Control of carbapenemase-producing Klebsiella Pneumoniae: a region-Wide intervention

被引:19
作者
Gagliotti, C. [1 ]
Cappelli, V. [1 ]
Carretto, E. [2 ]
Marchi, M. [1 ]
Pan, A. [1 ]
Ragni, P. [3 ]
Sarti, M. [4 ]
Suzzi, R. [5 ]
Tura, G. A. [6 ]
Moro, M. L. [1 ]
机构
[1] Agenzia Sanitaria Sociale Reg Emilia Roma, Bologna, Italy
[2] Azienda Osped Reggio Emilia, Arcispedale S Maria Nuova, Reggio Emilia, Italy
[3] Azienda Unita Sanitaria Locale Reggio Emilia, Reggio Emilia, Italy
[4] Nuovo Osped Civile S Agostino Estense, Azienda Unita Sanitaria Locale Modena, Baggiovara, MO, Italy
[5] Azienda Unita Sanitaria Locale Bologna, Bologna, Italy
[6] Azienda Unita Sanitaria Locale Rimini, Rimini, Italy
来源
EUROSURVEILLANCE | 2014年 / 19卷 / 43期
关键词
INFECTION-CONTROL; SPREAD; ENTEROBACTERIACEAE; SURVEILLANCE; HOSPITALS; OUTBREAK; PROGRAM;
D O I
10.2807/1560-7917.ES2014.19.43.20943
中图分类号
R51 [传染病];
学科分类号
100401 ;
摘要
Starting in 2010, there was a sharp increase in infections caused by Klebsiella pneumoniae resistant to carbapenems in the Emilia-Romagna region in Italy. A region-wide intervention to control the spread of carbapenemase-producing K. pneumoniae (CPKP) in Emilia-Romagna was carried out, based on a regional guideline issued in July 2011. The infection control measures recommended to the Health Trusts (HTs) were: phenotypic confirmation of carbapenemase production, active surveillance of asymptomatic carriers and contact isolation precautions for carriers. A specific surveillance system was activated and the implementation of control measures in HTs was followed up. A significant linear increase of incident CPKP cases over time (p < 0.001) was observed at regional level in Emilia-Romagna in the pre-intervention period, while the number of cases remained stable after the launch of the intervention (p = 0.48). Considering the patients hospitalised in five HTs that provided detailed data on incident cases, a downward trend was observed in incidence after the release of the regional guidelines (from 32 to 15 cases per 100,000 hospital patient days). The spread of CPKP in Emilia-Romagna was contained by a centrally-coordinated intervention. A further reduction in CPKP rates might be achieved by increased compliance with guidelines and specific activities of antibiotic stewardship.
引用
收藏
页码:13 / 20
页数:8
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