Initial impact of a national programme to contain the spread of carbapenemase-producing Enterobacterales in Ireland

Vellinga, Akke; Brennan, Wendy; Humphreys, Hilary; Burns, Karen

doi:10.1016/j.jhin.2021.01.001

Cited by 13 publications

(8 citation statements)

References 7 publications

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“…Second, blaOXA-48/blaOXA-like carbapenemases were the most prevalent carbapenemases identified in all species, except C. sp. FDAARGOS_156, accounting for 63.4 % of the total CPE up to 2017 and beyond [47,48] in Ireland, suggesting this to be the main cause of carbapenem resistance. While KPC-like, overall, was the predominant carbapenemase in the mainly invasive K. pneumoniae collections in mainland Europe [3,11], we found OXA-48 to be the most common among invasive (n=99, 60.6%) and non-invasive (n=140, 47.1%) isolates in Ireland.…”

Section: Discussionmentioning

confidence: 99%

Dissemination of carbapenemase-producing Enterobacterales in Ireland from 2012 to 2017: a retrospective genomic surveillance study

et al. 2023

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The spread of carbapenemase-producing Enterobacterales (CPE) is of major public health concern. The transmission dynamics of CPE in hospitals, particularly at the national level, are not well understood. Here, we describe a retrospective nationwide genomic surveillance study of CPE in Ireland between 2012 and 2017. We sequenced 746 national surveillance CPE samples obtained between 2012 and 2017. After clustering the sequences, we used thresholds based on pairwise SNPs, and reported within–host diversity along with epidemiological data to infer recent putative transmissions. All clusters in circulating clones, derived from high-resolution phylogenies, of a species ( Klebsiella pneumoniae , Escherichia coli , Klebsiella oxytoca , Enterobacter cloacae , Enterobacter hormaechei and Citrobacter freundii ) were individually examined for evidence of transmission. Antimicrobial resistance trends over time were also assessed. We identified 352 putative transmission events in six species including widespread and frequent transmissions in three species. We detected putative outbreaks in 4/6 species with three hospitals experiencing prolonged outbreaks. The bla OXA-48 gene was the main cause of carbapenem resistance in Ireland in almost all species. An expansion in the number of sequence types carrying bla OXA-48 was an additional cause of the increasing prevalence of carbapenemase-producing K. pneumoniae and E. coli .

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Section: Discussionmentioning

confidence: 99%

Dissemination of carbapenemase-producing Enterobacterales in Ireland from 2012 to 2017: a retrospective genomic surveillance study

et al. 2023

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“…Indeed, CPE was declared a National Public Health Emergency in Ireland in October 2017 [ 7 , 8 ]. Initial evaluations of the impact of measures taken suggest a positive effect on controlling the incidence of CPE acute hospitals in Ireland [ 9 ]. However, despite this positive impact, given the speed at which these organisms have spread globally and their increase in prevalence in Ireland [ 6 , [10] , [11] , [12] , 13 ], continued reports of hospital outbreaks are very likely.…”

Section: Introductionmentioning

confidence: 99%

Social network and genomic analysis of an OXA-48 carbapenemase-producing Enterobacterales hospital ward outbreak in Ireland, 2018–2019

Domegan¹,

Brehony²,

Fitzpatrick³

et al. 2023

Infection Prevention in Practice

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“…It has also reviewed the evolving epidemiology to inform national strategy and ensure alignment with the publicly funded healthcare service, the Health Service Executive's (HSE) antimicrobial resistance and infection control (AMRIC) implementation plan. An interim analysis of the effectiveness of that NPHE process has been recently reported [ 8 ]. Governance structures were established within the HSE to oversee and direct the establishment of a CPE Implementation Team (later incorporated into AMRIC Oversight and Implementation Teams) who were tasked with the implementation of guidance agreed by the CPE NPHET and EAG (e.g.…”

Section: Introductionmentioning

confidence: 99%

Reflections on a national public health emergency response to carbapenemase-producing Enterobacterales (CPE)

et al. 2022

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Carbapenemase-producing Enterobacterales (CPE) are important globally. In 2017, Ireland declared a national public health emergency to address CPE in acute hospitals. A National Public Health Emergency Team and an expert advisory group (EAG) were established. The EAG has identified key learnings to inform future strategies. First, there is still an opportunity to prevent CPE becoming endemic. Second, damp environmental reservoirs in hospitals are inadequately controlled. Third, antibiotic stewardship remains important in control. Finally, there is no current requirement to extend screening to detect CPE outside of acute hospitals. These conclusions and their implications may also be relevant in other countries.

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Initial impact of a national programme to contain the spread of carbapenemase-producing Enterobacterales in Ireland

Cited by 13 publications

References 7 publications

Dissemination of carbapenemase-producing Enterobacterales in Ireland from 2012 to 2017: a retrospective genomic surveillance study

Dissemination of carbapenemase-producing Enterobacterales in Ireland from 2012 to 2017: a retrospective genomic surveillance study

Social network and genomic analysis of an OXA-48 carbapenemase-producing Enterobacterales hospital ward outbreak in Ireland, 2018–2019

Reflections on a national public health emergency response to carbapenemase-producing Enterobacterales (CPE)

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