The CARBA-MAP study: national mapping of carbapenemases in Spain (2014–2018)

Frontiers in Microbiology

Microbiology

Jordi Càmara¹  Patricia Muñoz²  Jorge Calvo-Montes³  Rafael Cantón⁴  Xavier Mulet⁵  Nieves Larrosa-Escartín⁶  Miriam Torrecillas⁷  David Grandioso⁸  Iván Bloise⁸  Alberto Delgado-Iribarren García Campero⁹  Laura López-González^1,10  María Eugenia Portillo^1,11  Alicia Galar^1,12  Manuel Angel Rodríguez-Maresca^1,13  Jazmín Díaz-Regañón^1,14  María José Centelles-Serrano^1,15  José Manuel Azcona-Gutiérrez^1,16  Melisa Fernández-Quejo^1,17  Rainer Campo^1,18  María Reyes Vidal-Acuña^1,19  Francisco Javier Chamizo-López^2,20  Juan Carlos Rodríguez-Díaz^2,21  Yuliya Zboromyrska^2,22  Cristina Pitart^2,23  Javier Colomina-Rodríguez^2,24  Francisco Franco-Álvarez de Luna^2,25  Javier Castillo-García^2,26  María Siller^2,27  Fátima Galán-Sánchez^2,28  Desirée Gijón-Cordero^2,29  Lucía Chaves-Blanco^3,30  María del Pilar Ortega-Lafont^3,31  Maitane Arrastia-Erviti^3,32  María Nieves Gutiérrez-Zufiaurre^3,33  Ana Madueño-Alonso^3,34  Belén Viñado^3,35  Francisco José Vasallo^3,36  Sonia Rey-Cao^3,36  Irene Gracia-Ahufinger^3,37  Luis Martínez-Martínez^3,38  Genoveva Yagüe-Guirao^3,39 

[1] CIBER de Enfermedades Respiratorias (CIBERes), Instituto de Salud Carlos III, Madrid, Spain;Department of Basic Clinical Practice, University of Barcelona, Barcelona, Spain;Clinical Microbiology Department, Bellvitge University Hospital, L'Hospitalet de Llobregat, Spain;Institut Investigacio Biomedica de Bellvitge (IDIBELL), L'Hospitalet de Llobregat, Spain;Center for Biomedical Research in Infectious Diseases (CIBERINFEC), Carlos III Health Institute (ISCIII), Madrid, Spain;Clinical Microbiology and Infectious Diseases Department, Hospital General Universitario Gregorio Marañón, Madrid, Spain;Health Research Institute Hospital Gregorio Marañón, Madrid, Spain;Medicine Department, School of Medicine, Universidad Complutense de Madrid, Madrid, Spain;CIBER de Enfermedades Respiratorias (CIBERes), Instituto de Salud Carlos III, Madrid, Spain;Center for Biomedical Research in Infectious Diseases (CIBERINFEC), Carlos III Health Institute (ISCIII), Madrid, Spain;Microbiology Service, Marqués de Valdecilla University Hospital, Santander, Spain;Marqués de Valdecilla Health Research Institute (IDIVAL), Santander, Spain;Center for Biomedical Research in Infectious Diseases (CIBERINFEC), Carlos III Health Institute (ISCIII), Madrid, Spain;Microbiology Service, Ramón y Cajal University Hospital, Madrid, Spain;Ramón y Cajal Institute for Health Research (IRYCIS), Madrid, Spain;Center for Biomedical Research in Infectious Diseases (CIBERINFEC), Carlos III Health Institute (ISCIII), Madrid, Spain;Microbiology Service, Son Espases University Hospital, Palma de Mallorca, Spain;Institute for Health Research Illes Balears (IdISBa), Palma, Spain;Center for Biomedical Research in Infectious Diseases (CIBERINFEC), Carlos III Health Institute (ISCIII), Madrid, Spain;Microbiology Service, Vall d'Hebron University Hospital, Barcelona, Spain;Vall d'Hebron Research Institute (VHIR), Barcelona, Spain;Clinical Microbiology Department, Bellvitge University Hospital, L'Hospitalet de Llobregat, Spain;Clinical Microbiology Department, La Paz University Hospital, Madrid, Spain;Hospital La Paz Institute for Health Research (IdiPaz), Madrid, Spain;Clinical Microbiology Service, IML, San Carlos Clinical University Hospital, Madrid, Spain;Clinical Microbiology Service, IML, San Carlos Clinical University Hospital, Madrid, Spain;Health Research Institute of the Hospital Clínico San Carlos (IdISSC), Madrid, Spain;Clinical Microbiology Service, University Hospital of Navarra, Pamplona, Spain;Health Research Institute of Navarra (IdiSNA), Pamplona, Spain;Clinical Microbiology and Infectious Diseases Department, Hospital General Universitario Gregorio Marañón, Madrid, Spain;Health Research Institute Hospital Gregorio Marañón, Madrid, Spain;Medicine Department, School of Medicine, Universidad Complutense de Madrid, Madrid, Spain;CIBER de Enfermedades Respiratorias (CIBERes), Instituto de Salud Carlos III, Madrid, Spain;Laboratory Unit, Microbiology Section, Torrecardenas University Hospital, Almería, Spain;Medical Department, MSD España, Madrid, Spain;Microbiology Area, Clinical Laboratory, Hospital of Tortosa Virgen de la Cinta, Tortosa, Spain;Institute for Health Research Pere Virgili, Tortosa, Spain;Microbiology Laboratory, San Pedro Hospital, Logroño, Spain;Microbiology Service, A Coruña University Hospital, A Coruña, Spain;Microbiology Service, Asturias Central University Hospital, Oviedo, Spain;Microbiology Service, Cáceres University Hospital Complex, Cáceres, Spain;Microbiology Service, Doctor Negrín University Hospital of Gran Canaria, Gran Canaria, Spain;Microbiology Service, General University Hospital Dr. Balmis, Alicante, Spain;Health and Biomedical Research Institute of Alicante (ISABIAL), Alicante, Spain;Microbiology Service, Hospital Clinic, Barcelona, Spain;Department of Basic Clinical Practice, University of Barcelona, Barcelona, Spain;Microbiology Service, Hospital Clinic, Barcelona, Spain;Department of Basic Clinical Practice, University of Barcelona, Barcelona, Spain;Institute of Global Health of Barcelona, Barcelona, Spain;Microbiology Service, Hospital Clínico Universitario de Valencia, Valencia, Spain;Microbiology Service, Hospital Juan Ramón Jiménez, Huelva, Spain;Microbiology Service, Lozano Blesa Clinical University Hospital, Zaragoza, Spain;Institute for Health Research Aragón (IIS Aragón), Zaragoza, Spain;School of Medicine, University of Zaragoza, Zaragoza, Spain;Microbiology Service, Marqués de Valdecilla University Hospital, Santander, Spain;Marqués de Valdecilla Health Research Institute (IDIVAL), Santander, Spain;Microbiology Service, Puerta del Mar University Hospital, Cádiz, Spain;Microbiology Service, Ramón y Cajal University Hospital, Madrid, Spain;Ramón y Cajal Institute for Health Research (IRYCIS), Madrid, Spain;Microbiology Service, San Cecilio Clinical University Hospital, Granada, Spain;Microbiology Service, University Hospital of Burgos, Burgos, Spain;Microbiology Service, University Hospital of Donostia, San Sebastián, Spain;Microbiology Service, University Hospital of Salamanca, Salamanca, Spain;Microbiology Service, University Hospital of the Canary Islands, Tenerife, Spain;Microbiology Service, Vall d'Hebron University Hospital, Barcelona, Spain;Vall d'Hebron Research Institute (VHIR), Barcelona, Spain;Microbiology Service, Vigo University Hospital Complex (CHUVI), Vigo, Spain;Health Research Institute Galicia Sur (IISGS), Vigo, Spain;Unit of Microbiology, Reina Sofia University Hospital, Cordoba, Spain;Maimonides Biomedical Research Institute of Cordoba (IMIBIC), Cordoba, Spain;Center for Biomedical Research in Infectious Diseases (CIBERINFEC), Carlos III Health Institute (ISCIII), Madrid, Spain;Unit of Microbiology, Reina Sofia University Hospital, Cordoba, Spain;Maimonides Biomedical Research Institute of Cordoba (IMIBIC), Cordoba, Spain;Center for Biomedical Research in Infectious Diseases (CIBERINFEC), Carlos III Health Institute (ISCIII), Madrid, Spain;Department of Agricultural Chemistry, Soil Science and Microbiology, University of Cordoba, Cordoba, Spain;Virgen de la Arrixaca University Hospital, Murcia, Spain;Department of Genetics and Microbiology, University of Murcia, Murcia, Spain;Murcian Institute for Biomedical Research (IMIB), Murcia, Spain;

关键词: Klebsiella pneumoniae;    Escherichia coli;    Enterobacter cloacae;    Klebsiella;    Pseudomonas aeruginosa;    carbapenemases;    geographical distribution;   

DOI  :  10.3389/fmicb.2023.1247804

 received in 2023-06-26, accepted in 2023-08-15,  发布年份 2023

来源: Frontiers

【 摘 要 】

IntroductionInfections caused by carbapenem-resistant Enterobacterales (CRE) and carbapenem-resistant Pseudomonas aeruginosa, including isolates producing acquired carbapenemases, constitute a prevalent health problem worldwide. The primary objective of this study was to determine the distribution of the different carbapenemases among carbapenemase-producing Enterobacterales (CPE, specifically Escherichia coli, Klebsiella pneumoniae, Enterobacter cloacae complex, and Klebsiella aerogenes) and carbapenemase-producing P. aeruginosa (CPPA) in Spain from January 2014 to December 2018.MethodsA national, retrospective, cross-sectional multicenter study was performed. The study included the first isolate per patient and year obtained from clinical samples and obtained for diagnosis of infection in hospitalized patients. A structured questionnaire was completed by the participating centers using the REDCap platform, and results were analyzed using IBM SPSS Statistics 29.0.0.ResultsA total of 2,704 carbapenemase-producing microorganisms were included, for which the type of carbapenemase was determined in 2692 cases: 2280 CPE (84.7%) and 412 CPPA (15.3%), most often using molecular methods and immunochromatographic assays. Globally, the most frequent types of carbapenemase in Enterobacterales and P. aeruginosa were OXA-48-like, alone or in combination with other enzymes (1,523 cases, 66.8%) and VIM (365 cases, 88.6%), respectively. Among Enterobacterales, carbapenemase-producing K. pneumoniae was reported in 1821 cases (79.9%), followed by E. cloacae complex in 334 cases (14.6%). In Enterobacterales, KPC is mainly present in the South and South-East regions of Spain and OXA-48-like in the rest of the country. Regarding P. aeruginosa, VIM is widely distributed all over the country. Globally, an increasing percentage of OXA-48-like enzymes was observed from 2014 to 2017. KPC enzymes were more frequent in 2017–2018 compared to 2014–2016.DiscussionData from this study help to understand the situation and evolution of the main species of CPE and CPPA in Spain, with practical implications for control and optimal treatment of infections caused by these multi-drug resistant organisms.

【 授权许可】

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Copyright © 2023 Gracia-Ahufinger, López-González, Vasallo, Galar, Siller, Pitart, Bloise, Torrecillas, Gijón-Cordero, Viñado, Castillo-García, Campo, Mulet, Madueño-Alonso, Chamizo-López, Arrastia-Erviti, Galán-Sánchez, Fernández-Quejo, Rodríguez-Díaz, Gutiérrez-Zufiaurre, Rodríguez-Maresca, Ortega-Lafont, Yagüe-Guirao, Chaves-Blanco, Colomina-Rodríguez, Vidal-Acuña, Portillo, Franco-Álvarez de Luna, Centelles-Serrano, Azcona-Gutiérrez, Delgado-Iribarren García Campero, Rey-Cao, Muñoz, Calvo-Montes, Zboromyrska, Grandioso, Càmara, Cantón, Larrosa-Escartín, Díaz-Regañón and Martínez-Martínez.