Alarming increase in hospital outbreaks of carbapenemase-producing Enterobacter cloacae in Southern Spain

Rivera-Izquierdo, M.

doi:10.1016/j.jhin.2023.11.008

Cited by 1 publication

(1 citation statement)

References 8 publications

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“…A recent study has reported a worrying increase in carbapenemase-producing E. cloacae in the south of Spain from 2014 to 2022. 20 However, based on our data we did not observe an increase in the carbapenem resistance percentage. This apparent discrepancy may be due to this increment occurring only in Andalusia, and not in the rest of the country, from where a large proportion of our data was collected.…”

Section: Discussioncontrasting

confidence: 45%

Activity of cefepime, carbapenems and new β-lactam/β-lactamase inhibitor combinations on Enterobacter cloacae complex and Klebsiella aerogenes in Spain (SMART 2016–2022)

Rodríguez-Villodres,

Lepe-Balsalobre,

Ortiz De La Rosa

et al. 2024

JAC-Antimicrobial Resistance

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Objectives To analyse the susceptibility profile to cefepime, carbapenems and new β-lactam/β-lactamase inhibitor combinations in Enterobacter cloacae complex and Klebsiella aerogenes isolated from intra-abdominal, urinary, respiratory and bloodstream infections in the SMART (Study for Monitoring Antimicrobial Resistance Trends) surveillance study in Spain. Methods The susceptibilities of 759 isolates (473 E. cloacae complex and 286 K. aerogenes) collected in 11 Spanish hospitals from 2016 to 2022 were analysed following the EUCAST 2023 criteria. Molecular characterization looking for β-lactamase genes was performed through PCR and DNA sequencing analysis. Results E. cloacae complex showed resistance to third-generation cephalosporins in 25% of the cases, whereas K. aerogenes was resistant in 35%. Regarding cefepime, resistance in E. cloacae was higher (10%) than in K. aerogenes (2%). Carbapenems showed >85% activity in both microorganisms. Ceftazidime/avibactam, imipenem/relebactam and meropenem/vaborbactam had good activity against these microorganisms (>95%). In contrast, the activity of ceftolozane/tazobactam was lower (80%). A high proportion of the isolates resistant to new β-lactam/β-lactamase inhibitor combinations carried a carbapenemase, mainly OXA-48-like and VIM-1. Conclusions Ceftazidime/avibactam, imipenem/relebactam and meropenem/vaborbactam show high activity against both E. cloacae complex and K. aerogenes isolates recovered in the SMART-Spain study. In contrast, differences have been found in the case of cefepime, showing more activity against K. aerogenes than E. cloacae complex. These results are useful for antimicrobial stewardship programmes and for the implementation of local and national guidelines.

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Section: Discussioncontrasting

confidence: 45%