Diffusion and transmission of carbapenem-resistant Klebsiella pneumoniae in the medical and surgical wards of a university hospital in Milan, Italy

Ridolfo, A.L.; Rimoldi, S.G.; Pagani, C.; Marino, A.F.; Piol, A.; Rimoldi, M.; Olivieri, P.; Galli, M.; Dolcetti, L.; Gismondo, M.R.

doi:10.1016/j.jiph.2015.05.008

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Carbapenem-resistant Klebsiella pneumoniae (CRKP) is emerging as a public health problem worldwide. In Italy, a remarkable increase in CRKP cases has been reported since 2010. In this study, CRKP diffusion, distribution and in-hospital transmission trends were evaluated in a university hospital in Milan, Italy, from January 2012 to December 2013. Isolates from 63 newly detected CRKP-positive patients were genotyped, and possible transmission was determined by combining the molecular results with data concerning the patients' admission and in-hospital transfers. Most of the cases (90.4%) were from general medical and surgery wards, and the remaining 9.6% were from the intensive care unit. Fifteen of the 46 hospital-associated cases (32.6%) were attributable to in-hospital transmission. After the introduction of targeted and hospital-wide control measures, the transmission index significantly decreased from 0.65 to 0.13 (p = 0.01). There was also a decrease in the overall nosocomial case incidence, from 0.37 to 0.17 per 1000 person-days (p = 0.07).Our findings indicate that the spread of CRKP in Northern Italy hospitals may go far beyond high-risk settings (i.e., intensive care units) and that strict surveillance should be extended to general areas of care.

Diffusion and transmission of carbapenem-resistant Klebsiella pneumoniae in the medical and surgical wards of a university hospital in Milan, Italy / A.L. Ridolfo, S.G. Rimoldi, C. Pagani, A.F. Marino, A. Piol, M. Rimoldi, P. Olivieri, M. Galli, L. Dolcetti, M.R. Gismondo. - In: JOURNAL OF INFECTION AND PUBLIC HEALTH. - ISSN 1876-0341. - 9:1(2016), pp. 24-33.

Titolo:	Diffusion and transmission of carbapenem-resistant Klebsiella pneumoniae in the medical and surgical wards of a university hospital in Milan, Italy
Autori:	A. L. Ridolfo RIMOLDI, SARA GIORDANA (Secondo) PAGANI, CRISTINA MARINO, ANDREA FILIPPO A. Piol RIMOLDI, MATTEO P. Olivieri GALLI, MASSIMO L. Dolcetti GISMONDO, MARIA RITA (Ultimo) mostra contributor esterni nascondi contributor esterni
Parole Chiave:	Active screening; Active surveillance; Carbapenem-resistant Klebsiella pneumoniae; Cross-transmission; Infections control measures; Multidrug-resistant agents; Infectious Diseases; Public Health, Environmental and Occupational Health
Settore Scientifico Disciplinare:	Settore MED/17 - Malattie Infettive
Data di pubblicazione:	2016
Rivista:	JOURNAL OF INFECTION AND PUBLIC HEALTH
Tipologia:	Article (author)
Data ahead of print / Data di stampa:	23-giu-2015
Digital Object Identifier (DOI):	http://dx.doi.org/10.1016/j.jiph.2015.05.008
Appare nelle tipologie:	01 - Articolo su periodico

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