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...

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Autores: Ramírez de Arellano, Eva, López Causapé, Carla, Delgado Valverde, María Mercedes, Arroyo Muñoz, F. J., Alemparte Pardavila, E., Arca-Suárez, Jorge, Ayestarán, Ignacio, Riazzo, C., Rodríguez-Gómez, J., Oteo-Iglesias, J.
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
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spelling Multidrug-resistant gram-negative bacteria in Spanish ICU patients: clinical and microbiological characterization (MURAN-UCI Project)Ramírez de Arellano, EvaLópez Causapé, CarlaDelgado Valverde, María MercedesArroyo Muñoz, F. J.Alemparte Pardavila, E.Arca-Suárez, JorgeAyestarán, IgnacioRiazzo, C.Rodríguez-Gómez, J.Oteo-Iglesias, J.Multi-resistanceGram-negative bacteriaICUsColonizationsInfectionsMultidrug-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.American Society for MicrobiologyMicrobiologíaMinisterio de Ciencia e Innovación (MICIN). EspañaInstituto de Salud Carlos IIIEuropean Union (UE)2025info:eu-repo/semantics/articleinfo:eu-repo/semantics/publishedVersionapplication/pdfapplication/pdfhttps://hdl.handle.net/11441/182611https://doi.org/10.1128/spectrum.02987-25reponame:idUS. Depósito de Investigación de la Universidad de Sevillainstname:Universidad de Sevilla (US)InglésMicrobiology Spectrum, 14 (2), e02987-25.https://doi.org/10.1128/spectrum.02987-25info:eu-repo/semantics/openAccessoai:idus.us.es:11441/1826112026-06-17T12:51:07Z
dc.title.none.fl_str_mv Multidrug-resistant gram-negative bacteria in Spanish ICU patients: clinical and microbiological characterization (MURAN-UCI Project)
title Multidrug-resistant gram-negative bacteria in Spanish ICU patients: clinical and microbiological characterization (MURAN-UCI Project)
spellingShingle Multidrug-resistant gram-negative bacteria in Spanish ICU patients: clinical and microbiological characterization (MURAN-UCI Project)
Ramírez de Arellano, Eva
Multi-resistance
Gram-negative bacteria
ICUs
Colonizations
Infections
title_short Multidrug-resistant gram-negative bacteria in Spanish ICU patients: clinical and microbiological characterization (MURAN-UCI Project)
title_full Multidrug-resistant gram-negative bacteria in Spanish ICU patients: clinical and microbiological characterization (MURAN-UCI Project)
title_fullStr Multidrug-resistant gram-negative bacteria in Spanish ICU patients: clinical and microbiological characterization (MURAN-UCI Project)
title_full_unstemmed Multidrug-resistant gram-negative bacteria in Spanish ICU patients: clinical and microbiological characterization (MURAN-UCI Project)
title_sort Multidrug-resistant gram-negative bacteria in Spanish ICU patients: clinical and microbiological characterization (MURAN-UCI Project)
dc.creator.none.fl_str_mv Ramírez de Arellano, Eva
López Causapé, Carla
Delgado Valverde, María Mercedes
Arroyo Muñoz, F. J.
Alemparte Pardavila, E.
Arca-Suárez, Jorge
Ayestarán, Ignacio
Riazzo, C.
Rodríguez-Gómez, J.
Oteo-Iglesias, J.
author Ramírez de Arellano, Eva
author_facet Ramírez de Arellano, Eva
López Causapé, Carla
Delgado Valverde, María Mercedes
Arroyo Muñoz, F. J.
Alemparte Pardavila, E.
Arca-Suárez, Jorge
Ayestarán, Ignacio
Riazzo, C.
Rodríguez-Gómez, J.
Oteo-Iglesias, J.
author_role author
author2 López Causapé, Carla
Delgado Valverde, María Mercedes
Arroyo Muñoz, F. J.
Alemparte Pardavila, E.
Arca-Suárez, Jorge
Ayestarán, Ignacio
Riazzo, C.
Rodríguez-Gómez, J.
Oteo-Iglesias, J.
author2_role author
author
author
author
author
author
author
author
author
dc.contributor.none.fl_str_mv Microbiología
Ministerio de Ciencia e Innovación (MICIN). España
Instituto de Salud Carlos III
European Union (UE)
dc.subject.none.fl_str_mv Multi-resistance
Gram-negative bacteria
ICUs
Colonizations
Infections
topic Multi-resistance
Gram-negative bacteria
ICUs
Colonizations
Infections
description 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.
publishDate 2025
dc.date.none.fl_str_mv 2025
dc.type.none.fl_str_mv info:eu-repo/semantics/article
info:eu-repo/semantics/publishedVersion
format article
status_str publishedVersion
dc.identifier.none.fl_str_mv https://hdl.handle.net/11441/182611
https://doi.org/10.1128/spectrum.02987-25
url https://hdl.handle.net/11441/182611
https://doi.org/10.1128/spectrum.02987-25
dc.language.none.fl_str_mv Inglés
language_invalid_str_mv Inglés
dc.relation.none.fl_str_mv Microbiology Spectrum, 14 (2), e02987-25.
https://doi.org/10.1128/spectrum.02987-25
dc.rights.none.fl_str_mv info:eu-repo/semantics/openAccess
eu_rights_str_mv openAccess
dc.format.none.fl_str_mv application/pdf
application/pdf
dc.publisher.none.fl_str_mv American Society for Microbiology
publisher.none.fl_str_mv American Society for Microbiology
dc.source.none.fl_str_mv reponame:idUS. Depósito de Investigación de la Universidad de Sevilla
instname:Universidad de Sevilla (US)
instname_str Universidad de Sevilla (US)
reponame_str idUS. Depósito de Investigación de la Universidad de Sevilla
collection idUS. Depósito de Investigación de la Universidad de Sevilla
repository.name.fl_str_mv
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