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Enterobacterales carrying chromosomal AmpC β-lactamases in Europe (EuESCPM): Epidemiology and antimicrobial resistance burden from a cohort of 27 hospitals, 2020-2022.
- Source :
-
International journal of antimicrobial agents [Int J Antimicrob Agents] 2024 May; Vol. 63 (5), pp. 107115. Date of Electronic Publication: 2024 Feb 16. - Publication Year :
- 2024
-
Abstract
- Introduction: The ESCPM group (Enterobacter species including Klebsiella aerogenes - formerly Enterobacter aerogenes, Serratia species, Citrobacter freundii complex, Providencia species and Morganella morganii) has not yet been incorporated into systematic surveillance programs.<br />Methods: We conducted a multicentre retrospective observational study analysing all ESCPM strains isolated from blood cultures in 27 European hospitals over a 3-year period (2020-2022). Diagnostic approach, epidemiology, and antimicrobial susceptibility were investigated.<br />Results: Our study comprised 6,774 ESCPM isolates. MALDI-TOF coupled to mass spectrometry was the predominant technique for bacterial identification. Susceptibility to new β-lactam/β-lactamase inhibitor combinations and confirmation of AmpC overproduction were routinely tested in 33.3% and 29.6% of the centres, respectively. The most prevalent species were E. cloacae complex (44.8%) and S. marcescens (22.7%). Overall, third-generation cephalosporins (3GC), combined third- and fourth-generation cephalosporins (3GC + 4GC) and carbapenems resistance phenotypes were observed in 15.7%, 4.6%, and 9.5% of the isolates, respectively. AmpC overproduction was the most prevalent resistance mechanism detected (15.8%). Among carbapenemase-producers, carbapenemase type was provided in 44.4% of the isolates, VIM- (22.9%) and OXA-48-enzyme (16%) being the most frequently detected. E. cloacae complex, K. aerogenes and Providencia species exhibited the most notable cumulative antimicrobial resistance profiles, with the former displaying 3GC, combined 3GC + 4GC and carbapenems resistance phenotypes in 15.2%, 7.4%, and 12.8% of the isolates, respectively. K. aerogenes showed the highest rate of both 3GC resistant phenotype (29.8%) and AmpC overproduction (32.1%), while Providencia species those of both carbapenems resistance phenotype (42.7%) and carbapenemase production (29.4%). ESCPM isolates exhibiting both 3GC and combined 3GC + 4GC resistance phenotypes displayed high susceptibility to ceftazidime/avibactam (98.2% and 95.7%, respectively) and colistin (90.3% and 90.7%, respectively). Colistin emerged as the most active drug against ESCPM species (except those intrinsically resistant) displaying both carbapenems resistance phenotype (85.8%) and carbapenemase production (97.8%).<br />Conclusions: This study presented a current analysis of ESCPM species epidemiology in Europe, providing insights to inform current antibiotic treatments and guide strategies for antimicrobial stewardship and diagnostics.<br /> (Copyright © 2024 The Author(s). Published by Elsevier Ltd.. All rights reserved.)
- Subjects :
- Humans
Europe epidemiology
Retrospective Studies
Hospitals
beta-Lactamase Inhibitors pharmacology
Drug Resistance, Multiple, Bacterial
Bacterial Proteins genetics
Bacterial Proteins metabolism
beta-Lactamases genetics
beta-Lactamases metabolism
Enterobacteriaceae Infections microbiology
Enterobacteriaceae Infections epidemiology
Enterobacteriaceae Infections drug therapy
Anti-Bacterial Agents pharmacology
Microbial Sensitivity Tests
Enterobacteriaceae drug effects
Enterobacteriaceae genetics
Enterobacteriaceae enzymology
Enterobacteriaceae isolation & purification
Subjects
Details
- Language :
- English
- ISSN :
- 1872-7913
- Volume :
- 63
- Issue :
- 5
- Database :
- MEDLINE
- Journal :
- International journal of antimicrobial agents
- Publication Type :
- Academic Journal
- Accession number :
- 38367844
- Full Text :
- https://doi.org/10.1016/j.ijantimicag.2024.107115