{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,15]],"date-time":"2026-05-15T18:38:14Z","timestamp":1778870294397,"version":"3.51.4"},"reference-count":18,"publisher":"BMJ","issue":"4","license":[{"start":{"date-parts":[[2021,4,14]],"date-time":"2021-04-14T00:00:00Z","timestamp":1618358400000},"content-version":"unspecified","delay-in-days":13,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"name":"Ministry of University and Scientific Research Grant FIL, University of Parma, Italy","award":["N\/A"],"award-info":[{"award-number":["N\/A"]}]}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Open"],"accepted":{"date-parts":[[2021,4,4]]},"published-print":{"date-parts":[[2021,4]]},"abstract":"\n Objectives<\/jats:title>\n \n The distribution of carbapenemase-producing\n Klebsiella pneumoniae<\/jats:italic>\n (CPKP) phenotypes and genotypes in samples collected during 2011\u20132018 was evaluated. The association between patients with CPKP-positive rectal swab and those with CPKP infection, as well as the overall analysis of CPKP-infected patients, was performed.\n <\/jats:p>\n <\/jats:sec>\n \n Setting<\/jats:title>\n The study was performed in a tertiary-care hospital located in Northern Italy.<\/jats:p>\n <\/jats:sec>\n \n Participants<\/jats:title>\n Two groups were considered: 22 939 \u2018at-risk\u2019 patients submitted to active surveillance for CPKP detection in rectal swabs\/stools and 1094 CPKP-infected patients in which CPKP was detected in samples other than rectal swabs.<\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n \n CPKP-positive rectal swabs were detected in 5% (1150\/22 939). A CPKP infection was revealed in 3.1% (719\/22 939) of patients: 582 with CPKP-positive rectal swab (50.6% of the 1150 CPKP-positive rectal swabs) and 137 with CPKP-negative rectal swab. The 49.4% (568\/1150) of the patients with CPKP-positive rectal swab were carriers. The overall frequency of CPKP-positive patients (carriers and infected) was almost constant from 2012 to 2016 (excluding the 2015 peak) and then increased in 2017\u20132018.\n bla<\/jats:italic>\n KPC was predominant followed by\n bla<\/jats:italic>\n VIM. No difference was observed in the frequency of CPKP-positive rectal swab patients among the different material groups. Among the targeted carbapenemase genes,\n bla<\/jats:italic>\n VIM was more significantly detected from urine than from other samples.\n <\/jats:p>\n <\/jats:sec>\n \n Conclusions<\/jats:title>\n The high prevalence of carriers without evidence of infection, representing a potential reservoir of CPKP, suggests to maintain the guard about this problem, emphasising the importance of active surveillance for timely detection and separation of carriers, activation of contact precautions and antibiotic treatment guidance on suspicion of infection.<\/jats:p>\n <\/jats:sec>","DOI":"10.1136\/bmjopen-2020-042290","type":"journal-article","created":{"date-parts":[[2021,4,19]],"date-time":"2021-04-19T13:28:45Z","timestamp":1618838925000},"page":"e042290","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":8,"title":["Active surveillance for carbapenemase-producing\n Klebsiella pneumonia<\/i>\n e and correlation with infection in subjects attending an Italian tertiary-care hospital: a 7-year retrospective study"],"prefix":"10.1136","volume":"11","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-4308-3120","authenticated-orcid":false,"given":"Adriana","family":"Calderaro","sequence":"first","affiliation":[{"name":"Department of Medicine and Surgery, University of Parma, Parma, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mirko","family":"Buttrini","sequence":"additional","affiliation":[{"name":"Department of Medicine and Surgery, University of Parma, Parma, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Monica","family":"Martinelli","sequence":"additional","affiliation":[{"name":"Unit of Clinical Microbiology, University Hospital of Parma, Parma, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sara","family":"Montecchini","sequence":"additional","affiliation":[{"name":"Unit of Clinical Virology, University Hospital of Parma, Parma, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Silvia","family":"Covan","sequence":"additional","affiliation":[{"name":"Unit of Clinical Microbiology, University Hospital of Parma, Parma, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alberto","family":"Ruggeri","sequence":"additional","affiliation":[{"name":"Unit of Clinical Microbiology, University Hospital of Parma, Parma, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Isabella","family":"Rodighiero","sequence":"additional","affiliation":[{"name":"Unit of Clinical Microbiology, University Hospital of Parma, Parma, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alan","family":"Di Maio","sequence":"additional","affiliation":[{"name":"Unit of Clinical Microbiology, University Hospital of Parma, Parma, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mariapia","family":"Galullo","sequence":"additional","affiliation":[{"name":"Unit of Clinical Microbiology, University Hospital of Parma, Parma, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sandra","family":"Larini","sequence":"additional","affiliation":[{"name":"Unit of Clinical Microbiology, University Hospital of Parma, Parma, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Maria Cristina","family":"Arcangeletti","sequence":"additional","affiliation":[{"name":"Department of Medicine and Surgery, University of Parma, Parma, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Carlo","family":"Chezzi","sequence":"additional","affiliation":[{"name":"Department of Medicine and Surgery, University of Parma, Parma, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Flora","family":"De Conto","sequence":"additional","affiliation":[{"name":"Department of Medicine and Surgery, University of Parma, Parma, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2021,4,19]]},"reference":[{"key":"2025121403085976000_11.4.e042290.1","doi-asserted-by":"crossref","first-page":"ofy190","DOI":"10.1093\/ofid\/ofy190","article-title":"Gut microbiota and clinical features distinguish colonization with Klebsiella pneumoniae carbapenemase-producing Klebsiella pneumoniae at the time of admission to a long-term acute care hospital","volume":"5","author":"Seekatz","year":"2018","journal-title":"Open Forum Infect 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Indicazioni pratiche E protocolli operativi per La diagnosi, La sorveglianza E IL controllo degli enterobatteri produttori di carbapenemasi nelle strutture sanitarie E socio-sanitarie, 2017. Available: http:\/\/assr.regione.emilia-romagna.it\/it\/servizi\/pubblicazioni\/rapporti-documenti\/indicazioni-pratiche-diagnosi-cpe-2017"},{"key":"2025121403085976000_11.4.e042290.7","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajic.2008.03.002"},{"key":"2025121403085976000_11.4.e042290.8","unstructured":"Centers for Disease Control and Prevention . Antibiotic resistance threats in the United States, 2013, 2013. Available: http:\/\/www.cdc.gov\/drugresistance\/pdf\/ar-threats-2013-508.pdf"},{"key":"2025121403085976000_11.4.e042290.9","unstructured":"World Health Organization . Guidelines for the prevention and control of carbapenem-resistant Enterobacteriaceae, Acinetobacter baumannii and Pseudomonas aeruginosa in health care facilities, 2017. 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