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Combined clonal and plasmid-mediated outbreak of carbapenemase-producing Enterobacterales, Lithuania, 2019–2020

Carbapenem resistance in Enterobacteriaceae such as Klebsiella pneumoniae and Escherichia coli poses a significant threat to patients and healthcare systems in all European Union/European Economic Area (EU/EEA) countries. Carbapenem-resistant Enterobacteriaceae (CRE) infections are associated with high mortality, primarily due to delays in administration of effective treatment and the limited availability of treatment options.

Data are processed for the conduct of the carbapenem- and/or colistin-resistant Enterobacteriaceae (CCRE) survey as part of molecular surveillance of antimicrobial resistant pathogens according to a protocol. For the CCRE survey bacterial isolates (carbapenem and/or colistin-resistant Enterobacteriaceae and susceptible control isolates) and related patient data are collected in hospitals in 37 countries with the aim to determine transmission pathways and improve control measures.

A large outbreak of New Delhi metallo-beta-lactamase (NDM)-producing carbapenem-resistant Enterobacteriaceae (CRE) has been reported from the Tuscany region in Italy. Between November 2018 and May 2019, seven Tuscan hospitals notified a total of 350 cases.

This protocol is based partly on the laboratory manual developed for the European survey of carbapenemase-producing Enterobacteriaceae (EuSCAPE)

An ECDC country visit team conducted an assessment mission during the period 12–16 March 2018 to discuss antimicrobial resistance (AMR) issues in Norway. The overall objective of the mission was to provide an observation-based assessment of the situation in Norway regarding prevention and control of AMR through prudent use of antibiotics and infection control.

This expert consensus protocol for colistin resistance detection and characterisation was jointly developed by the EURGen CCRE consortium, the scientific advisory board for EURGen-Net and ECDC to agree upon the best available strategy for phenotypic and genotypic colistin-resistance detection and confirmation to be used for the CCRE survey.

This ECDC study protocol describes the technical requirements for implementing future EU-level genomic-based surveillance of carbapenem-resistant and/or colistin-resistant Enterobacteriaceae.