Carbapenemases producing gram-negative bacteria surveillance in Latin America and the caribbean: a retrospective observational study from 2015 to 2020Research in context

Abstract

Summary: Background: The rise of multidrug-resistant (MDR) bacteria represents a public health threat, with carbapenem resistance exacerbating this challenge. This study investigates carbapenemase-producing bacteria (CPB) across the Latin America and the Caribbean (LAC) region. Methods: A retrospective observational study was conducted across 12 LAC countries from 2015 to 2020. A total of 58,909 isolates were analyzed utilizing polymerase chain reaction (PCR) to detect key carbapenemases in Enterobacterales, Pseudomonas aeruginosa, and Acinetobacter baumannii complex (ABC). Findings: 47,804/58,909 (81.14%) carbapenemases were identified, with Brazil accounting for 73% of these. The majority were reported in carbapenem-resistant Enterobacterales–CRE (65.33%; 31,230/47,804), followed by carbapenem-resistant ABC-CRAB (22.05%; 10,542/47,804), and carbapenem-resistant P. aeruginosa–CRPA (6050/47,804; 12.66%). Among CRE, blaKPC was the most detected gene (78.67%; 24,569/31,230), with Klebsiella pneumoniae being the most commonly associated species (75.9%). A relevant upward trend in blaNDM was observed. CRPA exhibited diverse profiles, with blaVIM (47.64%) being the most common. In CRAB, blaOXA-23 was found in 88.80% (9361/10,542) of isolates. Carbapenemase co-production was detected in 2.60% (1190/47,804) of isolates, with CRPA blaIMP + blaVIM being the most frequent. Interpretation: This study highlights a high prevalence of CPB in LAC, with a stable trend in blaKPC but a rising trend in blaNDM. These findings underscore the urgent need for strengthened surveillance and public health interventions to combat carbapenemase-mediated resistance in the region. Funding: None.

Keywords

• Multidrug-resistant bacteria
• Carbapenemases
• Latin America
• Antimicrobial resistance
• Public health challenge