Tocco Tussardi Ilaria, Stevanin Gloria, Montesarchio Livio, Palladini Francesca, Aprili Irene, Zandonà Emanuela, Tecchio Cristina, Tardivo Stefano
Department of Diagnostics and Public Health, Section of Hygiene, University of Verona, 37134 Verona, Italy.
Hospital Management, University Hospital of Verona, 37126 Verona, Italy.
Healthcare (Basel). 2025 Jun 17;13(12):1457. doi: 10.3390/healthcare13121457.
Antimicrobial resistance (AMR) constitutes a critical threat to global public health, with carbapenem-resistant (CRE) presenting significant challenges due to their resistance to last-line antibiotics. Among these, New Delhi metallo-beta-lactamase (NDM)-producing (KP) is of particular concern. This study describes an outbreak of NDM-producing KP in the hematology unit of the University Hospital of Verona, Italy. This represents the second reported hospital outbreak of this strain in Italy, and the first to occur within a hematology ward. The outbreak involved four patients, all of whom were identified through active surveillance and microbiological screening. In response, a multidisciplinary team implemented a series of infection prevention and control (IPC) measures, which included enhanced environmental cleaning, strict hand hygiene protocols, patient isolation, and the development of a tailored IPC checklist. The outbreak was effectively contained within three weeks following the identification of the last case. This outcome underscores the importance of rapid and coordinated responses to NDM-producing KP outbreaks. This case study emphasizes the necessity of robust IPC protocols, rapid intervention, and continuous staff education in mitigating the spread of multidrug-resistant pathogens in healthcare settings. It further highlights the urgent need for healthcare systems to be adequately prepared and resilient in addressing the growing threat of AMR.
抗菌药物耐药性（AMR）对全球公共卫生构成了重大威胁，耐碳青霉烯类肠杆菌科细菌（CRE）因其对一线抗生素耐药而带来了重大挑战。其中，产新德里金属β-内酰胺酶（NDM）的肺炎克雷伯菌（KP）尤为令人担忧。本研究描述了意大利维罗纳大学医院血液科产NDM的KP暴发情况。这是意大利第二例报告的该菌株医院暴发事件，也是首例发生在血液科病房的事件。此次暴发涉及4名患者，所有患者均通过主动监测和微生物筛查得以确认。对此，一个多学科团队实施了一系列感染预防与控制（IPC）措施，包括加强环境清洁、严格的手卫生规程、患者隔离以及制定专门的IPC检查表。在最后一例病例确诊后的三周内，疫情得到了有效控制。这一结果凸显了对产NDM的KP暴发做出迅速和协调反应的重要性。本案例研究强调了强有力的IPC规程、快速干预以及持续的员工教育对于减轻医疗环境中多重耐药病原体传播的必要性。它进一步凸显了医疗系统在应对AMR日益增长的威胁时充分准备和具备韧性的迫切需求。
