Corrigendum: Understanding the burden of antibiotic resistance: a decade of carbapenem-resistant Gram-negative bacterial infections in Italian intensive care units

Giovanni Scaglione ^1,2 Matilde Perego ³ Marta Colaneri ^1,4* Camilla Genovese ^1,2 Fabio Brivio ^1,2 Alice Covizzi ¹ Bruno Viaggi ⁵ Alessandra Bandera ^6,7 Andrea Gori ^1,2,4* Stefano Finazzi ³ Emanuele Palomba ^1,4

• ¹ Luigi Sacco Hospital, Milan, Lombardy, Italy
• ² Department of Biomedical and Clinical Sciences, Luigi Sacco Hospital, Milan, Lombardy, Italy
• ³ Laboratory of Clinical Data Science, Department of Public Health, Mario Negri Pharmacological Research Institute (IRCCS), Milano, Lombardy, Italy
• ⁴ Centre for Multidisciplinary Research in Health Science (MACH), University of Milan, Milan, Italy
• ⁵ Department of Anaesthesiology, Neuro-Intensive Care Unit, Careggi University Hospital, Florence, Italy
• ⁶ Infectious Diseases Unit, Foundation IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Lombardy, Italy
• ⁷ Department of Pathophysiology and Transplantation, Università degli Studi di Milano, Italy, Milano, Lombardy, Italy

In the published article, there was an error in Figure 6 as published. In Figure 6 the percentage of carbapenem-resistant strains was not correct. The corrected Figure 6 and its caption **Figure 6. Distribution of infections caused by Acinetobacter spp. acquired in intensive care during the study period, overall and for infection site, with the relative prevalence of carbapenem-resistant strains. appear below.The authors apologize for this error and state that this does not change the scientific conclusions of the article in any way. The original article has been updated.Reminder: Figures, tables, and images will be published under a Creative Commons CC-BY licence and permission must be obtained for use of copyrighted material from other sources (including re-published/adapted/modified/partial figures and images from the internet). It is the responsibility of the authors to acquire the licenses, to follow any citation instructions requested by third-party rights holders, and cover any supplementary charges. The authors apologize for this error and state that this does not change the scientific conclusions of the article in any way. The original article has been updated.In the published article, there was an error. The percentages of carbapenem-resistant Acinetobacter spp. strains were not correct.A correction has been made to Results, 3.2.3 Acinetobacter spp. infections. This sentence previously stated: "Acinetobacter spp. was the least frequently isolated GNB of the three in study (2183/25966, 8.4%) and displayed the overall lowest rates of resistance to carbapenems (290/2183, 13.3%). This pathogen was mainly responsible for VAP (1146/9260, 12.4%) and to a lesser extent for IAI (171/1921, 9.0%), BSI (147/2940, 5.0%), and UTI (77/1959, 3.9%). The carbapenem resistance proportion was the highest in BSI (19/147, 13.0%), followed by VAP (130/1146, 11.3%), UTI (7/77, 9.1%) and IAI (14/171, 8.2%). Carbapenem-resistant Acinetobacter spp. rates varied greatly from one year to the other and this pathogen was most prevalent in the years 2019 (21%) and 2022 (19.2%)"The corrected sentence appears below: "Acinetobacter spp. was the least frequently isolated GNB of the three in study (2183/25966, 8.4%) and displayed the overall highest rates of resistance to carbapenems (1893/2183, 86.7%). This pathogen was mainly responsible for VAP (1146/9260, 12.4%) and to a lesser extent for IAI (171/1921, 9.0%), BSI (147/2940, 5.0%), and UTI (77/1959, 3.9%). The carbapenem resistance proportion was the highest in IAI (157/171, 91.8%), followed by UTI (70/77, 90.1%), VAP (1016/1146, 88.7%), and BSI (130/147, 88.4%). Carbapenem-resistant Acinetobacter spp. rates varied greatly from one year to the other, with a peak of 91.9% in 2020."A correction has been made to Discussion. This sentence previously stated:"The findings of our study shed light on the epidemiology of HAIs in Italian ICUs over a tenyear period. Our analysis reveals a substantial burden of HAIs, with an average of 1.5 infections per patient over the study period, with high prevalence of CR-GNB, particularly Pseudomonas aeruginosa, Klebsiella and Acinetobacter species. This trend was mainly driven by Klebsiella spp. and Pseudomonas aeruginosa, with 31.4% and 21.8% of isolate showing this susceptibility profile, respectively. In particular, CR-GNB accounted for a third of IAI and a quarter of each VAP, BSI and UTI caused by these pathogens. Finally, during the SARS-CoV-2 pandemic, ICU-PAGE \* Arabic \* MERGEFORMAT 3HAIs showed a peak in both incidence and CR-GNB rates, in contrast to a previously declining trend."The corrected sentence appears below:"The findings of our study shed light on the epidemiology of HAIs in Italian ICUs over a tenyear period. Our analysis reveals a substantial burden of HAIs, with an average of 1.5 infections per patient over the study period, with high prevalence of CR-GNB, particularly Pseudomonas aeruginosa, Klebsiella and Acinetobacter species. This trend was mainly driven by Klebsiella spp. and Pseudomonas aeruginosa, with 31.4% and 21.8% of isolate showing this susceptibility profile, respectively. In particular, CR-GNB accounted for a third of IAI and a quarter of each VAP, BSI and UTI caused by these pathogens. Notably, over the course of the decade, up to 90% of Acinetobacter spp. isolates retrieved showed carbapenem-resistant. Finally, during the SARS-CoV-2 pandemic, ICU-HAIs showed a peak in both incidence and CR-GNB rates, in contrast to a previously declining trend."A correction has been made to Discussion. This sentence previously stated: "In our cohort, Acinetobacter spp. caused less than one tenth of all ICU-acquired infections and showed the overall lowest rates of resistance to carbapenems (13.3%). This data is in contrast with European and national reports, where carbapenem-resistant strains account for up to one third of all isolates globally, with even higher percentages in Italy, where carbapenem-resistance in Acinetobacter baumannii reaches peaks of 88% (European Centre for Disease Prevention and Control, 2022). These differences may be explained by the higher prevalence of carbapenemresistant strains in settings different than ICU, as other European studies have already observed (Said et al., 2021;Kinross et al., 2022). Furthermore, our analysis only included infections diagnosed by a physician and did not consider respiratory, intestinal and device colonisations, which are often characteristic of Acinetobacter species. Finally, we considered all Acinetobacter spp. strains, not focusing only on Acinetobacter baumannii, which may have partially lowered the overall prevalence of carbapenem-resistance. As confirmed by our findings, infections caused by Acinetobacter spp. typically exhibit a varied distribution, marked by sporadic outbreaks, thereby serving as an indicator for evaluating infection control and prevention strategies. The emergence of the SARS-CoV-2 pandemic has accentuated these distinctive patterns, highlighting avenues for enhancing management approaches (Mangioni et al., 2023b)."The corrected sentence appears below: "In our cohort, Acinetobacter spp. caused less than one tenth of all ICU-acquired infections and showed the overall highest rates of resistance to carbapenems (86.7%). This data is in line with European and national reports, where carbapenem-resistant strains account for up to one third of all isolates globally, with even higher percentages in Italy, where carbapenem-resistance in