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Inclusion of carbapenemase-producing Gram-negative bacteria in NOIDs weekly reports
Since 1 October 2020, diagnostic laboratories in England have had a duty to report the results of any antimicrobial susceptibility test, and any carbapenem resistance mechanism identified, in respect of the causative agents listed in Schedule 2 of the relevant Regulations (SI 674/2020), where this is known to the operator.
In response to this, weekly totals of Gram-negative species, categorised by carbapenemase mechanism, are now being included in the Causative Agent Notification of Infectious Disease Reports (NOIDs) published by PHE on a weekly basis.
The case numbers presented within these weekly reports cover the most recent 6 weeks only, where cases have been reported by a laboratory through to PHE’s Second Generation Surveillance System (SGSS). Cases are classified by root organism and by one of the ‘big 5’ carbapenemase mechanisms (KPC, VIM, IMP, NDM, OXA-48) as applicable.
As patients may have more than one positive specimen taken, specimens taken from the same patient that yielded growth of the same pathogen and carbapenemase resistance mechanism within a 52 week period from the initial positive sterile site specimen, or screening site specimen, are regarded as comprising the same episode of infection and are being de-duplicated.
The case numbers presented within the weekly NOIDs reports are taken from SGSS and are presented at national level. Publication of more detailed analyses covering the entire notifiable period (October 2020 onwards), including data on additional mechanisms reported to the AMRHAI reference unit, is planned in the coming weeks.
The principal category of carbapenemase-producing Gram-negative bacteria are the carbapenemase-producing Enterobacterales (CPE). The national Framework of Actions to contain CPE sets out a range of measures to help health and social care providers minimise the impact of all such antimicrobial resistant pathogens.