Listed for Impact Factor Europe’s journal on infectious disease epidemiology, prevention and control ECDC © Special edition: Antimicrobial resistance 18 November 2010 • To tie in with the European Antibiotic Awareness Day 2010, a Eurosurveillance special issue presents a series of articles on antimicrobial resistance with a particular focus on the emergence of resistant Klebsiella pneumoniae and reviews the spread of the New Delhi metallo-beta-lactamase 1 in European countries www.eurosurveillance.org Editorial team Editorial board Based at the European Centre for Austria: Reinhild Strauss, Vienna Disease Prevention and Control (ECDC), Belgium: Koen De Schrijver, Antwerp 171 83 Stockholm, Sweden Belgium: Sophie Quoilin, Brussels Telephone number Bulgaria: Mira Kojouharova, Sofia +46 (0)8 58 60 11 38 or +46 (0)8 58 60 11 36 Croatia: Borislav Aleraj, Zagreb Fax number Cyprus: Olga Poyiadji-Kalakouta, Nicosia +46 (0)8 58 60 12 94 Czech Republic: Bohumir Križ, Prague Denmark: Peter Henrik Andersen, Copenhagen E-mail England and Wales: Neil Hough, London [email protected] Estonia: Kuulo Kutsar, Tallinn Editor-in-Chief Finland: Hanna Nohynek, Helsinki Karl Ekdahl France: Judith Benrekassa, Paris Germany: Jamela Seedat, Berlin Managing Editor Greece: Rengina Vorou, Athens Ines Steffens Hungary: Ágnes Csohán, Budapest Scientific Editors Iceland: Haraldur Briem, Reykjavik Kathrin Hagmaier Ireland: Lelia Thornton, Dublin Williamina Wilson Italy: Paola De Castro, Rome Assistant Editors Latvia: Jurijs Perevoščikovs, Riga Alina Buzdugan Lithuania: Milda Zygutiene, Vilnius Ingela Söderlund Luxembourg: Robert Hemmer, Luxembourg FYR of Macedonia: Elisaveta Stikova, Skopje Associate Editors Malta: Tanya Melillo Fenech, Valletta Andrea Ammon, ECDC, Stockholm, Sweden Netherlands: Paul Bijkerk, Bilthoven Tommi Asikainen, ECDC, Stockholm, Sweden Norway: Hilde Klovstad, Oslo Mike Catchpole, Health Protection Agency, Poland: Malgorzata Sadkowska-Todys, Warsaw London, United Kingdom Portugal: Judite Catarino, Lisbon Denis Coulombier, ECDC, Stockholm, Sweden Romania: Daniela Pitigoi, Bucharest Christian Drosten, Universitätsklinikum Bonn, Bonn, Germany Scotland: Norman Macdonald, Glasgow Johan Giesecke, ECDC, Stockholm, Sweden Slovakia: Lukáš Murajda, Martin Herman Goossens, Universiteit Antwerpen, Antwerp, Belgium Slovenia: Alenka Kraigher, Ljubljana David Heymann, World Health Organization, Geneva, Spain: Elena Rodríguez Valín, Madrid Switzerland Sweden: Aase Sten, Stockholm Irena Klavs, National Institute of Public Health, Ljubljana, Slovenia Turkey: Aysegul Gozalan, Istanbul Karl Kristinsson, Landspitali University Hospital, Reykjavik, European Commission: Paolo Guglielmetti, Luxembourg Iceland World Health Organization Regional Office for Europe: Nedret Daniel Lévy-Bruhl, Institut de Veille Sanitaire, Paris, France Emiroglu, Copenhagen Richard Pebody, Health Protection Agency, London, United Kingdom Panayotis T. Tassios, University of Athens, Athens, Greece Hélène Therre, Institut de Veille Sanitaire, Paris, France Henriette de Valk, Institut de Veille Sanitaire, Paris, France Sylvie van der Werf, Institut Pasteur, Paris, France Design / Layout Fabrice Donguy / Martin Wincent Webmaster Sami Dufva www.eurosurveillance.org © Eurosurveillance, 2011 Contents Special edition: Antimicrobial resistance Editorials Antimicrobial resistance 2010: global attention on carbapenemase-producing bacteria 2 by ECDC Antimicrobial Resistance and Healthcare- Associated Infections Programme Rapid communications Possible importation and subsequent cross- transmission of OXA-48-producing Klebsiella pneumoniae, France, 2010 6 by D Decre, G Birgand, D Geneste, E Maury, JC Petit, F Barbut, G Arlet Research articles New Delhi metallo-beta-lactamase 1–producing Enterobacteriaceae: emergence and response in Europe 8 by MJ Struelens, DL Monnet, AP Magiorakos, F Santos O’Connor, J Giesecke, the European NDM-1 Survey Participants Prevalence of meticillin-resistant Staphylococcus aureus amongst professional meat handlers in the Netherlands, March–July 2008 16 by R de Jonge, JE Verdier, AH Havelaar Euroroundups Carbapenem-non-susceptible Enterobacteriaceae in Europe: conclusions from a meeting of national experts 21 by H Grundmann, DM Livermore, CG Giske, R Canton, GM Rossolini, J Campos, A Vatopoulos, M Gniadkowski, A Toth, Y Pfeifer, V Jarlier, Y Carmeli, the CNSE Working Group Surveillance and outbreak reports Extended measures for controlling an outbreak of VIM-1 producing imipenem-resistant Klebsiella pneumoniae in a liver transplant centre in France, 2003–2004 34 by N Kassis-Chikhani, F Saliba, A Carbonne, S Neuville, D Decre, C Sengelin, C Guerin, N Gastiaburu, A Lavigne-Kriaa, C Boutelier, G Arlet, D Samuel, D Castaing, E Dussaix, V Jarlier Appropriateness of antimicrobial therapy: a multicentre prevalence survey in the Netherlands, 2008–2009 41 by I Willemsen, T van der Kooij, B van Benthem, J Wille, J Kluytmans Microorganisms resistant to antibiotic treatment have become a common problem in hospitals across Europe. © ECDC www.eurosurveillance.org 1 Editorials Antimicrobial resistance 2010: global attention on carbapenemase-producing bacteria ECDC Antimicrobial Resistance and Healthcare-Associated Infections Programme1,2 1. European Centre for Disease Prevention and Control (ECDC), Stockholm, Sweden 2. Members of the programme are listed at the end of the editorial Citation style for this article: ECDC Antimicrobial Resistance and Healthcare-Associated Infections Programme. Antimicrobial resistance 2010: global attention on carbapenemase-producing bacteria . Euro Surveill. 2010;15(46):pii=19719. Available online: http://www.eurosurveillance.org/ViewArticle.aspx?ArticleId=19719 Article published on 18 November 2010 A year ago in November 2009, a study in this journal these have in common that they are able to rapidly hydro- highlighted the emergence of infections with totally or lyse most of the beta-lactams including the carbapen- almost totally resistant bacteria in European intensive ems, thus conferring resistance to these antibiotics. care units [1]. Most of them were Gram-negative bacilli In addition, they are in most cases encoded by a gene that showed resistance to a class of antibiotics con- located on transferable elements which allows transfer sidered last-line therapy: the carbapenems. Already of the gene among species of Enterobacteriaceae. This in 2008, Souli et al. had reviewed the emergence of issue of Eurosurveillance highlights the challenges rep- extensively drug-resistant (XDR) bacteria in Europe [2] resented by carbapenemase-producing, XDR bacteria, and pointed out the high proportion of isolates that but also offers examples from EU countries on how the were resistant to carbapenems, through production spread of such bacteria can be contained. of a carbapenemase enzyme. Indeed, an increasing number of reports on carbapenemases and infections Although NDM-1 has been the focus of media atten- with carbapenemase-producing bacteria have been tion concerning antimicrobial resistance during the published in recent years indicating the rising impor- past months, it is neither the most frequently identi- tance of these bacteria. A PubMed search with the key- fied carbapenemase in Europe, nor the only carbapen- word ‘carbapenemase’ and excluding review articles, emase associated with transfer of patients between yielded 35 articles for the year 2007, 48 articles for countries. In this issue of the journal, a group of 2008, 80 articles for 2009 and 109 articles for 2010 (as European experts report on carbapenemase-produc- of 14 November). ing Enterobacteriaceae in Europe and show that car- bapenemases other than NDM-1 are the dominant The year 2010 will certainly be remembered as the types in all European countries except the UK [5]. As year when carbapenemase-producing, XDR bacteria an example, Decré et al. describe the likely importa- attracted global attention. Significant media attention tion from Morocco to France of an OXA-48-producing and increasing awareness of these bacteria followed K. pneumoniae strain with subsequent cross-transmis- the publication by Kumarasamy et al. on 11 August on sion to another patient [6], a pattern similar to that the spread to the United Kingdom (UK) of a new type described for previous OXA-48 cases from other coun- of carbapenemase, the New Delhi metallo-beta-lacta- tries. As for NDM-1, the spread of KPC- and OXA-48- mase 1 (NDM-1), often associated with travel to India or producing bacteria has been associated with transfer Pakistan [3]. In this issue of Eurosurveillance, Struelens of patients from hospitals in countries where they are et al. review the spread of NDM-1 in the European frequently found, to hospitals in other countries [7,8]. Union (EU), Iceland and Norway and show that, in addi- tion to the UK, 11 other EU countries plus Norway have Accurate laboratory detection, control identified patients infected or colonised with NDM-1- of patient-to-patient transmission producing Enterobacteriaceae [4]. Similar to the cases and prudent use of antibiotics are described in the UK, the majority of these NDM-1 cases cornerstones of containment had previously travelled or been admitted to a hospital Identification of carbapenemase-producing bacte- in India or Pakistan. In addition, a few cases had been ria remains a challenge. According to the survey by hospitalised in the Balkan region [4]. Grundmann et al. there is likely underreporting of such isolates in more than one third of European countries