Evolving epidemiology of carbapenemase-producing Enterobacteriaceae in Portugal: 2012 retrospective cohort at a tertiary hospital in Lisbon

Pires, David; Zagalo, Alexandra; Santos, Cláudia Simone Silveira dos; Medeiros, F. Cota de; Duarte, Ana; Lito, Luı́s; Melo‐Cristino, José; Caldeira, Liliana

doi:10.1016/j.jhin.2015.11.006

Cited by 8 publications

(4 citation statements)

References 4 publications

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“…The most common carbapenemase described worldwide is KPC-2 [18,19,20,21,22] but KPC-3 has already been identified in the United States [23], Israel [22], Italy [24] and Spain [25]. In Portugal, the first carbapenem-resistant K. pneumoniae was identified in 2009 [26] and since then, dissemination to other Enterobacteriaceae [27] and the increasing frequency of hospital outbreaks [28] has led to the creation of the Epidemiological Surveillance of Antimicrobial Resistance Guidelines, which contains mandatory notification of these pathogens [29].…”

Section: Discussionmentioning

confidence: 99%

First Description of Colistin and Tigecycline-Resistant Acinetobacter baumannii Producing KPC-3 Carbapenemase in Portugal

et al. 2018

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Herein, we describe a case report of carbapenem-resistant Acinetobacter baumannii and Klebsiella pneumoniae isolates that were identified from the same patient at a Tertiary University Hospital Centre in Portugal. Antimicrobial susceptibility and the molecular characterization of resistance and virulence determinants were performed. PCR screening identified the presence of the resistance genes blaKPC-3, blaTEM-1 and blaSHV-1 in both isolates. The KPC-3 K. pneumoniae isolate belonged to the ST-14 high risk clone and accumulated an uncommon resistance and virulence profile additional to a horizontal dissemination capacity. In conclusion, the molecular screening led to the first identification of the A. baumannii KPC-3 producer in Portugal with a full antimicrobial resistance profile including tigecycline and colistin.

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Section: Discussionmentioning

confidence: 99%

First Description of Colistin and Tigecycline-Resistant Acinetobacter baumannii Producing KPC-3 Carbapenemase in Portugal

et al. 2018

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“…During the same period the share of isolates with combined resistance to third generation cephalosporins, fluoroquinolones and aminoglycosides (26.5% in 2019) oscillated without an upward trend 6 . Several recent small epidemiological studies in Portugal have focused on carbapenemase producing Kp isolates 11 – 16 , and bla KPC-3 was the most frequently identified carbapenem resistance gene. The bla KPC-3 gene is most frequently located within the Tn 4401 d transposon, and IncN, IncFII, IncFIB and IncFIIA plasmid families are the main traffickers 11 , 13 , 15 , 17 .…”

Section: Introductionmentioning

confidence: 99%

Genomic epidemiological analysis of Klebsiella pneumoniae from Portuguese hospitals reveals insights into circulating antimicrobial resistance

Spadar

Phelan

Elias

et al. 2022

Sci Rep

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Klebsiella pneumoniae (Kp) bacteria are an increasing threat to public health and represent one of the most concerning pathogens involved in life-threatening infections and antimicrobial resistance (AMR). To understand the epidemiology of AMR of Kp in Portugal, we analysed whole genome sequencing, susceptibility testing and other meta data on 509 isolates collected nationwide from 16 hospitals and environmental settings between years 1980 and 2019. Predominant sequence types (STs) included ST15 (n = 161, 32%), ST147 (n = 36, 7%), ST14 (n = 26, 5%) or ST13 (n = 26, 5%), while 31% of isolates belonged to STs with fewer than 10 isolates. AMR testing revealed widespread resistance to aminoglycosides, fluoroquinolones, cephalosporins and carbapenems. The most common carbapenemase gene was blaKPC-3. Whilst the distribution of AMR linked plasmids appears uncorrelated with ST, their frequency has changed over time. Before year 2010, the dominant plasmid group was associated with the extended spectrum beta-lactamase gene blaCTX-M-15, but this group appears to have been displaced by another carrying the blaKPC-3 gene. Co-carriage of blaCTX-M and blaKPC-3 was uncommon. Our results from the largest genomics study of Kp in Portugal highlight the active transmission of strains with AMR genes and provide a baseline set of variants for future resistance monitoring and epidemiological studies.

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“…That report also showed that Portugal faced an annual increasing trend of carbapenem resistance among K. pneumoniae since 2014 (1.8% in 2014, 3.4% in 2015, 5.2% in 2016, and 8.6% in 2017), exceeding the overall prevalence for Europe (7.2%). Nevertheless, data on the molecular epidemiology of nosocomial carbapenemase-producing K. pneumoniae in Portugal are still limited, and the existing studies include isolates recovered until 2014 only ( 10 , 12 , 13 ). Therefore, the aim of our study was to provide updated epidemiologic data on contemporary carbapenemase-producing K. pneumoniae in an acute-care facility hospital in Portugal by characterizing a collection of nonrepetitive isolates recovered during a 6-year period (2013–2018).…”

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confidence: 99%

Epidemiology of Carbapenemase-Producing Klebsiella pneumoniae in a Hospital, Portugal

Aires-de-Sousa¹,

Rosa²,

Gonçalves³

et al. 2019

Emerg. Infect. Dis.

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We aimed to provide updated epidemiologic data on carbapenem-resistant Klebsiella pneumoniae in Portugal by characterizing all isolates (N = 46) recovered during 2013–2018 in a 123-bed hospital in Lisbon. We identified bla KPC-3 (n = 36), bla OXA-181 (n = 9), and bla GES-5 (n = 8) carbapenemase genes and observed co-occurrence of bla KPC-3 and bla GES-5 in 7 isolates. A single GES-5–producing isolate co-produced the extended-spectrum β-lactamase BEL-1; both corresponding genes were co-located on the same ColE1-like plasmid. The bla OXA-181 gene was always located on an IncX3 plasmid, whereas bla KPC-3 was carried on IncN, IncFII, IncFIB, and IncFIIA plasmid types. The 46 isolates were distributed into 13 pulsotypes and 9 sequence types. All isolates remained susceptible to ceftazidime/avibactam, but some exhibited reduced antimicrobial susceptibility (MIC = 3 mg/L).

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Evolving epidemiology of carbapenemase-producing Enterobacteriaceae in Portugal: 2012 retrospective cohort at a tertiary hospital in Lisbon

Cited by 8 publications

References 4 publications

First Description of Colistin and Tigecycline-Resistant Acinetobacter baumannii Producing KPC-3 Carbapenemase in Portugal

First Description of Colistin and Tigecycline-Resistant Acinetobacter baumannii Producing KPC-3 Carbapenemase in Portugal

Genomic epidemiological analysis of Klebsiella pneumoniae from Portuguese hospitals reveals insights into circulating antimicrobial resistance

Epidemiology of Carbapenemase-Producing Klebsiella pneumoniae in a Hospital, Portugal

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