{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,6]],"date-time":"2026-10-06T17:24:17Z","timestamp":1791307457759,"version":"4.3.1"},"reference-count":0,"publisher":"European Centre for Disease Control and Prevention (ECDC)","issue":"46","license":[{"start":{"date-parts":[[2010,11,18]],"date-time":"2010-11-18T00:00:00Z","timestamp":1290038400000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2010,11,18]]},"abstract":"<jats:p>The emergence and global spread of carbapenemase-producing Enterobacteriaceae is of great concern to health services worldwide. These bacteria are often resistant to all beta-lactam antibiotics and frequently co-resistant to most other antibiotics, leaving very few treatment options. The epidemiology is compounded by the diversity of carbapenem-hydrolysing enzymes and the ability of their genes to spread between different bacterial species. Difficulties are also encountered by laboratories when trying to detect carbapenemase production during routine diagnostic procedures due to an often heterogeneous expression of resistance. Some of the resistance genes are associated with successful clonal lineages which have a selective advantage in those hospitals where antimicrobial use is high and opportunities for transmission exist; others are more often associated with transmissible plasmids. A genetically distinct strain of Klebsiella pneumoniae sequence type (ST) 258 harbouring the K. pneumoniae carbapenemases (KPC) has been causing epidemics of national and international proportions. It follows the pathways of patient referrals, causing hospital outbreaks along the way. Simultaneously, diverse strains harbouring New Delhi metallo-beta-lactamase (NDM-1) are repeatedly being imported into Europe, commonly via patients with prior medical exposure in the Indian subcontinent. Since the nature and scale of carbapenem-non-susceptible Entrobacteriaceae as a threat to hospital patients in Europe remains unclear, a consultation of experts from 31 countries set out to identify the gaps in diagnostic and response capacity, to index the magnitude of carbapenem-non-susceptibility across Europe using a novel five-level staging system, and to provide elements of a strategy to combat this public health issue in a concerted manner. \n<\/jats:p>","DOI":"10.2807\/ese.15.46.19711-en","type":"journal-article","created":{"date-parts":[[2017,11,28]],"date-time":"2017-11-28T11:55:18Z","timestamp":1511870118000},"update-policy":"https:\/\/doi.org\/10.2807\/1560-7917.es.crp2020","source":"Crossref","is-referenced-by-count":175,"title":["Carbapenem-non-susceptible Enterobacteriaceae in Europe: conclusions from a meeting of national experts"],"prefix":"10.2807","volume":"15","author":[{"given":"H","family":"Grundmann","sequence":"first","affiliation":[{"name":"National Institute for Public Health and the Environment (RIVM), Bilthoven, the Netherlands"},{"name":"Department of  Medical Microbiology, University Medical Centre, Groningen, the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"D M","family":"Livermore","sequence":"additional","affiliation":[{"name":"Antibiotic Resistance Monitoring and Reference Laboratory, Health Protection Agency Centre for Infections, London, United Kingdom"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"C G","family":"Giske","sequence":"additional","affiliation":[{"name":"Microbiology and Tumour Biology Centre, Karolinska Institute, Stockholm, Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"R","family":"Cant\u00f3n","sequence":"additional","affiliation":[{"name":"Associated Resistance Unit National Research Council (Unidad de Resistencia Asociada al Consejo Superior de Investigaciones Cient\u00edficas; CSIC), Madrid, Spain"},{"name":"Microbiology Service, CIBER Epidemiology and Public Health (CIBERESP), University hospital Cajal and Institute Ram\u00f3n and Cajal for Health Research (IRYCIS), Madrid, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"G M","family":"Rossolini","sequence":"additional","affiliation":[{"name":"Department of Molecular Biology, Section Microbiology, University of Siena, Siena, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"J","family":"Campos","sequence":"additional","affiliation":[{"name":"Antibiotic Laboratory, National Centre of Microbiology, Instituto de Salud Carlos III, Madrid, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"A","family":"Vatopoulos","sequence":"additional","affiliation":[{"name":"Department of Microbiology, National School of Public Health, Athens, Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"M","family":"Gniadkowski","sequence":"additional","affiliation":[{"name":"National Medicines Institute, Warsaw, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"A","family":"Toth","sequence":"additional","affiliation":[{"name":"Department of Bacteriology, National Centre for Epidemiology, Budapest, Hungary"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Y","family":"Pfeifer","sequence":"additional","affiliation":[{"name":"Robert Koch Institute, Nosocomial Infections, Wernigerode, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"V","family":"Jarlier","sequence":"additional","affiliation":[{"name":"University Pierre and Marie Curie\u2013Hospital Piti\u00e9-Salp\u00eatri\u00e8re, Assistance Publique\u2013H\u00f4pitaux de Paris, Paris, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Y","family":"Carmeli","sequence":"additional","affiliation":[{"name":"Tel Aviv Sourasky Medical Center, Tel Aviv, Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Collective","family":"the CNSE Working Group","sequence":"additional","affiliation":[{"name":"The members of the group are listed at the end of the article"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"7995","container-title":["Eurosurveillance"],"original-title":[],"language":"en","deposited":{"date-parts":[[2022,9,15]],"date-time":"2022-09-15T11:52:39Z","timestamp":1663242759000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.eurosurveillance.org\/content\/10.2807\/ese.15.46.19711-en"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2010,11,18]]},"references-count":0,"journal-issue":{"issue":"46","published-print":{"date-parts":[[2010,11,18]]}},"URL":"https:\/\/doi.org\/10.2807\/ese.15.46.19711-en","relation":{},"ISSN":["1560-7917"],"issn-type":[{"value":"1560-7917","type":"print"}],"subject":[],"published":{"date-parts":[[2010,11,18]]}}}