Carbapenem-resistant Enterobacterales (CRE), including carbapenem-resistant Klebsiella pneumoniae and carbapenem-resistant Escherichia coli , pose a major risk to patients and healthcare systems in the EU/EEA. In fact, according to an updated ECDC risk assessment the epidemiological situation has been deteriorating since 2019.
Carbapenem-resistant K. pneumoniae bloodstream infections have surged in 23 EU member states, driven by the continued spread of multidrug-resistant high-risk lineages in hospitals. In addition, some K. pneumoniae lineages that are more likely to cause severe diseases have also become resistant to carbapenems, including the hypervirulent lineage K. pneumoniae ST23. Newly emerging carbapenem-resistant Enterobacterales species (other than K. pneumoniae ) are also spreading in hospitals.
Furthermore, isolates and small clusters of certain carbapenem-resistant E. coli strains are increasingly being detected, posing a risk for spread in the community.
‘These findings indicate a high probability of further spread of CRE in the EU/EEA, both in hospital settings and in community, a worrying trend since CRE infections are linked to high mortality. Even though several new antibiotics are available, treatment options remain limited overall. Immediate action is essential to control this problem and protect patients from infections that are becoming increasingly difficult to treat,’ says Piotr Kramarz, ECDC Chief Scientist.
Although infection prevention and control (IPC) measures are essential to address the spread of CRE, their implementation in many hospitals is sub-optimal and insufficient to achieve sustained control of the high-risk lineages of carbapenem-resistant K. pneumoniae and other Enterobacterales.
Enhanced and coordinated efforts are therefore urgently required in all EU/EEA countries to address the inter-hospital and inter-regional spread of CRE.
ECDC recommends EU/EEA countries to:
ECDC calls on all EU/EEA countries and hospitals to intensify their efforts to address this deteriorating epidemiological situation, mitigate the high risk of further CRE spread and, ultimately, protect patients and communities.
3-Feb-2025
None declared.