CARB-ES-19 Multicenter Study of Carbapenemase-Producing Klebsiella pneumoniae and Escherichia coli From All Spanish Provinces Reveals Interregional Spread of High-Risk Clones Such as ST307/OXA-48 and ST512/KPC-3.

Cañada García, Javier E.; Moure, Zaira; Sola Campoy, Pedro J.; Delgado Valverde, Mercedes; Cano, María E.; Gijón Cordero, Desirée; González, Mónica; Gracia Ahufinger, Irene; Larrosa, Nieves; Mulet, Xavier; Pitart, Cristina; Rivera, Alba; Bou, Germán; Calvo, Jorge; Cantón, Rafael; González-López, Juan José; Martínez-Martínez, Luis; Navarro, Ferran; Oliver, Antonio; Palacios Baena, Zaira R.; Pascual, Alvaro; Ruiz Carrascoso, Guillermo; Vila Estapé, Jordi; Aracil, Belén; Pérez-Vázquez, María; Oteo Iglesias, Jesús; GEMARA/GEIRAS-SEIMC/REIPI CARB-ES-19 Study Group

CARB-ES-19 Multicenter Study of Carbapenemase-Producing Klebsiella pneumoniae and Escherichia coli From All Spanish Provinces Reveals Interregional Spread of High-Risk Clones Such as ST307/OXA-48 and ST512/KPC-3.

CARB-ES-19 is a comprehensive, multicenter, nationwide study integrating whole-genome sequencing (WGS) in the surveillance of carbapenemase-producing K. pneumoniae (CP-Kpn) and E. coli (CP-Eco) to determine their incidence, geographical distribution, phylogeny, and resistance mechanisms in Spain. Me...

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Autores:	Cañada García, Javier E., Moure, Zaira, Sola Campoy, Pedro J., Delgado Valverde, Mercedes, Cano, María E., Gijón Cordero, Desirée, González, Mónica, Gracia Ahufinger, Irene, Larrosa, Nieves, Mulet, Xavier, Pitart, Cristina, Rivera, Alba, Bou, Germán, Calvo, Jorge, Cantón, Rafael, González-López, Juan José, Martínez-Martínez, Luis, Navarro, Ferran, Oliver, Antonio, Palacios Baena, Zaira R., Pascual, Alvaro, Ruiz Carrascoso, Guillermo, Vila Estapé, Jordi, Aracil, Belén, Pérez-Vázquez, María, Oteo Iglesias, Jesús, GEMARA/GEIRAS-SEIMC/REIPI CARB-ES-19 Study Group
Tipo de recurso:	artículo
Estado:	Versión publicada
Fecha de publicación:	2022
País:	España
Institución:	Universidad de Barcelona
Repositorio:	Dipòsit Digital de la UB
OAI Identifier:	oai:diposit.ub.edu:2445/191256
Acceso en línea:	https://hdl.handle.net/2445/191256
Access Level:	acceso abierto
Palabra clave:	Antibiòtics betalactàmics Klebsiella pneumoniae Escheríchia coli Genoma humà Enterobacteriàcies Beta lactam antibiotics Escherichia coli Human genome Enterobacteriaceae

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spelling	CARB-ES-19 Multicenter Study of Carbapenemase-Producing Klebsiella pneumoniae and Escherichia coli From All Spanish Provinces Reveals Interregional Spread of High-Risk Clones Such as ST307/OXA-48 and ST512/KPC-3.Cañada García, Javier E.Moure, ZairaSola Campoy, Pedro J.Delgado Valverde, MercedesCano, María E.Gijón Cordero, DesiréeGonzález, MónicaGracia Ahufinger, IreneLarrosa, NievesMulet, XavierPitart, CristinaRivera, AlbaBou, GermánCalvo, JorgeCantón, RafaelGonzález-López, Juan JoséMartínez-Martínez, LuisNavarro, FerranOliver, AntonioPalacios Baena, Zaira R.Pascual, AlvaroRuiz Carrascoso, GuillermoVila Estapé, JordiAracil, BelénPérez-Vázquez, MaríaOteo Iglesias, JesúsGEMARA/GEIRAS-SEIMC/REIPI CARB-ES-19 Study GroupAntibiòtics betalactàmicsKlebsiella pneumoniaeEscheríchia coliGenoma humàEnterobacteriàciesBeta lactam antibioticsKlebsiella pneumoniaeEscherichia coliHuman genomeEnterobacteriaceaeCARB-ES-19 is a comprehensive, multicenter, nationwide study integrating whole-genome sequencing (WGS) in the surveillance of carbapenemase-producing K. pneumoniae (CP-Kpn) and E. coli (CP-Eco) to determine their incidence, geographical distribution, phylogeny, and resistance mechanisms in Spain. Methods: In total, 71 hospitals, representing all 50 Spanish provinces, collected the first 10 isolates per hospital (February to May 2019); CPE isolates were first identified according to EUCAST (meropenem MIC > 0.12 mg/L with immunochromatography, colorimetric tests, carbapenem inactivation, or carbapenem hydrolysis with MALDI-TOF). Prevalence and incidence were calculated according to population denominators. Antibiotic susceptibility testing was performed using the microdilution method (EUCAST). All 403 isolates collected were sequenced for high-resolution single-nucleotide polymorphism (SNP) typing, core genome multilocus sequence typing (cgMLST), and resistome analysis. Results: In total, 377 (93.5%) CP-Kpn and 26 (6.5%) CP-Eco isolates were collected from 62 (87.3%) hospitals in 46 (92%) provinces. CP-Kpn was more prevalent in the blood (5.8%, 50/853) than in the urine (1.4%, 201/14,464). The cumulative incidence for both CP-Kpn and CP-Eco was 0.05 per 100 admitted patients. The main carbapenemase genes identified in CP-Kpn were bla OXA-48 (263/377), bla KPC-3 (62/377), bla VIM-1 (28/377), and bla NDM-1 (12/377). All isolates were susceptible to at least two antibiotics. Interregional dissemination of eight high-risk CP-Kpn clones was detected, mainly ST307/OXA-48 (16.4%), ST11/OXA-48 (16.4%), and ST512-ST258/KPC (13.8%). ST512/KPC and ST15/OXA-48 were the most frequent bacteremia-causative clones. The average number of acquired resistance genes was higher in CP-Kpn (7.9) than in CP-Eco (5.5). Conclusion: This study serves as a first step toward WGS integration in the surveillance of carbapenemase-producing Enterobacterales in Spain. We detected important epidemiological changes, including increased CP-Kpn and CP-Eco prevalence and incidence compared to previous studies, wide interregional dissemination, and increased dissemination of high-risk clones, such as ST307/OXA-48 and ST512/KPC-3.Frontiers Media2022info:eu-repo/semantics/articleinfo:eu-repo/semantics/publishedVersionapplication/pdfhttps://hdl.handle.net/2445/191256Articles publicats en revistes (Fonaments Clínics)reponame:Dipòsit Digital de la UBinstname:Universidad de BarcelonaInglésReproducció del document publicat a: https://doi.org/10.3389/fmicb.2022.918362Frontiers in Microbiology, 2022, vol. 13, p. 918362https://doi.org/10.3389/fmicb.2022.918362cc-by (c) Cañada García, Javier E. et al., 2022https://creativecommons.org/licenses/by/4.0/info:eu-repo/semantics/openAccessoai:diposit.ub.edu:2445/1912562026-05-27T06:46:51Z
dc.title.none.fl_str_mv	CARB-ES-19 Multicenter Study of Carbapenemase-Producing Klebsiella pneumoniae and Escherichia coli From All Spanish Provinces Reveals Interregional Spread of High-Risk Clones Such as ST307/OXA-48 and ST512/KPC-3.
title	CARB-ES-19 Multicenter Study of Carbapenemase-Producing Klebsiella pneumoniae and Escherichia coli From All Spanish Provinces Reveals Interregional Spread of High-Risk Clones Such as ST307/OXA-48 and ST512/KPC-3.
spellingShingle	CARB-ES-19 Multicenter Study of Carbapenemase-Producing Klebsiella pneumoniae and Escherichia coli From All Spanish Provinces Reveals Interregional Spread of High-Risk Clones Such as ST307/OXA-48 and ST512/KPC-3. Cañada García, Javier E. Antibiòtics betalactàmics Klebsiella pneumoniae Escheríchia coli Genoma humà Enterobacteriàcies Beta lactam antibiotics Klebsiella pneumoniae Escherichia coli Human genome Enterobacteriaceae
title_short	CARB-ES-19 Multicenter Study of Carbapenemase-Producing Klebsiella pneumoniae and Escherichia coli From All Spanish Provinces Reveals Interregional Spread of High-Risk Clones Such as ST307/OXA-48 and ST512/KPC-3.
title_full	CARB-ES-19 Multicenter Study of Carbapenemase-Producing Klebsiella pneumoniae and Escherichia coli From All Spanish Provinces Reveals Interregional Spread of High-Risk Clones Such as ST307/OXA-48 and ST512/KPC-3.
title_fullStr	CARB-ES-19 Multicenter Study of Carbapenemase-Producing Klebsiella pneumoniae and Escherichia coli From All Spanish Provinces Reveals Interregional Spread of High-Risk Clones Such as ST307/OXA-48 and ST512/KPC-3.
title_full_unstemmed	CARB-ES-19 Multicenter Study of Carbapenemase-Producing Klebsiella pneumoniae and Escherichia coli From All Spanish Provinces Reveals Interregional Spread of High-Risk Clones Such as ST307/OXA-48 and ST512/KPC-3.
title_sort	CARB-ES-19 Multicenter Study of Carbapenemase-Producing Klebsiella pneumoniae and Escherichia coli From All Spanish Provinces Reveals Interregional Spread of High-Risk Clones Such as ST307/OXA-48 and ST512/KPC-3.
dc.creator.none.fl_str_mv	Cañada García, Javier E. Moure, Zaira Sola Campoy, Pedro J. Delgado Valverde, Mercedes Cano, María E. Gijón Cordero, Desirée González, Mónica Gracia Ahufinger, Irene Larrosa, Nieves Mulet, Xavier Pitart, Cristina Rivera, Alba Bou, Germán Calvo, Jorge Cantón, Rafael González-López, Juan José Martínez-Martínez, Luis Navarro, Ferran Oliver, Antonio Palacios Baena, Zaira R. Pascual, Alvaro Ruiz Carrascoso, Guillermo Vila Estapé, Jordi Aracil, Belén Pérez-Vázquez, María Oteo Iglesias, Jesús GEMARA/GEIRAS-SEIMC/REIPI CARB-ES-19 Study Group
author	Cañada García, Javier E.
author_facet	Cañada García, Javier E. Moure, Zaira Sola Campoy, Pedro J. Delgado Valverde, Mercedes Cano, María E. Gijón Cordero, Desirée González, Mónica Gracia Ahufinger, Irene Larrosa, Nieves Mulet, Xavier Pitart, Cristina Rivera, Alba Bou, Germán Calvo, Jorge Cantón, Rafael González-López, Juan José Martínez-Martínez, Luis Navarro, Ferran Oliver, Antonio Palacios Baena, Zaira R. Pascual, Alvaro Ruiz Carrascoso, Guillermo Vila Estapé, Jordi Aracil, Belén Pérez-Vázquez, María Oteo Iglesias, Jesús GEMARA/GEIRAS-SEIMC/REIPI CARB-ES-19 Study Group
author_role	author
author2	Moure, Zaira Sola Campoy, Pedro J. Delgado Valverde, Mercedes Cano, María E. Gijón Cordero, Desirée González, Mónica Gracia Ahufinger, Irene Larrosa, Nieves Mulet, Xavier Pitart, Cristina Rivera, Alba Bou, Germán Calvo, Jorge Cantón, Rafael González-López, Juan José Martínez-Martínez, Luis Navarro, Ferran Oliver, Antonio Palacios Baena, Zaira R. Pascual, Alvaro Ruiz Carrascoso, Guillermo Vila Estapé, Jordi Aracil, Belén Pérez-Vázquez, María Oteo Iglesias, Jesús GEMARA/GEIRAS-SEIMC/REIPI CARB-ES-19 Study Group
author2_role	author author author author author author author author author author author author author author author author author author author author author author author author author author
dc.subject.none.fl_str_mv	Antibiòtics betalactàmics Klebsiella pneumoniae Escheríchia coli Genoma humà Enterobacteriàcies Beta lactam antibiotics Klebsiella pneumoniae Escherichia coli Human genome Enterobacteriaceae
topic	Antibiòtics betalactàmics Klebsiella pneumoniae Escheríchia coli Genoma humà Enterobacteriàcies Beta lactam antibiotics Klebsiella pneumoniae Escherichia coli Human genome Enterobacteriaceae
description	CARB-ES-19 is a comprehensive, multicenter, nationwide study integrating whole-genome sequencing (WGS) in the surveillance of carbapenemase-producing K. pneumoniae (CP-Kpn) and E. coli (CP-Eco) to determine their incidence, geographical distribution, phylogeny, and resistance mechanisms in Spain. Methods: In total, 71 hospitals, representing all 50 Spanish provinces, collected the first 10 isolates per hospital (February to May 2019); CPE isolates were first identified according to EUCAST (meropenem MIC > 0.12 mg/L with immunochromatography, colorimetric tests, carbapenem inactivation, or carbapenem hydrolysis with MALDI-TOF). Prevalence and incidence were calculated according to population denominators. Antibiotic susceptibility testing was performed using the microdilution method (EUCAST). All 403 isolates collected were sequenced for high-resolution single-nucleotide polymorphism (SNP) typing, core genome multilocus sequence typing (cgMLST), and resistome analysis. Results: In total, 377 (93.5%) CP-Kpn and 26 (6.5%) CP-Eco isolates were collected from 62 (87.3%) hospitals in 46 (92%) provinces. CP-Kpn was more prevalent in the blood (5.8%, 50/853) than in the urine (1.4%, 201/14,464). The cumulative incidence for both CP-Kpn and CP-Eco was 0.05 per 100 admitted patients. The main carbapenemase genes identified in CP-Kpn were bla OXA-48 (263/377), bla KPC-3 (62/377), bla VIM-1 (28/377), and bla NDM-1 (12/377). All isolates were susceptible to at least two antibiotics. Interregional dissemination of eight high-risk CP-Kpn clones was detected, mainly ST307/OXA-48 (16.4%), ST11/OXA-48 (16.4%), and ST512-ST258/KPC (13.8%). ST512/KPC and ST15/OXA-48 were the most frequent bacteremia-causative clones. The average number of acquired resistance genes was higher in CP-Kpn (7.9) than in CP-Eco (5.5). Conclusion: This study serves as a first step toward WGS integration in the surveillance of carbapenemase-producing Enterobacterales in Spain. We detected important epidemiological changes, including increased CP-Kpn and CP-Eco prevalence and incidence compared to previous studies, wide interregional dissemination, and increased dissemination of high-risk clones, such as ST307/OXA-48 and ST512/KPC-3.
publishDate	2022
dc.date.none.fl_str_mv	2022
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/2445/191256
url	https://hdl.handle.net/2445/191256
dc.language.none.fl_str_mv	Inglés
language_invalid_str_mv	Inglés
dc.relation.none.fl_str_mv	Reproducció del document publicat a: https://doi.org/10.3389/fmicb.2022.918362 Frontiers in Microbiology, 2022, vol. 13, p. 918362 https://doi.org/10.3389/fmicb.2022.918362
dc.rights.none.fl_str_mv	cc-by (c) Cañada García, Javier E. et al., 2022 https://creativecommons.org/licenses/by/4.0/ info:eu-repo/semantics/openAccess
rights_invalid_str_mv	cc-by (c) Cañada García, Javier E. et al., 2022 https://creativecommons.org/licenses/by/4.0/
eu_rights_str_mv	openAccess
dc.format.none.fl_str_mv	application/pdf
dc.publisher.none.fl_str_mv	Frontiers Media
publisher.none.fl_str_mv	Frontiers Media
dc.source.none.fl_str_mv	Articles publicats en revistes (Fonaments Clínics) reponame:Dipòsit Digital de la UB instname:Universidad de Barcelona
instname_str	Universidad de Barcelona
reponame_str	Dipòsit Digital de la UB
collection	Dipòsit Digital de la UB
repository.name.fl_str_mv
repository.mail.fl_str_mv
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CARB-ES-19 Multicenter Study of Carbapenemase-Producing Klebsiella pneumoniae and Escherichia coli From All Spanish Provinces Reveals Interregional Spread of High-Risk Clones Such as ST307/OXA-48 and ST512/KPC-3.

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