Prospective multicenter study of carbapenemase-producing Enterobacteriaceae from 83 hospitals in Spain reveals high in vitro susceptibility to colistin and meropenem

Oteo, J ; Ortega, A ; Bartolomé, R ; Bou, G ; Conejo, C ; Fernández-Martínez, M ; González-López, JJ ; Martínez-García, L ; Martínez-Martínez, L ; Merino, M ; Miró, E ; Mora, M ; Navarro, F ; Oliver, A ; Pascual, A ; Rodríguez-Baño, J ; Ruiz-Carrascoso, G ; Ruiz-Garbajosa, P ; Zamorano, L ; Bautista, V ; Pérez-Vázquez, M ; Campos, J ; on behalf of GEIH-GEMARA (SEIMC) and REIPI

Resumen: The aim of this study was to determine the impact of carbapenemase-producing Enterobacteriaceae (CPE) in Spain in 2013 by describing the prevalence, dissemination, and geographic distribution of CPE clones, and their population structure and antibi- otic susceptibility. From February 2013 to May 2013, 83 hospitals (about 40,000 hospital beds) prospectively collected nondupli- cate Enterobacteriaceae using the screening cutoff recommended by EUCAST. Carbapenemase characterization was performed by phenotypic methods and confirmed by PCR and sequencing. Multilocus sequencing types (MLST) were determined for Kleb- siella pneumoniae and Escherichia coli. A total of 702 Enterobacteriaceae isolates met the inclusion criteria; 379 (54%) were CPE. OXA-48 (71.5%) and VIM-1 (25.3%) were the most frequent carbapenemases, and K. pneumoniae (74.4%), Enterobacter cloacae (10.3%), and E. coli (8.4%) were the species most affected. Susceptibility to colistin, amikacin, and meropenem was 95.5%, 81.3%, and 74.7%, respectively. The most prevalent sequence types (STs) were ST11 and ST405 for K. pneumoniae and ST131 for E. coli. Forty-five (54.1%) of the hospitals had at least one CPE case. For K. pneumoniae, ST11/OXA-48, ST15/OXA-48, ST405/ OXA-48, and ST11/VIM-1 were detected in two or more Spanish provinces. ST11 isolates carried four carbapenemases (VIM-1, OXA-48, KPC-2, and OXA-245), but ST405 isolates carried OXA-48 only. A wide interregional spread of CPE in Spain was ob- served, mainly due to a few successful clones of OXA-48-producing K. pneumoniae (e.g., ST11 and ST405). The dissemination of OXA-48-producing E. coli is a new finding of public health concern. According to the susceptibilities determined in vitro, most of the CPE (94.5%) had three or more options for antibiotic treatment.

Idioma: Inglés

Año: 2015

Publicado en: Antimicrobial Agents and Chemotherapy 59, 6 (2015), 3406-3412
ISSN: 0066-4804

Factor impacto JCR: 4.415 (2015)

Categ. JCR: PHARMACOLOGY & PHARMACY rank: 34 / 255 = 0.133 (2015) - Q1 - T1
Categ. JCR: MICROBIOLOGY rank: 22 / 123 = 0.179 (2015) - Q1 - T1

Factor impacto SCIMAGO: 2.343 - Infectious Diseases (Q1) - Pharmacology (medical) (Q1) - Pharmacology (Q1)

Financiación: info:eu-repo/grantAgreement/ES/FIS/PI12-01242

Tipo y forma: Artículo (Versión definitiva)