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
Copyright © 2022 Cañada-García, Moure, Sola-Campoy, Delgado-Valverde, Cano, Gijón, González, Gracia-Ahufinger, Larrosa, Mulet, Pitart, Rivera, Bou, Calvo, Cantón, González-López, Martínez-Martínez, Navarro, Oliver, Palacios-Baena, Pascual, Ruiz-Carrascoso, Vila, Aracil, Pérez-Vázquez, Oteo-Iglesias and the GEMARA/GEIRAS-SEIMC/REIPI CARB-ES-19 Study Group..
Objectives: 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.
| Errataetall: |
ErratumIn: Front Microbiol. 2023 Nov 28;14:1331657. - PMID 38098654 |
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| Medienart: |
E-Artikel |
| Erscheinungsjahr: |
2022 |
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| Erschienen: |
2022 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:13 |
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| Enthalten in: |
Frontiers in microbiology - 13(2022) vom: 05., Seite 918362 |
| Sprache: |
Englisch |
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| Links: |
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| Themen: |
CARB-ES-19 study |
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| Anmerkungen: |
Date Revised 15.12.2023 published: Electronic-eCollection ErratumIn: Front Microbiol. 2023 Nov 28;14:1331657. - PMID 38098654 Citation Status PubMed-not-MEDLINE |
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| doi: |
10.3389/fmicb.2022.918362 |
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| 245 | 1 | 0 | |a 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 |
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| 500 | |a Date Revised 15.12.2023 | ||
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| 500 | |a ErratumIn: Front Microbiol. 2023 Nov 28;14:1331657. - PMID 38098654 | ||
| 500 | |a Citation Status PubMed-not-MEDLINE | ||
| 520 | |a Copyright © 2022 Cañada-García, Moure, Sola-Campoy, Delgado-Valverde, Cano, Gijón, González, Gracia-Ahufinger, Larrosa, Mulet, Pitart, Rivera, Bou, Calvo, Cantón, González-López, Martínez-Martínez, Navarro, Oliver, Palacios-Baena, Pascual, Ruiz-Carrascoso, Vila, Aracil, Pérez-Vázquez, Oteo-Iglesias and the GEMARA/GEIRAS-SEIMC/REIPI CARB-ES-19 Study Group. | ||
| 520 | |a Objectives: 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 | ||
| 520 | |a 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 | ||
| 520 | |a 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) | ||
| 520 | |a 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 | ||
| 650 | 4 | |a Journal Article | |
| 650 | 4 | |a CARB-ES-19 study | |
| 650 | 4 | |a Klebsiella pneumoniae | |
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| 700 | 1 | |a Cano, María E |e verfasserin |4 aut | |
| 700 | 1 | |a Gijón, Desirèe |e verfasserin |4 aut | |
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| 700 | 1 | |a Pilar Ortega Lafont, M |e investigator |4 oth | |
| 700 | 1 | |a Cercenado, Emilia |e investigator |4 oth | |
| 700 | 1 | |a Del Rosario And Jose Luis Perez Arellano, Cristobal |e investigator |4 oth | |
| 700 | 1 | |a Lecuona, María |e investigator |4 oth | |
| 700 | 1 | |a López-Urrutia Lorente, Luis |e investigator |4 oth | |
| 700 | 1 | |a Leiva And José Luis Del Pozo, José |e investigator |4 oth | |
| 700 | 1 | |a Giner And Juan Frasquet, Salvador |e investigator |4 oth | |
| 700 | 1 | |a Garcia Agudo And Soledad Illescas, Lidia |e investigator |4 oth | |
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| 700 | 1 | |a Torres Sopena, Luis |e investigator |4 oth | |
| 700 | 1 | |a Manuel Azcona, José |e investigator |4 oth | |
| 700 | 1 | |a Belles, Alba |e investigator |4 oth | |
| 700 | 1 | |a García González, Mercè |e investigator |4 oth | |
| 700 | 1 | |a Valverde Troya And Begoña Palop, Miriam |e investigator |4 oth | |
| 700 | 1 | |a García Garrote, Fernando |e investigator |4 oth | |
| 700 | 1 | |a Luis Barrios Andrés, Jose |e investigator |4 oth | |
| 700 | 1 | |a López Soria, Leyre |e investigator |4 oth | |
| 700 | 1 | |a Gimeno, Adelina |e investigator |4 oth | |
| 700 | 1 | |a Sabater, Susana |e investigator |4 oth | |
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