Nationwide, population-based observational study of the molecular epidemiology and temporal trend of carbapenemase-producing Enterobacterales in Norway, 2015 to 2021
(2023) In Euro surveillance : bulletin Europeen sur les maladies transmissibles = European communicable disease bulletin 28(27). p.1-11- Abstract
IntroductionNational and regional carbapenemase-producing Enterobacterales (CPE) surveillance is essential to understand the burden of antimicrobial resistance, elucidate outbreaks, and develop infection-control or antimicrobial-treatment recommendations.AimThis study aimed to describe CPE and their epidemiology in Norway from 2015 to 2021.MethodsA nationwide, population-based observational study of all verified clinical and carriage CPE isolates submitted to the national reference laboratory was conducted. Isolates were characterised by antimicrobial susceptibility testing, whole genome sequencing (WGS) and basic metadata. Annual CPE incidences were also estimated.ResultsA total of 389 CPE isolates were identified from 332 patients of... (More)
IntroductionNational and regional carbapenemase-producing Enterobacterales (CPE) surveillance is essential to understand the burden of antimicrobial resistance, elucidate outbreaks, and develop infection-control or antimicrobial-treatment recommendations.AimThis study aimed to describe CPE and their epidemiology in Norway from 2015 to 2021.MethodsA nationwide, population-based observational study of all verified clinical and carriage CPE isolates submitted to the national reference laboratory was conducted. Isolates were characterised by antimicrobial susceptibility testing, whole genome sequencing (WGS) and basic metadata. Annual CPE incidences were also estimated.ResultsA total of 389 CPE isolates were identified from 332 patients of 63 years median age (range: 0-98). These corresponded to 341 cases, 184 (54%) being male. Between 2015 and 2021, the annual incidence of CPE cases increased from 0.6 to 1.1 per 100,000 person-years. For CPE-isolates with available data on colonisation/infection, 58% (226/389) were associated with colonisation and 38% (149/389) with clinical infections. WGS revealed a predominance of OXA-48-like (51%; 198/389) and NDM (34%; 134/389) carbapenemases in a diversified population of
(Less)
Escherichia coli and
Klebsiella pneumoniae, including high-risk clones also detected globally. Most CPE isolates were travel-related (63%; 245/389). Although local outbreaks and healthcare-associated transmission occurred, no interregional spread was detected. Nevertheless, 18% (70/389) of isolates not directly related to import points towards potentially unidentified transmission routes. A decline in travel-associated cases was observed during the COVID-19 pandemic.ConclusionsThe close-to-doubling of CPE case incidence between 2015 and 2021 was associated with foreign travel and genomic diversity. To limit further transmission and outbreaks, continued screening and monitoring is essential.
- author
- Ljungquist, Oskar LU ; Haldorsen, Bjørg ; Pöntinen, Anna Kaarina ; Janice, Jessin ; Josefsen, Ellen Haldis ; Elstrøm, Petter ; Kacelnik, Oliver ; Sundsfjord, Arnfinn and Samuelsen, Ørjan
- author collaboration
- organization
- publishing date
- 2023-07
- type
- Contribution to journal
- publication status
- published
- subject
- in
- Euro surveillance : bulletin Europeen sur les maladies transmissibles = European communicable disease bulletin
- volume
- 28
- issue
- 27
- pages
- 1 - 11
- publisher
- European Centre for Disease Prevention and Control (ECDC)
- external identifiers
-
- scopus:85166338492
- pmid:37410381
- ISSN
- 1560-7917
- DOI
- 10.2807/1560-7917.ES.2023.28.27.2200774
- language
- English
- LU publication?
- yes
- id
- e4402c2c-1ee5-45ab-b318-74aa0e658d12
- date added to LUP
- 2023-07-08 20:04:55
- date last changed
- 2024-04-20 01:57:47
@article{e4402c2c-1ee5-45ab-b318-74aa0e658d12,
abstract = {{<p>IntroductionNational and regional carbapenemase-producing Enterobacterales (CPE) surveillance is essential to understand the burden of antimicrobial resistance, elucidate outbreaks, and develop infection-control or antimicrobial-treatment recommendations.AimThis study aimed to describe CPE and their epidemiology in Norway from 2015 to 2021.MethodsA nationwide, population-based observational study of all verified clinical and carriage CPE isolates submitted to the national reference laboratory was conducted. Isolates were characterised by antimicrobial susceptibility testing, whole genome sequencing (WGS) and basic metadata. Annual CPE incidences were also estimated.ResultsA total of 389 CPE isolates were identified from 332 patients of 63 years median age (range: 0-98). These corresponded to 341 cases, 184 (54%) being male. Between 2015 and 2021, the annual incidence of CPE cases increased from 0.6 to 1.1 per 100,000 person-years. For CPE-isolates with available data on colonisation/infection, 58% (226/389) were associated with colonisation and 38% (149/389) with clinical infections. WGS revealed a predominance of OXA-48-like (51%; 198/389) and NDM (34%; 134/389) carbapenemases in a diversified population of<br>
Escherichia coli and <br>
Klebsiella pneumoniae, including high-risk clones also detected globally. Most CPE isolates were travel-related (63%; 245/389). Although local outbreaks and healthcare-associated transmission occurred, no interregional spread was detected. Nevertheless, 18% (70/389) of isolates not directly related to import points towards potentially unidentified transmission routes. A decline in travel-associated cases was observed during the COVID-19 pandemic.ConclusionsThe close-to-doubling of CPE case incidence between 2015 and 2021 was associated with foreign travel and genomic diversity. To limit further transmission and outbreaks, continued screening and monitoring is essential.<br>
</p>}},
author = {{Ljungquist, Oskar and Haldorsen, Bjørg and Pöntinen, Anna Kaarina and Janice, Jessin and Josefsen, Ellen Haldis and Elstrøm, Petter and Kacelnik, Oliver and Sundsfjord, Arnfinn and Samuelsen, Ørjan}},
issn = {{1560-7917}},
language = {{eng}},
number = {{27}},
pages = {{1--11}},
publisher = {{European Centre for Disease Prevention and Control (ECDC)}},
series = {{Euro surveillance : bulletin Europeen sur les maladies transmissibles = European communicable disease bulletin}},
title = {{Nationwide, population-based observational study of the molecular epidemiology and temporal trend of carbapenemase-producing Enterobacterales in Norway, 2015 to 2021}},
url = {{http://dx.doi.org/10.2807/1560-7917.ES.2023.28.27.2200774}},
doi = {{10.2807/1560-7917.ES.2023.28.27.2200774}},
volume = {{28}},
year = {{2023}},
}