Carbapenemase producing Enterobacteriaceae in intensive care units in Ecuador: Results from a multicenter study

Soria‐Segarra, Carmen; Soria-Segarra, Claudia; Catagua-González, Angel; Gutiérrez‐Fernández, José

doi:10.1016/j.jiph.2019.06.013

Cited by 23 publications

(23 citation statements)

References 24 publications

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“…On the other hand, the (26). In Ecuador, bla KPC-2 is the most prevalent carbapenemase gene detected in E. coli in hospitals (27,28), and recently it was detected in an urban river in Citrobacter freundii (29). However, there are no reports of carbapenemases from poultry in our region (carbapenems are not used for poultry production).…”

Section: Discussionmentioning

confidence: 77%

Broiler Farms and Carcasses Are an Important Reservoir of Multi-Drug Resistant Escherichia coli in Ecuador

et al. 2020

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Antimicrobial resistance (AMR) is a major health threat for public and animal health in the twenty-first century. In Ecuador, antibiotics have been used by the poultry industry for decades resulting in the presence of multi-drug resistant (MDR) bacteria in the poultry meat production chain, with the consequent risk for public health. This study evaluated the prevalence of ESBL/AmpC and mcr genes in third-generation cephalosporin-resistant Escherichia coli (3GC-R E. coli) isolated from broiler farms (animal component), broiler carcasses (food component), and human enteritis (human component) in Quito-Ecuador. Samples were collected weekly from November 2017 to November 2018. For the animal, food, and human components, 133, 335, and 302 samples were analyzed, respectively. Profiles of antimicrobial resistance were analyzed by an automated microdilution system. Resistance genes were studied by PCR and Sanger sequencing. From all samples, 122 (91.7%), 258 (77%), and 146 (48.3%) samples were positive for 3GC-R E. coli in the animal, food, and human components, respectively. Most of the isolates (472/526, 89.7%) presented MDR phenotypes. The ESBL blaCTX-M-55, blaCTX-M-3, blaCTX-M-15, blaCTX-M-65, blaCTX-M-27, and blaCTX-M-14 were the most prevalent ESBL genes while blaCMY-2 was the only AmpC detected gene. The mcr-1 gene was found in 20 (16.4%), 26 (10.1%), and 3 (2.1%) of isolates from animal, food, and human components, respectively. The implication of poultry products in the prevalence of ESBL/AmpC and mcr genes in 3GC-R must be considered in the surveillance of antimicrobial resistance.

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Section: Discussionmentioning

confidence: 77%

Broiler Farms and Carcasses Are an Important Reservoir of Multi-Drug Resistant Escherichia coli in Ecuador

et al. 2020

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“…Our statistical analysis revealed that halo diameters were significantly larger for VIM-1- versus OXA-48-carrier bacteria on ERT disks, which may indicate a lower activity for this type of enzyme than for OXA-48 carbapenemases. Although the difference was not significant, the diameter range generated by bacteria expressing the KPC-3 enzyme was also lower, as in the case of the OXA-48 enzyme, although the isolated activity of KPC-3 was not sufficient to generate resistance to all β-lactams [ 36 , 37 , 38 ].…”

Section: Discussionmentioning

confidence: 99%

Clinical Relevance of Antibiotic Susceptibility Profiles for Screening Gram-negative Microorganisms Resistant to Beta-Lactam Antibiotics

et al. 2020

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The increasing resistance to antibiotics is compromising the empirical treatment of infections caused by resistant bacteria. Rapid, efficient, and clinically applicable phenotypic methods are needed for their detection. This study examines the phenotypic behavior of β-lactam-resistant Gram-negative bacteria grown on ChromID ESBL medium with ertapenem, cefoxitin, and cefepime disks, reports on the coloration of colonies, and establishes a halo diameter breakpoint for the detection of carbapenemase-producing bacteria. We studied 186 β-lactam-resistant Gram-negative microorganisms (77 with extended spectrum beta lactamase (ESBL), 97 with carbapenemases, and 12 with AmpC β-lactamases (AmpC)). Susceptibility profiles of Gram-negative bacteria that produced ESBL, AmpC, and carbapenemases were similar to the expected profiles, with some differences in the response to cefepime of ESBL-producing microorganisms. Coloration values did not differ from those described by the manufacturer of ChromID ESBL medium. In the screening of carbapenemase production, inhibition halo diameter breakpoints for antibiotic resistance were 18 mm for Enterobacterales and ertapenem, 18 mm for Pseudomonas and cefepime, and 16 mm for Acinetobacter baumannii and cefepime. This innovative phenotypic approach is highly relevant to clinical laboratories, combining susceptibility profiles with detection by coloration of high-priority resistant microorganisms such as carbapenemase-producing A. baumannii, carbapenemase-producing Pseudomonas spp., and ESBL and/or carbapenemase-producing Enterobacterales.

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“…Las tasas de aislamientos clínicos de Enterobacterales productores de carbapenemasas son del 1,7% en España [15] y de colonización del 2% [22], la mismas pueden variar del 13,4% al 73,1% dependiendo del país [4,17,[23][24][25][26], los microorganismos predominantes son K. pneumoniae y E. coli [24]. En este trabajo la tasa de colonización se encuentra dentro de los valores estimados para España, y se demuestra que la detección de estos microorganismos en FR juega un papel preponderante, incluso pudiendo predecir la infección.…”

Section: Tabla 2 Microorganismos Aislados En Estudios Simultáneos En Frotis Rectal (Fr) Y Faríngeo (Ff)unclassified

“…Estudios moleculares han demostrado que la tasa de colonización por microorganismos productores de carbapenemasas es alta [4,5], lo que constituye un reto para el control de infecciones, el manejo clínico de los pacientes y la salud pública [6]. Por otro lado, las infecciones por BRC, como Pseudomonas aeruginosa, Acinetobacter baumannii y Enterobacterales, están ampliamente distribuidas en países tanto de escasos o altos recursos económicos [7,8], generando importantes procesos clínicos con elevada morbimortalidad [9], así como grandes costes para los sistemas sanitario.…”

Section: Introductionunclassified

Infections in patients colonized with carbapenem-resistant Gram-negative bacteria in a medium Spanish city

Soria‐Segarra¹,

Delgado-Valverde²,

Serrano-García³

et al. 2021

Rev Esp Quimioter

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Objective. Because there are few studies on the clinical implications of colonization by carbapenem-resistant gram-negative bacteria (CRB) this was analyzed in rectal smears (RS) and pharyngeals (PS) and its ability to predict infection/colonization. Methodology. A cross-sectional, retrospective study from adult inpatients between January 2016 and December 2019 was conducted. The isolates were characterized by MicroScan and spectrometry of masses applying EUCAST 2018 cutoff points. The detection of carbapenemases was performed by PCR and Sanger sequencing; sequencies was assigned by MLST. The genetic relationship between the clinical isolates was made by pulsed field electrophoresis using the enzymes Xbal, Spel or Apal. Results. A total of 308 (86.03%) RS and 50 (13.97%) positive PS were detected, the RS had a 85% sensibility, 100% specificity, 100% positive predictive value and 97% negative predictive value. In RS, the following were isolated: 44% (n=135) Acinetobacter baumannii, 26% (n =80) Enterobacterales (20 KPC, 29 OXA-48, 22 VIM, 2 IMP, 7 NDM), 17% (n=53) Pseudomonas aeruginosa and 13% (n=40) Stenotrophomonas maltophilia. In the PS were isolated 44% (n=22) S. maltophilia, 40% (n = 20) A. baumannii, 8% (n=4) P. aeruginosa and 8% (n=4) Enterobacterales (3 VIM, 1 OXA). From the patients with simultaneous RS and PS, 41 (40.6%) had positivity in both smears, 45 (44.6%) only in RS and 15 (14.9%) only in PS. Colonization preceded infection in 81.3% (n=13) of the isolates; association between infection and colonization was found (p<0.001; χ2); and the episodes where the information was found all the isolates from the clinical samples and from the smears were similar. Conclusions. The probability of predicting infection through the CRB colonized in different clinical samples is feasible. The RS has a major sensibility to detect colonization.

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Carbapenemase producing Enterobacteriaceae in intensive care units in Ecuador: Results from a multicenter study

Cited by 23 publications

References 24 publications

Broiler Farms and Carcasses Are an Important Reservoir of Multi-Drug Resistant Escherichia coli in Ecuador

Broiler Farms and Carcasses Are an Important Reservoir of Multi-Drug Resistant Escherichia coli in Ecuador

Clinical Relevance of Antibiotic Susceptibility Profiles for Screening Gram-negative Microorganisms Resistant to Beta-Lactam Antibiotics

Infections in patients colonized with carbapenem-resistant Gram-negative bacteria in a medium Spanish city

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