Detection and Prevalence of Carbapenem-resistant Gram-negative Bacteria Among European Laboratories Part of the COMBACTE Network: A COMBACTE LAB-Net Survey

Abstract: Antimicrobial resistance (AMR) represents a global public health threat which jeopardizes the progress that modern medicine has made over the last century.

To confront AMR, the Innovative Medicines Initiative (IMI) has supported the development of a large network of hospitals and laboratories in Europe as part of the New Drugs for Bad Bugs (ND4BB) programme and the COMBACTE projects. COMBACTE LAB-Net conducted a pilot survey on distribution and usage of carbapenem resistance detection methods among laboratories in the COMBACTE network at the occasion of two clinical trials as part of the COMBACTE-CARE project. The survey was sent out to 211 laboratories in 20 European countries between May 2015 and June 2017. Answers were collected from 165 laboratories (78%). Sixty laboratories (36%) reported that they had an outbreak of carbapenem-resistant (CR) Enterobacteriaceae during one of the two years preceding the completion of the survey. High rates of CR Acinetobacter spp. above 50% were reported by 74 laboratories (47%), particularly in the Western Balkan countries where the rates were sometimes higher than 90%. Apart from determining the antimicrobial susceptibility of isolates, laboratories also used various methods such as i.e. MALDI-TOF, Carba NP test or molecular methods to detect CR Gram-negative bacteria. The survey resulted in selection of sites with high resistance rates that successfully recruited many patients in the to the survey helped in the selection of EURECA observational clinical trial.