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Title: CARB-ES-19 Multicenter Study of Carbapenemase-Producing Klebsiella pneumoniae and Escherichia coli From All Spanish Provinces Reveals Interregional Spread of High-Risk Clones Such as ST307/OXA-48 and ST512/KPC-3.
Author: Cañada García, Javier E.
Moure, Zaira
Sola Campoy, Pedro J.
Delgado Valverde, Mercedes
Cano, María E.
Gijón, Desirèe
González, Mónica
Gracia Ahufinger, Irene
Larrosa, Nieves
Mulet, Xavier
Pitart, Cristina
Rivera, Alba
Bou, Germán
Calvo, Jorge
Cantón, Rafael
González-López, Juan José
Martínez-Martínez, Luis
Navarro, Ferran
Oliver, Antonio
Palacios Baena, Zaira R.
Pascual, Alvaro
Ruiz Carrascoso, Guillermo
Vila Estapé, Jordi
Aracil, Belén
Pérez-Vázquez, María
Oteo Iglesias, Jesús
Keywords: Antibiòtics betalactàmics
Klebsiella pneumoniae
Escheríchia coli
Genoma humà
Beta lactam antibiotics
Klebsiella pneumoniae
Escherichia coli
Human genome
Issue Date: 30-Jun-2022
Publisher: Frontiers Media
Abstract: CARB-ES-19 is a comprehensive, multicenter, nationwide study integrating whole-genome sequencing (WGS) in the surveillance of carbapenemase-producing K. pneumoniae (CP-Kpn) and E. coli (CP-Eco) to determine their incidence, geographical distribution, phylogeny, and resistance mechanisms in Spain. Methods: In total, 71 hospitals, representing all 50 Spanish provinces, collected the first 10 isolates per hospital (February to May 2019); CPE isolates were first identified according to EUCAST (meropenem MIC > 0.12 mg/L with immunochromatography, colorimetric tests, carbapenem inactivation, or carbapenem hydrolysis with MALDI-TOF). Prevalence and incidence were calculated according to population denominators. Antibiotic susceptibility testing was performed using the microdilution method (EUCAST). All 403 isolates collected were sequenced for high-resolution single-nucleotide polymorphism (SNP) typing, core genome multilocus sequence typing (cgMLST), and resistome analysis. Results: In total, 377 (93.5%) CP-Kpn and 26 (6.5%) CP-Eco isolates were collected from 62 (87.3%) hospitals in 46 (92%) provinces. CP-Kpn was more prevalent in the blood (5.8%, 50/853) than in the urine (1.4%, 201/14,464). The cumulative incidence for both CP-Kpn and CP-Eco was 0.05 per 100 admitted patients. The main carbapenemase genes identified in CP-Kpn were bla OXA-48 (263/377), bla KPC-3 (62/377), bla VIM-1 (28/377), and bla NDM-1 (12/377). All isolates were susceptible to at least two antibiotics. Interregional dissemination of eight high-risk CP-Kpn clones was detected, mainly ST307/OXA-48 (16.4%), ST11/OXA-48 (16.4%), and ST512-ST258/KPC (13.8%). ST512/KPC and ST15/OXA-48 were the most frequent bacteremia-causative clones. The average number of acquired resistance genes was higher in CP-Kpn (7.9) than in CP-Eco (5.5). Conclusion: This study serves as a first step toward WGS integration in the surveillance of carbapenemase-producing Enterobacterales in Spain. We detected important epidemiological changes, including increased CP-Kpn and CP-Eco prevalence and incidence compared to previous studies, wide interregional dissemination, and increased dissemination of high-risk clones, such as ST307/OXA-48 and ST512/KPC-3.
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It is part of: Frontiers in Microbiology, 2022, vol. 13, p. 918362
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ISSN: 1664-302X
Appears in Collections:Articles publicats en revistes (Fonaments Clínics)
Articles publicats en revistes (ISGlobal)

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