Frontiers in Microbiology (Sep 2023)

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

  • Irene Gracia-Ahufinger,
  • Irene Gracia-Ahufinger,
  • Irene Gracia-Ahufinger,
  • Laura López-González,
  • Laura López-González,
  • Francisco José Vasallo,
  • Francisco José Vasallo,
  • Alicia Galar,
  • Alicia Galar,
  • Alicia Galar,
  • Alicia Galar,
  • María Siller,
  • María Siller,
  • Cristina Pitart,
  • Cristina Pitart,
  • Cristina Pitart,
  • Iván Bloise,
  • Iván Bloise,
  • Miriam Torrecillas,
  • Desirée Gijón-Cordero,
  • Desirée Gijón-Cordero,
  • Belén Viñado,
  • Belén Viñado,
  • Javier Castillo-García,
  • Javier Castillo-García,
  • Javier Castillo-García,
  • Rainer Campo,
  • Xavier Mulet,
  • Xavier Mulet,
  • Xavier Mulet,
  • Ana Madueño-Alonso,
  • Francisco Javier Chamizo-López,
  • Maitane Arrastia-Erviti,
  • Fátima Galán-Sánchez,
  • Melisa Fernández-Quejo,
  • Juan Carlos Rodríguez-Díaz,
  • Juan Carlos Rodríguez-Díaz,
  • María Nieves Gutiérrez-Zufiaurre,
  • Manuel Angel Rodríguez-Maresca,
  • María del Pilar Ortega-Lafont,
  • Genoveva Yagüe-Guirao,
  • Genoveva Yagüe-Guirao,
  • Genoveva Yagüe-Guirao,
  • Lucía Chaves-Blanco,
  • Javier Colomina-Rodríguez,
  • María Reyes Vidal-Acuña,
  • María Eugenia Portillo,
  • María Eugenia Portillo,
  • Francisco Franco-Álvarez de Luna,
  • María José Centelles-Serrano,
  • María José Centelles-Serrano,
  • José Manuel Azcona-Gutiérrez,
  • Alberto Delgado-Iribarren García Campero,
  • Sonia Rey-Cao,
  • Sonia Rey-Cao,
  • Patricia Muñoz,
  • Patricia Muñoz,
  • Patricia Muñoz,
  • Patricia Muñoz,
  • Patricia Muñoz,
  • Jorge Calvo-Montes,
  • Jorge Calvo-Montes,
  • Jorge Calvo-Montes,
  • Yuliya Zboromyrska,
  • Yuliya Zboromyrska,
  • David Grandioso,
  • David Grandioso,
  • Jordi Càmara,
  • Jordi Càmara,
  • Jordi Càmara,
  • Jordi Càmara,
  • Rafael Cantón,
  • Rafael Cantón,
  • Rafael Cantón,
  • Nieves Larrosa-Escartín,
  • Nieves Larrosa-Escartín,
  • Nieves Larrosa-Escartín,
  • Jazmín Díaz-Regañón,
  • Luis Martínez-Martínez,
  • Luis Martínez-Martínez,
  • Luis Martínez-Martínez,
  • Luis Martínez-Martínez

DOI
https://doi.org/10.3389/fmicb.2023.1247804
Journal volume & issue
Vol. 14

Abstract

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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.

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