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

Frontiers in Microbiology

Jordi Vila¹  Cristina Pitart¹  Alba Rivera²  Ferran Navarro²  Luis Martínez-Martínez³  Zaira R. Palacios-Baena⁴  Álvaro Pascual⁴  Guillermo Ruiz-Carrascoso⁵  the GEMARA/GEIRAS-SEIMC/REIPI CARB-ES-19 Study Group⁶  Nuria Iglesias Nuñez⁶  Federico García⁶  Rosario Sánchez Benito⁶  Carmen Aspiroz⁶  Ma Isabel Paz Vidal⁶  José Leiva and José Luis del Pozo⁶  Eugenio Garduño⁶  Eva Riquelme Bravo⁶  Carolina Roldán⁶  Caridad Sainz de Baranda⁶  Ma Luisa Pérez del Molino Bernal⁶  Jose Luis Barrios Andrés⁶  José María Saavedra⁶  M.a José Rodríguez Escudero⁶  Lidia Garcia Agudo and Soledad Illescas⁶  Amparo Coira Nieto⁶  Miriam Albert Hernández⁶  Emilia Cercenado⁶  Cristobal del Rosario and Jose Luis Perez Arellano⁶  Adelina Gimeno⁶  Nieves Gonzalo Jiménez⁶  Ma Dolores Quesada⁶  Susana Sabater⁶  Pilar Zamarrón⁶  Mariela Martínez Ramírez⁶  María Huertas⁶  Encarnación Clavijo⁶  Javier Castillo⁶  Juan Manuel Sánchez Hospital de Jérez⁶  Jennifer Villa⁶  Natalia Chueca⁶  Lucía Martínez Lamas⁶  Leyre López Soria⁶  Fernando García Garrote⁶  Salvador Giner and Juan Frasquet⁶  María Lecuona⁶  Miriam Valverde Troya and Begoña Palop⁶  Ma Isabel Fernández Natal and Marta Arias⁶  Luis López-Urrutia Lorente⁶  Carmina Martí Sala⁶  Carmen Liébana⁶  Raquel Elisa Rodríguez Tarazona⁶  Fe Tubau Quintano⁶  Marta Lamata Subero⁶  Inmaculada García García⁶  Ester Clapés Sanchez⁶  Oscar Esparcia Rodríguez⁶  M. Pilar Ortega Lafont⁶  Almudena Tinajas⁶  Pedro de la Iglesia⁶  Jose Luis Díaz de Tuesta⁶  Ma Isabel Cabeza⁶  José Gutierrez Fernández⁶  Jorge Gaitán⁶  María Gomáriz Díaz⁶  Luis Torres Sopena⁶  Fátima Galán Sánchez⁶  Jesús Rodríguez-Baño⁶  Cristina Seral⁶  Antonio Casabella Pernas⁶  Genoveva Yagüe Guirao⁶  Nerea Sanchez⁶  Mar Olga Pérez Moreno⁶  Andrés Canut Blasco⁶  Ana Isabel López-Calleja⁶  Ma Luz Albina Cordón Rodriguez⁶  Carmen Aldea⁶  Maria Pilar Chocarro⁶  Matxalen Vidal-García⁶  José Manuel Azcona⁶  Nuria Prim⁶  Sonia Rey Cao⁶  Mercè García González⁶  Susana Hernando⁶  Moises García Bravo⁶  Francisco Javier Ramos⁶  Rafael Sánchez Arroyo⁶  Laura Mora⁶  Ma Teresa Cabezas Fernández⁶  Alba Belles⁶  Jesús Oteo-Iglesias⁷  María Pérez-Vázquez⁷  Belén Aracil⁷  Mercedes Delgado-Valverde⁷  Juan José González-López⁸  Nieves Larrosa⁸  Javier E. Cañada-García⁹  Pedro J. Sola-Campoy⁹  Zaira Moure⁹  Irene Gracia-Ahufinger^1,10  Mónica González^1,11  Germán Bou^1,11  Jorge Calvo^1,12  María E. Cano^1,12  Desirèe Gijón^1,13  Rafael Cantón^1,13  Antonio Oliver^1,14  Xavier Mulet^1,14 

[1] 0Servicio de Microbiología, Hospital Clínic de Barcelona, ISGlobal Barcelona Institute for Global Health, Barcelona, Spain;1Microbiology Department, Hospital de la Santa Creu i Sant Pau, Universitat Autónoma de Barcelona (UAB), Sant Pau Biomedical Research Institute (IIB Sant Pau), Barcelona, Spain;2Department of Agricultural Chemistry, Soil Science and Microbiology, University of Córdoba, Córdoba, Spain;3Departamento de Microbiología, Universidad de Sevilla, Seville, Spain;4Servicio de Microbiología Clínica, Hospital Universitario La Paz (IdiPAz), Madrid, Spain;;CIBER de Enfermedades Infecciosas (CIBERINFEC), REIPI, Instituto de Salud Carlos III, Madrid, Spain;Departament de Genetica i Microbiologia, Servei de Microbiologia, Hospital Universitari Vall d’Hebron, Universitat Autònoma de Barcelona, Barcelona, Spain;Laboratorio de Referencia e Investigación en Resistencia a Antibióticos e Infecciones Relacionadas con la Asistencia Sanitaria, Centro Nacional de Microbiología, Instituto de Salud Carlos III, Madrid, Spain;Microbiology Unit, Reina Sofia University Hospital, Maimonides Biomedical Research Institute of Cordoba (IMIBIC), Córdoba, Spain;Servicio Microbiología, Hospital Universitario A Coruña, Instituto Investigación Biomédica A Coruña (INIBIC), A Coruña, Spain;Servicio de Microbiología, Hospital Universitario Marqués de Valdecilla, IDIVAL, Santander, Spain;Servicio de Microbiología, Hospital Universitario Ramón y Cajal, Instituto Ramón y Cajal de Investigación Sanitaria (IRYCIS), Madrid, Spain;Servicio de Microbiología, Hospital Universitario Son Espases, Instituto de investigación sanitaria Illes Balears (IdISBa), Palma de Mallorca, Spain;Unidad de Enfermedades Infecciosas y Microbiología, Hospital Universitario Virgen Macarena, Instituto de Biomedicina de Sevilla (Hospital Universitario Virgen Macarena/CSIC/Universidad de Sevilla), Seville, Spain;

关键词: CARB-ES-19 study;    carbapenemases;    whole genome sequencing;    Klebsiella pneumoniae;    high-risk clones;   

DOI  :  10.3389/fmicb.2022.918362

来源: DOAJ

【 摘 要 】

ObjectivesCARB-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.MethodsIn 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.ResultsIn 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 blaOXA–48 (263/377), blaKPC–3 (62/377), blaVIM–1 (28/377), and blaNDM–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).ConclusionThis 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.

【 授权许可】

Unknown