Multidrug-resistant gram-negative bacteria in Spanish ICU patients: clinical and microbiological characterization (MURAN-UCI Project)
Multidrug-resistant gram-negative bacteria (MDR-GNB) are one of the main challenges in intensive care units (ICUs), mainly extended-spectrum β-lactamase-producing Klebsiella pneumoniae (EKP), carbapenemase-producing Enterobacterales, carbapenem-resistant (CR) Pseudomonas aeruginosa, and CR Acinetoba...
| Autores: | , , , , , , , , , |
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| Tipo de recurso: | artículo |
| Estado: | Versión publicada |
| Fecha de publicación: | 2025 |
| País: | España |
| Institución: | Universidad de Sevilla (US) |
| Repositorio: | idUS. Depósito de Investigación de la Universidad de Sevilla |
| OAI Identifier: | oai:idus.us.es:11441/182611 |
| Acceso en línea: | https://hdl.handle.net/11441/182611 https://doi.org/10.1128/spectrum.02987-25 |
| Access Level: | acceso abierto |
| Palabra clave: | Multi-resistance Gram-negative bacteria ICUs Colonizations Infections |
| Sumario: | Multidrug-resistant gram-negative bacteria (MDR-GNB) are one of the main challenges in intensive care units (ICUs), mainly extended-spectrum β-lactamase-producing Klebsiella pneumoniae (EKP), carbapenemase-producing Enterobacterales, carbapenem-resistant (CR) Pseudomonas aeruginosa, and CR Acinetobacter spp. The objectives were to determine the prevalence and incidence of colonization/infection by these bacteria in Spanish ICUs, their antimicrobial susceptibility, resistome, and phylogeny. All patients admitted to ICUs of seven Spanish hospitals were evaluated (15 February to 30 March 2023). Colonization was determined in rectal and oropharyngeal swabs upon admission and the firstand second weeks after admission. Infections were studied for up to 60 days from admission. Antimicrobial susceptibility was determined by broth microdilution. Whole-genome sequencing was performed to analyze the resistome and phylogeny (core-genome Multi-Locus Sequence-Typing). In total, 767 patients were studied. The prevalence of MDR-GNB colonization on admission was 2.9% (23/767), and EKP was the most prevalent bacterium. The incidence of acquired colonization was 1.3 (22/1,694) cases per 100 ICU-admitted patients-day, with colonization by CR P. aeruginosa being the most frequent (n = 14/22). Twenty-one patients had an infection (prevalence: 2.7%), mainly CR P. aeruginosa (12/21). The major resistance mechanisms and clones detected were some of the most frequent circulating clones in Spain: EKP-ST15/blaVIM-1+OXA-48, EKP-ST307/blaCTXM-15, and CR P. aeruginosa ST175/OprD porin deficiency.The antibiotics with the greatest activity against Enterobacterales (n = 26) were colistin, cefiderocol,and meropenem-vaborbactam (100%); while in CR P. aeruginosa (n = 20), they were colistin, cefiderocol,and imipenem-relebactam (95%–100%). The prevalence/incidence of colonization/infection by MDR-GNB in the ICUs of this study was low, but with important variations between hospitals. CR P. aeruginosa was the most common bacterium identified. |
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