Title |
Prospective Multicenter Study of Carbapenemase-Producing Enterobacteriaceae from 83 Hospitals in Spain Reveals High In Vitro Susceptibility to Colistin and Meropenem
|
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Published in |
Antimicrobial Agents and Chemotherapy, March 2015
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DOI | 10.1128/aac.00086-15 |
Pubmed ID | |
Authors |
Jesús Oteo, Adriana Ortega, Rosa Bartolomé, Germán Bou, Carmen Conejo, Marta Fernández-Martínez, Juan José González-López, Laura Martínez-García, Luis Martínez-Martínez, María Merino, Elisenda Miró, Marta Mora, Ferran Navarro, Antonio Oliver, Álvaro Pascual, Jesús Rodríguez-Baño, Guillermo Ruiz-Carrascoso, Patricia Ruiz-Garbajosa, Laura Zamorano, Verónica Bautista, María Pérez-Vázquez, José Campos |
Abstract |
The aim of this study was to determine the impact of the carbapenemase-producing Enterobacteriaceae (CPE) in Spain in 2013 by describing their prevalence, dissemination and geographic distribution of CPE clones, their population structure and antibiotic susceptibility. From February 2013 to May 2013, 83 hospitals (about 40,000 hospital beds) prospectively collected non-duplicate Enterobacteriaceae using the screening cut-off recommended by EUCAST. Carbapenemase characterisation was performed by phenotypic methods and confirmed by PCR and sequencing. MLST types were determined for Klebsiella 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 STs were ST11 and ST405 in K. pneumoniae, and ST131 in E. coli. Forty-five (54.1%) of the hospitals had at least one CPE case. In K. pneumoniae, ST11/OXA-48, ST15/OXA-48, ST405/OXA-48, and ST11/VIM-1 were detected in two or more Spanish provinces. ST11 carried four carbapenemases (VIM-1, OXA-48, KPC-2, and OXA-245), but ST405 carried OXA-48 only. A wide interregional spread of CPE in Spain was observed mainly due to a few successful clones of OXA-48-producing K. pneumoniae (e.g. ST11 and ST405). Dissemination of OXA-48-producing E. coli is a new finding of public health concern. According to in vitro susceptibilities, most of the CPE (94.5%) had three or more options of antibiotic treatment. |
X Demographics
Geographical breakdown
Country | Count | As % |
---|---|---|
Unknown | 1 | 100% |
Demographic breakdown
Type | Count | As % |
---|---|---|
Members of the public | 1 | 100% |
Mendeley readers
Geographical breakdown
Country | Count | As % |
---|---|---|
Spain | 4 | 2% |
Ireland | 1 | <1% |
Unknown | 161 | 97% |
Demographic breakdown
Readers by professional status | Count | As % |
---|---|---|
Student > Ph. D. Student | 24 | 14% |
Researcher | 22 | 13% |
Student > Master | 21 | 13% |
Other | 19 | 11% |
Student > Doctoral Student | 15 | 9% |
Other | 32 | 19% |
Unknown | 33 | 20% |
Readers by discipline | Count | As % |
---|---|---|
Medicine and Dentistry | 39 | 23% |
Immunology and Microbiology | 20 | 12% |
Agricultural and Biological Sciences | 19 | 11% |
Biochemistry, Genetics and Molecular Biology | 17 | 10% |
Pharmacology, Toxicology and Pharmaceutical Science | 5 | 3% |
Other | 18 | 11% |
Unknown | 48 | 29% |