Il Progetto CCM “Metodologie di screening fenotipiche e molecolari per il rilevamento delle colonizzazioni da enterobatteri resistenti ai carbapenemi (CRE)”

Carbapenem-resistant Enterobacterales (CREs) are global ly considered to be a major threat to public health. Nation al and international guidelines emphasize the importance of routine active surveillance policies to prevent their transmis sion. Consequently, screening for the evaluation of the sta tus of colonization by CREs in hospitalized patients in Italy is considered essential to contain and control the spread of these microorganisms and their evolution towards infection. The Italian Ministry of Health funding the CCM Project “Phe notypic and molecular screening methodologies for the de- tection of colonizations due to carbapenem-resistant entero bacterales (CRE)”, carried out between February 2018 and January 2021 with the aim of evaluating phenotypic and mo lecular tests as methods able to detect patients colonized by CRE in Italian hospital setting. To assess the impact of the SARS-CoV-2 pandemic on CRE colonization, the observation period was divided into two periods: September 2018-Sep tember 2019 (first period) and October 2019-September 2020 (second period). As general objective of the project, the evaluation of the ef fectiveness of the methods has been appropriately foreseen. In addition, four specific objectives have been envisaged: 1. to standardize and to compare phenotypic and molecu lar methods, in terms of Turnaround Time (TAT); 2. to quan tify the frequency of colonization at the admission and dur ing hospitalization in Intensive Care Unit (ICU) and non-ICU wards; 3. to evaluate the effectiveness of screening interven tions; 4. to provide activities that attest to the importance of screening. In order to evaluate the role of hospitalization in CRE-colo nization, 11,063 patients were enrolled to perform rectal swabs on admission, and, if negative, weekly for three weeks during hospitalization. The data were collected in a dedicat ed IT platform. The molecular test demonstrated to be able to detect colo nized patients and presence of resistance markers within 60 minutes from the sample arriving. The prevalence of CRE has increased during SARS-CoV-2 pandemic, especially in hospitals in South Italy. K. pneumoni ae was the species most frequently associated with patients colonized by CRE. Training activities have been started for hospital staff, in or der to reduce the frequency of colonization of patients. All the participating centres have defined the procedures to be applied locally for the screening of CRE colonized patients and have started screening activities.