The epidemiology of carbapenemases in Latin America and the Caribbean

Abstract

Enterobacteriaceae, Pseudomonas spp., and Acinetobacter spp. infections are major causes of morbidity and mortality, especially due to the emergence and spread of β-lactamases. Carbapenemases, which are β-lactamases with the capacity to hydrolyze or inactivate carbapenems, have become a serious concern as they have the largest hydrolytic spectrum and therefore limit the utility of most β-lactam antibiotics. Areas covered: Here, we present an update of the current status of carbapenemases in Latin America and the Caribbean. Expert commentary: The increased frequency of reports on carbapenemases in Latin America and the Caribbean shows that they have successfully spread and have even become endemic in some countries. Countries such as Brazil, Colombia, Argentina, and Mexico account for the majority of these reports. Early suspicion and detection along with implementation of antimicrobial stewardship programs in all healthcare settings are crucial for the control and prevention of carbapenemase-producing bacteria.

Carbapenem-resistant Klebsiella pneumoniae in Barbados: Driving change in practice at the national level

“…KPC-3 specifically has been documented in Acinetobacter species in Puerto Rico but not in other Caribbean nations [22]. This study adds to the minimal body of current literature on carbapenemases in the English-speaking Caribbean, and specifically is one of the first to address KPC and CRKP [21]. In addition, this study further highlights the presence and person-to person transmission of the dominant worldwide clone ST-258.…”

“…There is small but growing body of literature on carbapenemases from countries in the Caribbean including Cuba, Guadeloupe, Trinidad and Tobago, and Puerto Rico [20,21]. KPC-3 specifically has been documented in Acinetobacter species in Puerto Rico but not in other Caribbean nations [22].…”

Comparative genome analysis of a multidrug-resistant Pseudomonas aeruginosa sequence type 277 clone that harbours two copies of the blaSPM-1 gene and multiple single nucleotide polymorphisms in other resistance-associated genes

“…Previous studies demonstrate ST277 strains have a highly conserved DNA sequence and share several virulence and antimicrobial resistance-related features. However, to date, the presence of bla SPM-1 gene conferring resistance to carbapenem is a singular trait of Brazilian clones [4,25]. The purpose of this study was to reassemble and to re-annotate CCBH4851 genome in order to perform a thorough characterization and a genomic comparison with other P. aeruginosa strains.…”

“…However, bla SPM-1 presence was only detected in isolates originating from Brazil and it is unknown why the SPM-1 epidemiology is restricted to a specific region while other MBLs tend to spread worldwide. Nevertheless, the risk of SPM-1 worldwide dissemination should not be neglected [4]. In 2008, an isolate was recovered from the catheter tip of a patient admitted in a hospital located in the state of Goiás.…”

OXA-48 Carbapenemase in Klebsiella pneumoniae Sequence Type 307 in Ecuador

“…Serine carbapenemases (KPC) and metallo-β-lactamases (NDM, IMP, VIM) are the most prevalent carbapenemases reported all around the globe [6], KPC being the first to be described in 2001 in an isolate of Klebsiella pneumoniae in USA [7]. Carbapenem-resistant isolates within K. pneumoniae have been spread globally [8][9][10][11], including clone 307, which has significantly increased in the mid-1990s and is associated with several resistance genes, such as OXA-48 [12,13].…”