Autor(es):
Boattini, Matteo ; Bianco, Gabriele ; Llorente, Laura Iglesias ; Acero, Laura Alonso ; Nunes, Daniel ; Seruca, Miguel ; Mendes, Vasco Santos ; Almeida, André ; Bastos, Paulo ; Rodríguez-Villodres, Ángel ; Gascón, Adelina Gimeno ; Halperin, Ana Verónica ; Cantón, Rafael ; Escartín, Maria Nieves Larrosa ; González-López, Juan José ; Floch, Pauline ; Massip, Clémence ; Chainier, Delphine ; Barraud, Olivier ; Dortet, Laurent ; Cuzon, Gaëlle ; Zancanaro, Clément ; Mizrahi, Assaf ; Schade, Rogier ; Rasmussen, Asger Nellemann ; Schønning, Kristian ; Hamprecht, Axel ; Schaffarczyk, Lukas ; Glöckner, Stefan ; Rödel, Jürgen ; Kristóf, Katalin ; Balonyi, Ágnes ; Mancini, Stefano ; Quiblier, Chantal ; Fasciana, Teresa ; Giammanco, Anna ; Paglietti, Bianca ; Rubino, Salvatore ; Budimir, Ana ; Bedenić, Branka ; Rubic, Zana ; Marinović, Jelena ; Gartzonika, Konstantina ; Christaki, Eirini ; Mavromanolaki, Viktoria Eirini ; Maraki, Sofia ; Yalçın, Tuğba Yanık ; Azap, Özlem Kurt ; Licker, Monica ; Musuroi, Corina ; Talapan, Daniela ; Vrancianu, Corneliu Ovidiu ; Comini, Sara ; Zalas-Więcek, Patrycja ; Michalska, Anna ; Cavallo, Rossana ; Melo Cristino, José ; Costa, Cristina
Data: 2024
Identificador Persistente: http://hdl.handle.net/10362/165562
Origem: Repositório Institucional da UNL
Assunto(s): AmpC β-lactamase; Antimicrobial resistance; Blood culture; COVID-19; Enterobacterales; Sepsis; Microbiology (medical); Infectious Diseases; Pharmacology (medical); SDG 3 - Good Health and Well-being
Descrição
Publisher Copyright: © 2024 The Author(s)
Introduction: The ESCPM group (Enterobacter species including Klebsiella aerogenes - formerly Enterobacter aerogenes, Serratia species, Citrobacter freundii complex, Providencia species and Morganella morganii) has not yet been incorporated into systematic surveillance programs. Methods: We conducted a multicentre retrospective observational study analysing all ESCPM strains isolated from blood cultures in 27 European hospitals over a 3-year period (2020–2022). Diagnostic approach, epidemiology, and antimicrobial susceptibility were investigated. Results: Our study comprised 6,774 ESCPM isolates. MALDI-TOF coupled to mass spectrometry was the predominant technique for bacterial identification. Susceptibility to new β-lactam/β-lactamase inhibitor combinations and confirmation of AmpC overproduction were routinely tested in 33.3% and 29.6% of the centres, respectively. The most prevalent species were E. cloacae complex (44.8%) and S. marcescens (22.7%). Overall, third-generation cephalosporins (3GC), combined third- and fourth-generation cephalosporins (3GC + 4GC) and carbapenems resistance phenotypes were observed in 15.7%, 4.6%, and 9.5% of the isolates, respectively. AmpC overproduction was the most prevalent resistance mechanism detected (15.8%). Among carbapenemase-producers, carbapenemase type was provided in 44.4% of the isolates, VIM- (22.9%) and OXA-48-enzyme (16%) being the most frequently detected. E. cloacae complex, K. aerogenes and Providencia species exhibited the most notable cumulative antimicrobial resistance profiles, with the former displaying 3GC, combined 3GC + 4GC and carbapenems resistance phenotypes in 15.2%, 7.4%, and 12.8% of the isolates, respectively. K. aerogenes showed the highest rate of both 3GC resistant phenotype (29.8%) and AmpC overproduction (32.1%), while Providencia species those of both carbapenems resistance phenotype (42.7%) and carbapenemase production (29.4%). ESCPM isolates exhibiting both 3GC and combined 3GC + 4GC resistance phenotypes displayed high susceptibility to ceftazidime/avibactam (98.2% and 95.7%, respectively) and colistin (90.3% and 90.7%, respectively). Colistin emerged as the most active drug against ESCPM species (except those intrinsically resistant) displaying both carbapenems resistance phenotype (85.8%) and carbapenemase production (97.8%). Conclusions: This study presented a current analysis of ESCPM species epidemiology in Europe, providing insights to inform current antibiotic treatments and guide strategies for antimicrobial stewardship and diagnostics.
