Prolonged outbreak of New Delhi metallo-beta-lactamase-producing carbapenem-resistant Enterobacterales (NDM-CRE), Tuscany, Italy, 2018 to 2019
Lara Tavoschi, Silvia Forni, Andrea Davide Porretta, Lorenzo Righi, Filippo Pieralli, Francesco Menichetti, Marco Falcone, Giulia Gemignani, Spartaco Sani, Paola Vivani, Tommaso Bellandi, Danilo Tacconi, Lucia Turini, Giulio Toccafondi, Gaetano Pierpaolo Privitera, Pierluigi Lopalco, Angelo Baggiani, Fabrizio Gemmi, Grazia Luchini, Maurizio Petrillo, Lorenzo Roti, Patrizio Pezzotti, Annalisa Pantosti, Stefania Iannazzo, Maria Teresa Mechi, Gian María Rossolini
Abstract
In Tuscany, Italy, New Delhi metallo-beta-lactamase-producing carbapenem-resistant Enterobacterales (NDM-CRE) have increased since November 2018. Between November 2018 and October 2019, 1,645 samples were NDM-CRE-positive: 1,270 (77.2%) cases of intestinal carriage, 129 (7.8%) bloodstream infections and 246 (14.9%) infections/colonisations at other sites. Klebsiella pneumoniae were prevalent (1,495; 90.9%), with ST147/NDM-1 the dominant clone. Delayed outbreak identification and response resulted in sustained NDM-CRE transmission in the North-West area of Tuscany, but successfully contained spread within the region.