501–512.CrossRefGoogle ScholarPubMed
Ben-David, D, Maor, Y, Keller, N, et al.Potential role of active surveillance in the control of a hospital-wide outbreak of carbapenem-resistant Klebsiella pneumoniae infection. Infect Control Hosp Epidemiol 2010;31:620–626.CrossRefGoogle ScholarPubMed
Guh, AY, Bulens, SN, Mu, Y, et al.Epidemiology of carbapenem-resistant Enterobacteriaceae in 7 US communities, 2012–2013. JAMA 2015;314:1479–1487.10.1001/jama.2015.12480CrossRefGoogle ScholarPubMed
Centers for Disease Control and Prevention. Facility Guidance for Control of Carbapenem-Resistant Enterobacteriaceae (CRE) Update-CRE Toolkit. Atlanta: CDC; 2015.Google Scholar
Traub, WH, Raymond, EA, Linehan, J. Identification of Enterobacteriaceae in the clinical microbiology laboratory. Appl Microbiol 1970;20:303–308.CrossRefGoogle ScholarPubMed
Performance Standards for Antimicrobial Susceptiblity Testing. 22nd Ed. CLSI Supplement M100. Vol 32. Wayne, PA: Clinical Laboratory Standards Institute; 2012.Google Scholar
Performance Standards for Antimicrobial Susceptiblity Testing. 23rd Ed. CLSI Supplement M100. Wayne, PA: Clinical Laboratory Standards Institute; 2013.Google Scholar
Performance Standards for Antimicrobial Susceptiblity Testing. 24th Ed. CLSI Supplement M100. Wayne, PA: Clinical Laboratory Standards Institute; 2014.Google Scholar
Performance Standards for Antimicrobial Susceptiblity Testing. 25th Ed. CLSI Supplement M100. Wayne, PA: Clinical Laboratory Standards Institute; 2015.Google Scholar
Performance Standards for Antimicrobial Susceptiblity Testing. 26th Ed. CLSI Supplement M100. Wayne, PA: Clinical Laboratory Standards Institute; 2016.Google Scholar
Performance Standards for Antimicrobial Susceptibility Testing. 27th Ed. CLSI Supplement M100. Wayne, PA: Clinical Laboratory Standards Institute; 2017.Google Scholar
Pierce, VM, Simner, PJ, Lonsway, DR, et al.Modified carbapenem inactivation method for phenotypic detection of carbapenemase production among Enterobacteriaceae. J Clin Microbiol 2017;55:2321–2333.10.1128/JCM.00193-17CrossRefGoogle ScholarPubMed
Ramana, K, Rao, R, Sharada, C V, Kareem, M, Reddy, R, Ratna Mani, M. Modified Hodge test: a useful and the low-cost phenotypic method for detection of carbapenemase producers in Enterobacteriaceae members. J Nat Sci Biol Med. 2013;4:346–348.CrossRefGoogle ScholarPubMed
Mataseje, LF, Boyd, DA, Willey, BM, et al.Plasmid comparison and molecular analysis of Klebsiella pneumoniae harbouring blakpc from New York City and Toronto. J Antimicrob Chemother 2011;66:1273–1277.10.1093/jac/dkr092CrossRefGoogle Scholar
Doyle, D, Peirano, G, Lascols, C, Lloyd, T, Church, DL, Pitouta, JDD. Laboratory detection of Enterobacteriaceae that produce carbapenemases. J Clin Microbiol 2012;50:3877–3880.10.1128/JCM.02117-12CrossRefGoogle ScholarPubMed
Munoz-Price, LS, Poirel, L, Bonomo, RA, et al.Clinical epidemiology of the global expansion of Klebsiella pneumoniae carbapenemases. Lancet Infect Dis 2013;13:785–796.CrossRefGoogle ScholarPubMed
Guh, AY, Limbago, BM, Kallen, AJ.Epidemiology and prevention of carbapenem-resistant Enterobacteriaceae in the United States. Expert Rev Anti Infect Ther 2014;12:565–580.CrossRefGoogle ScholarPubMed
Tracking CRE. Centers for Disease Control and Prevention website. https://www.cdc.gov/hai/organisms/cre/trackingcre.html. Published 2017. Accessed February 10, 2020.Google Scholar
Frieden, TR, Harold Jaffe, DW, Cardo, DM, et al.Morbidity and Mortality Weekly Report Centers for Disease Control and Prevention MMWR Editorial and Production Staff MMWR Editorial Board.Google Scholar
Patel, TS, Nagel, JLClinical outcomes of enterobacteriaceae infections stratified by carbapenem MICs. J Clin Microbiol 2015;53:201–205.CrossRefGoogle ScholarPubMed
Lazarovitch, T, Amity, K, Coyle, JR, et al.The complex epidemiology of carbapenem-resistant Enterobacter infections: a multicenter descriptive analysis. Infect Control Hosp Epidemiol. 2015;36:1283–1291.CrossRefGoogle ScholarPubMed
Van Duin, D, Perez, F, Rudin, SD, et al.Surveillance of carbapenem-resistant Klebsiella pneumoniae: tracking molecular epidemiology and outcomes through a regional network. Antimicrob Agents Chemother 2014;58:4035–4041.CrossRefGoogle ScholarPubMed
van Duin, D, Doi, Y. The global epidemiology of carbapenemase-producing Enterobacteriaceae. Virulence 2017;8:460–469.CrossRefGoogle ScholarPubMed
Rasheed, JK, Kitchel, B, Zhu, W, et al.New Delhi metallo-β-lactamase–producing enterobacteriaceae, United States. Emerg Infect Dis 2013;19:870–878.CrossRefGoogle Scholar
Livorsi, DJ, Chorazy, ML, Schweizer, ML, et al.A systematic review of the epidemiology of carbapenem-resistant Enterobacteriaceae in the United States. Antimicrob Resist Infect Control 2018;7:55.10.1186/s13756-018-0346-9CrossRefGoogle ScholarPubMed
Van der Bij, AK, Pitout, JDD. The role of international travel in the worldwide spread of multiresistant enterobacteriaceae. J Antimicrob Chemother 2012;67:2090–2100.CrossRefGoogle ScholarPubMed
Bush, K. Proliferation and significance of clinically relevant β-lactamases. Ann N Y Acad Sci 2013;1277:84–90.CrossRefGoogle ScholarPubMed
Fontana, L, Bonura, E, Lyski, Z, Messer, W. The brief case: Klebsiella variicola—identifying the misidentified. J Clin Microbiol 2019;57(1):e00825–18.Google ScholarPubMed
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