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Junghee Hyun 1 Article
Epidemiological characteristics of carbapenemase-producing Enterobacteriaceae outbreaks in the Republic of Korea between 2017 and 2022
Hyoseon Jeong, Junghee Hyun, Yeon-Kyeng Lee
Osong Public Health Res Perspect. 2023;14(4):312-320.   Published online August 21, 2023
DOI: https://doi.org/10.24171/j.phrp.2023.0069
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  • 4 Web of Science
  • 4 Crossref
Graphical AbstractGraphical Abstract AbstractAbstract PDF
Objectives
We aimed to describe the epidemiological characteristics of carbapenemase-producing Enterobacteriaceae (CPE) outbreaks in healthcare settings in the Republic of Korea between 2017 and 2022.
Methods
Under the national notifiable disease surveillance system, we obtained annual descriptive statistics regarding the isolated species, carbapenemase genotype, healthcare facility type, outbreak location and duration, and number of patients affected and recommended interventions. We used epidemiological investigation reports on CPE outbreaks reported to Korea Disease Control and Prevention Agency from June 2017 to September 2022.
Results
Among the 168 reports analyzed, Klebsiella pneumoniae (85.1%) was the most frequently reported species, while K. pneumoniae carbapenemase (KPC, 82.7%) was the most common carbapenemase genotype. Both categories increased from 2017 to 2022 (p<0.01). General hospitals had the highest proportion (54.8%), while tertiary general hospitals demonstrated a decreasing trend (p<0.01). The largest proportion of outbreaks occurred exclusively in intensive care units (ICUs, 44.0%), and the frequency of concurrent outbreaks in ICUs and general wards increased over time (p<0.01). The median outbreak duration rose from 43.5 days before the coronavirus disease 2019 (COVID-19) pandemic (2017–2019) to 79.5 days during the pandemic (2020–2022) (p=0.01), and the median number of patients associated with each outbreak increased from 5.0 to 6.0 (p=0.03). Frequently recommended interventions included employee education (38.1%), and 3 or more measures were proposed for 45.2% of outbreaks.
Conclusion
In the Republic of Korea, CPE outbreaks have been consistently dominated by K. pneumoniae and KPC. The size of these outbreaks increased during the COVID-19 pandemic. Our findings highlight the need for continuing efforts to control CPE outbreaks using a multimodal approach, while considering their epidemiology.

Citations

Citations to this article as recorded by  
  • Comparison of clinical outcomes of patients with serial negative surveillance cultures according to a subsequent polymerase chain reaction test for carbapenemase-producing Enterobacterales
    H. Seo, S. Kim, Y.W. Lee, H.S. Oh, H-S. Kim, Y.K. Kim
    Journal of Hospital Infection.2024; 146: 93.     CrossRef
  • Identifying Contact Time Required for Secondary Transmission of Clostridioides difficile Infections by Using Real-Time Locating System
    Min Hyung Kim, Jaewoong Kim, Heejin Ra, Sooyeon Jeong, Yoon Soo Park, Dongju Won, Hyukmin Lee, Heejung Kim
    Emerging Infectious Diseases.2024;[Epub]     CrossRef
  • Antimicrobial activity of ceftazidime-avibactam against KPC-2-producing Enterobacterales: a cross-combination and dose-escalation titration study with relebactam and vaborbactam
    Min Seo Kang, Jin Yang Baek, Jae-Hoon Ko, Sun Young Cho, Keon Young Lee, Young Ho Lee, Jinyoung Yang, Tae Yeul Kim, Hee Jae Huh, Nam Yong Lee, Kyungmin Huh, Cheol-In Kang, Doo Ryeon Chung, Kyong Ran Peck, Bobby G. Warren
    Microbiology Spectrum.2024;[Epub]     CrossRef
  • Performance comparison of BD Phoenix CPO detect panel with Cepheid Xpert Carba-R assay for the detection of carbapenemase-producing Klebsiella pneumoniae isolates
    Nazmiye Ülkü Tüzemen, Uğur Önal, Osman Merdan, Bekir Akca, Beyza Ener, Halis Akalın, Cüneyt Özakın
    BMC Microbiology.2024;[Epub]     CrossRef

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