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

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 BautistaMaría Pérez-Vázquez, José Campos

Research output: Contribution to journalArticleResearchpeer-review

87 Citations (Scopus)

Abstract

Copyright © 2015, American Society for Microbiology. All Rights Reserved. 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 antibiotic susceptibility. From February 2013 to May 2013, 83 hospitals (about 40,000 hospital beds) prospectively collected nonduplicate 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 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 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 observed, 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.
Original languageEnglish
Pages (from-to)3406-3412
JournalAntimicrobial Agents and Chemotherapy
Volume59
Issue number6
DOIs
Publication statusPublished - 1 Jun 2015

Fingerprint Dive into the research topics of 'Prospective multicenter study of carbapenemase-producing Enterobacteriaceae from 83 hospitals in Spain reveals high in vitro susceptibility to colistin and meropenem'. Together they form a unique fingerprint.

Cite this