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|
RIMOLDI, SARA GIORDANA (Secondo)
GISMONDO, MARIA RITA (Ultimo)
|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|
|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|