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Article

A Study in a Regional Hospital of a Mid-Sized Spanish City Indicates a Major Increase in Infection/Colonization by Carbapenem-Resistant Bacteria, Coinciding with the COVID-19 Pandemic

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Department of Preventive Medicine and Public Health, Virgen de las Nieves University Hospital & ibs, Granada-Instituto de Investigación Biosanitaria de Granada, Avda. de las Fuerzas Armadas, 2, 18014 Granada, Spain
2
Unidad de Gestión Clínica de Enfermedades Infecciosas y Microbiología Clínica, Hospital Universitario Virgen Macarena & Instituto de Biomedicina de Sevilla (IBIs), Hospital Universitario Virgen Macarena/CSIC/Universidad de Sevilla, 41020 Sevilla, Spain
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Laboratory of Microbiology, Virgen de las Nieves University Hospital. & ibs, Granada-Instituto de Investigación Biosanitaria de Granada, Avda. de las Fuerzas Armadas, 2, 18014 Granada, Spain
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Department of Microbiology, School of Medicine, University of Granada & ibs, Granada-Instituto de Investigación Biosanitaria de Granada, Avda. de la Investigación, 11, 18016 Granada, Spain
*
Author to whom correspondence should be addressed.
Academic Editor: Francesca Andreoni
Antibiotics 2021, 10(9), 1127; https://doi.org/10.3390/antibiotics10091127
Received: 20 July 2021 / Revised: 10 September 2021 / Accepted: 14 September 2021 / Published: 18 September 2021
(This article belongs to the Special Issue Carbapenemase-Producing Enterobacterales)
Bacterial resistance to antibiotics has proven difficult to control over the past few decades. The large group of multidrug-resistant bacteria includes carbapenemase-producing bacteria (CPB), for which limited therapeutic options and infection control measures are available. Furthermore, carbapenemases associate with high-risk clones that are defined by the sequence type (ST) to which each bacterium belongs. The objectives of this cross-sectional and retrospective study were to describe the CPB population isolated in a third-level hospital in Southern Spain between 2015 and 2020 and to establish the relationship between the ST and the epidemiological situation defined by the hospital. CPB were microbiologically studied in all rectal and pharyngeal swabs and clinical samples received between January 2015 and December 2020, characterizing isolates using MicroScan and mass spectrometry. Carbapenemases were detected by PCR and Sanger sequencing, and STs were assigned by multilocus sequence typing (MLST). Isolates were genetically related by pulsed-field gel electrophoresis using Xbal, Spel, or Apal enzymes. The episodes in which each CPB was isolated were recorded and classified as involved or non-involved in an outbreak. There were 320 episodes with CPB during the study period: 18 with K. pneumoniae, 14 with Klebisella oxytoca, 9 with Citrobacter freundii, 11 with Escherichia coli, 46 with Enterobacter cloacae, 70 with Acinetobacter baumannii, and 52 with Pseudomonas aeruginosa. The carbapenemase groups detected were OXA, VIM, KPC, and NDM with various subgroups. Synchronous relationships were notified between episodes of K. pneumoniae and outbreaks for ST15, ST258, ST307, and ST45, but not for the other CPB. There was a major increase in infections with CPB over the years, most notably during 2020, coinciding with the COVID-19 pandemic. This study highlights the usefulness of gene sequencing techniques to control the spread of these microorganisms, especially in healthcare centers. These techniques offer faster results, and a reduction in their cost may make their real-time application more feasible. The combination of epidemiological data with real-time molecular sequencing techniques can provide a major advance in the transmission control of these CPB and in the management of infected patients. Real-time sequencing is essential to increase precision and thereby control outbreaks and target infection prevention measures in a more effective manner. View Full-Text
Keywords: carbapenems resistance; carbapenemases; Gram-negative bacteria; infection; colonization; COVID-19 carbapenems resistance; carbapenemases; Gram-negative bacteria; infection; colonization; COVID-19
MDPI and ACS Style

Cano-Martín, E.; Portillo-Calderón, I.; Pérez-Palacios, P.; Navarro-Marí, J.M.; Fernández-Sierra, M.A.; Gutiérrez-Fernández, J. A Study in a Regional Hospital of a Mid-Sized Spanish City Indicates a Major Increase in Infection/Colonization by Carbapenem-Resistant Bacteria, Coinciding with the COVID-19 Pandemic. Antibiotics 2021, 10, 1127. https://doi.org/10.3390/antibiotics10091127

AMA Style

Cano-Martín E, Portillo-Calderón I, Pérez-Palacios P, Navarro-Marí JM, Fernández-Sierra MA, Gutiérrez-Fernández J. A Study in a Regional Hospital of a Mid-Sized Spanish City Indicates a Major Increase in Infection/Colonization by Carbapenem-Resistant Bacteria, Coinciding with the COVID-19 Pandemic. Antibiotics. 2021; 10(9):1127. https://doi.org/10.3390/antibiotics10091127

Chicago/Turabian Style

Cano-Martín, Estefanía, Inés Portillo-Calderón, Patricia Pérez-Palacios, José María Navarro-Marí, María Amelia Fernández-Sierra, and José Gutiérrez-Fernández. 2021. "A Study in a Regional Hospital of a Mid-Sized Spanish City Indicates a Major Increase in Infection/Colonization by Carbapenem-Resistant Bacteria, Coinciding with the COVID-19 Pandemic" Antibiotics 10, no. 9: 1127. https://doi.org/10.3390/antibiotics10091127

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