View in EDS PDF Full Text

Description of carbapenemase-producing Enterobacteriaceae isolates in a Spanish tertiary hospital. Epidemiological analysis and clinical impact.

Saved in:
Bibliographic Details
Title: Description of carbapenemase-producing Enterobacteriaceae isolates in a Spanish tertiary hospital. Epidemiological analysis and clinical impact.
Alternate Title: Descripción de los aislamientos de enterobacterias productoras de carbapenemasa en un hospital terciario. Análisis epidemiológico e impacto clínico.
Authors: López-González, Laura1, Viñuela-Prieto, José Manuel1, Rodriguez-Avial, Icíar1, Manzano, Rocío2, Javier Candel, Francisco1,3 fj.candel@gmail.com
Source: Revista Española de Quimioterapia. jun2019, Vol. 32 Issue 3, p254-262. 9p.
Subjects: ENTEROBACTERIACEAE, CARBAPENEMASE, EPIDEMIOLOGY, CARBAPENEMS, ANTI-infective agents, KLEBSIELLA pneumoniae
Abstract (English): Objectives. The aim of the study was to carry out an epidemiological analysis of patients with carbapenemase-producing Enterobacteriaceae (CPE) isolations in our hospital as well as to perform a description of the genotypic temporal evolution of CPE isolated. Material and methods. An observational prospective cohort study was performed involving all patients with CPE isolates from clinical samples during November 2014 to November 2016 in a Spanish teaching hospital. Patients were clinically evaluated and classified either as infected or colonized. Information on the consumption of carbapenems in the hospital during the study period was also analyzed. PCR was used for identification of the carbapenemase genes blaKPC, blaVIM, and blaOXA-48. Results. A total of 301 CPE isolates were obtained (107 in 2014, 89 in 2015 and 105 in 2016). Klebsiella pneumoniae (73.4%) was the most prevalent microorganism. Hundred and seventy (56.7%) of carbapenemases detected were blaOXA-48, 73 (24.3%) were blaKPC and 57 (19%) were blaVIM. In year 2014 KPC was predominant while in 2016 OXA-48 predominated. In 2014 we observed a significant association between the medical wards and the ICU with a higher prevalence of OXA-48 (OR 4.15; P<0.001) and VIM (OR 7.40; P<0.001) in the univariate analysis, in the following years there was no association. Regarding the clinical significance of microbiological results after assessing our patients, 60% of isolates represented infection and 40% behaved as colonizers. One third of hospitalized patients with CPE isolation died within 30 days, regardless of whether they were colonized or infected. Conclusions. We have observed an epidemiological change in the genotypes of our isolates along the study period. A thorough knowledge of the CPE's epidemiological distribution in each hospital is fundamental for optimizing antimicrobial chemotherapy. [ABSTRACT FROM AUTHOR]
Abstract (Spanish): Objetivos. Se realizó un análisis epidemiológico de aquellos pacientes con aislamiento de Enterobacterias portadoras de carbapenemasas (EPC) en un hospital terciario, así como una descripción temporal de los genotipos de dichas EPC. Material y métodos. Estudio de cohortes prospectivo observacional que incluyó todos los aislamientos de EPC obtenidos de muestras clínicas entre noviembre de 2014 y noviembre de 2016 en un hospital universitario. Los pacientes fueron evaluados clínicamente para determinar si el aislamiento era en el contexto de una infección o de una colonización. También se recopiló la información acerca del consumo de carbapenémicos en el hospital durante el periodo de estudio. Se usó la técnica PCR para la identificación de los genes de carbapenemasas blaKPC, blaVIM, and blaOXA-48. Resultados. Se obtuvieron un total de 301 aislamientos de EPC (107 en 2014, 89 en 2015 y 105 en 2016). Klebsiella pneumoniae (73,4%) fue el microorganismo más prevalente. De las carbapenemasas aisladas, 170 (56,7%) correspondieron a blaOXA-48, 73 (24,3%) a blaKPC y 57 (19%) a blaVIM. En el año 2014 KPC fue la predominante mientras que en 2016 lo fue OXA-48. En 2014 la prevalencia de OXA-48 (OR 4,15; P<0,001) y de VIM (OR 7,40; P<0,001) fue significativamente mayor en las áreas médicas y en la UCI en el análisis univariante, sin embargo en los siguientes años no hubo ninguna asociación. Respecto a la significación clínica de los resultados microbiológicos, un 60% de los aislamientos correspondían a una infección y un 40% a una colonización. Un tercio de los pacientes hospitalizados con aislamiento para EPC murieron en los 30 días siguientes al mismo, independientemente de si representaba una colonización o una infección. Conclusiones. Hemos constatado un cambio en el patrón epidemiológico de los genotipos de nuestros aislamientos a lo largo del período de estudio. Un conocimiento pormenorizado de los patrones de distribución epidemiológica de las EPC dentro de cada hospital es fundamental para optimizar la terapéutica antimicrobiana. [ABSTRACT FROM AUTHOR]
Copyright of Revista Española de Quimioterapia is the property of Sociedad Espanola de Quimioterapia and its content may not be copied or emailed to multiple sites without the copyright holder's express written permission. Additionally, content may not be used with any artificial intelligence tools or machine learning technologies. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)
Database: MedicLatina
FullText Links:
  – Type: pdflink
Text:
  Availability: 0
Header DbId: lth
DbLabel: MedicLatina
An: 137112632
AccessLevel: 6
PubType: Academic Journal
PubTypeId: academicJournal
PreciseRelevancyScore: 0
IllustrationInfo
Items – Name: Title
  Label: Title
  Group: Ti
  Data: Description of carbapenemase-producing Enterobacteriaceae isolates in a Spanish tertiary hospital. Epidemiological analysis and clinical impact.
– Name: TitleAlt
  Label: Alternate Title
  Group: TiAlt
  Data: Descripci&#243;n de los aislamientos de enterobacterias productoras de carbapenemasa en un hospital terciario. An&#225;lisis epidemiol&#243;gico e impacto cl&#237;nico.
– Name: Author
  Label: Authors
  Group: Au
  Data: &lt;searchLink fieldCode=&quot;AR&quot; term=&quot;%22L&#243;pez-Gonz&#225;lez%2C+Laura%22&quot;&gt;L&#243;pez-Gonz&#225;lez, Laura&lt;/searchLink&gt;&lt;relatesTo&gt;1&lt;/relatesTo&gt;&lt;br /&gt;&lt;searchLink fieldCode=&quot;AR&quot; term=&quot;%22Vi&#241;uela-Prieto%2C+Jos&#233;+Manuel%22&quot;&gt;Vi&#241;uela-Prieto, Jos&#233; Manuel&lt;/searchLink&gt;&lt;relatesTo&gt;1&lt;/relatesTo&gt;&lt;br /&gt;&lt;searchLink fieldCode=&quot;AR&quot; term=&quot;%22Rodriguez-Avial%2C+Ic&#237;ar%22&quot;&gt;Rodriguez-Avial, Ic&#237;ar&lt;/searchLink&gt;&lt;relatesTo&gt;1&lt;/relatesTo&gt;&lt;br /&gt;&lt;searchLink fieldCode=&quot;AR&quot; term=&quot;%22Manzano%2C+Roc&#237;o%22&quot;&gt;Manzano, Roc&#237;o&lt;/searchLink&gt;&lt;relatesTo&gt;2&lt;/relatesTo&gt;&lt;br /&gt;&lt;searchLink fieldCode=&quot;AR&quot; term=&quot;%22Javier+Candel%2C+Francisco%22&quot;&gt;Javier Candel, Francisco&lt;/searchLink&gt;&lt;relatesTo&gt;1,3&lt;/relatesTo&gt;&lt;i&gt; fj.candel@gmail.com&lt;/i&gt;
– Name: TitleSource
  Label: Source
  Group: Src
  Data: &lt;searchLink fieldCode=&quot;JN&quot; term=&quot;%22Revista+Espa&#241;ola+de+Quimioterapia%22&quot;&gt;Revista Espa&#241;ola de Quimioterapia&lt;/searchLink&gt;. jun2019, Vol. 32 Issue 3, p254-262. 9p.
– Name: Subject
  Label: Subjects
  Group: Su
  Data: &lt;searchLink fieldCode=&quot;DE&quot; term=&quot;%22ENTEROBACTERIACEAE%22&quot;&gt;ENTEROBACTERIACEAE&lt;/searchLink&gt;&lt;br /&gt;&lt;searchLink fieldCode=&quot;DE&quot; term=&quot;%22CARBAPENEMASE%22&quot;&gt;CARBAPENEMASE&lt;/searchLink&gt;&lt;br /&gt;&lt;searchLink fieldCode=&quot;DE&quot; term=&quot;%22EPIDEMIOLOGY%22&quot;&gt;EPIDEMIOLOGY&lt;/searchLink&gt;&lt;br /&gt;&lt;searchLink fieldCode=&quot;DE&quot; term=&quot;%22CARBAPENEMS%22&quot;&gt;CARBAPENEMS&lt;/searchLink&gt;&lt;br /&gt;&lt;searchLink fieldCode=&quot;DE&quot; term=&quot;%22ANTI-infective+agents%22&quot;&gt;ANTI-infective agents&lt;/searchLink&gt;&lt;br /&gt;&lt;searchLink fieldCode=&quot;DE&quot; term=&quot;%22KLEBSIELLA+pneumoniae%22&quot;&gt;KLEBSIELLA pneumoniae&lt;/searchLink&gt;
– Name: Abstract
  Label: Abstract (English)
  Group: Ab
  Data: Objectives. The aim of the study was to carry out an epidemiological analysis of patients with carbapenemase-producing Enterobacteriaceae (CPE) isolations in our hospital as well as to perform a description of the genotypic temporal evolution of CPE isolated. Material and methods. An observational prospective cohort study was performed involving all patients with CPE isolates from clinical samples during November 2014 to November 2016 in a Spanish teaching hospital. Patients were clinically evaluated and classified either as infected or colonized. Information on the consumption of carbapenems in the hospital during the study period was also analyzed. PCR was used for identification of the carbapenemase genes blaKPC, blaVIM, and blaOXA-48. Results. A total of 301 CPE isolates were obtained (107 in 2014, 89 in 2015 and 105 in 2016). Klebsiella pneumoniae (73.4%) was the most prevalent microorganism. Hundred and seventy (56.7%) of carbapenemases detected were blaOXA-48, 73 (24.3%) were blaKPC and 57 (19%) were blaVIM. In year 2014 KPC was predominant while in 2016 OXA-48 predominated. In 2014 we observed a significant association between the medical wards and the ICU with a higher prevalence of OXA-48 (OR 4.15; P&lt;0.001) and VIM (OR 7.40; P&lt;0.001) in the univariate analysis, in the following years there was no association. Regarding the clinical significance of microbiological results after assessing our patients, 60% of isolates represented infection and 40% behaved as colonizers. One third of hospitalized patients with CPE isolation died within 30 days, regardless of whether they were colonized or infected. Conclusions. We have observed an epidemiological change in the genotypes of our isolates along the study period. A thorough knowledge of the CPE&#39;s epidemiological distribution in each hospital is fundamental for optimizing antimicrobial chemotherapy. [ABSTRACT FROM AUTHOR]
– Name: Abstract
  Label: Abstract (Spanish)
  Group: Ab
  Data: Objetivos. Se realiz&#243; un an&#225;lisis epidemiol&#243;gico de aquellos pacientes con aislamiento de Enterobacterias portadoras de carbapenemasas (EPC) en un hospital terciario, as&#237; como una descripci&#243;n temporal de los genotipos de dichas EPC. Material y m&#233;todos. Estudio de cohortes prospectivo observacional que incluy&#243; todos los aislamientos de EPC obtenidos de muestras cl&#237;nicas entre noviembre de 2014 y noviembre de 2016 en un hospital universitario. Los pacientes fueron evaluados cl&#237;nicamente para determinar si el aislamiento era en el contexto de una infecci&#243;n o de una colonizaci&#243;n. Tambi&#233;n se recopil&#243; la informaci&#243;n acerca del consumo de carbapen&#233;micos en el hospital durante el periodo de estudio. Se us&#243; la t&#233;cnica PCR para la identificaci&#243;n de los genes de carbapenemasas blaKPC, blaVIM, and blaOXA-48. Resultados. Se obtuvieron un total de 301 aislamientos de EPC (107 en 2014, 89 en 2015 y 105 en 2016). Klebsiella pneumoniae (73,4%) fue el microorganismo m&#225;s prevalente. De las carbapenemasas aisladas, 170 (56,7%) correspondieron a blaOXA-48, 73 (24,3%) a blaKPC y 57 (19%) a blaVIM. En el a&#241;o 2014 KPC fue la predominante mientras que en 2016 lo fue OXA-48. En 2014 la prevalencia de OXA-48 (OR 4,15; P&lt;0,001) y de VIM (OR 7,40; P&lt;0,001) fue significativamente mayor en las &#225;reas m&#233;dicas y en la UCI en el an&#225;lisis univariante, sin embargo en los siguientes a&#241;os no hubo ninguna asociaci&#243;n. Respecto a la significaci&#243;n cl&#237;nica de los resultados microbiol&#243;gicos, un 60% de los aislamientos correspond&#237;an a una infecci&#243;n y un 40% a una colonizaci&#243;n. Un tercio de los pacientes hospitalizados con aislamiento para EPC murieron en los 30 d&#237;as siguientes al mismo, independientemente de si representaba una colonizaci&#243;n o una infecci&#243;n. Conclusiones. Hemos constatado un cambio en el patr&#243;n epidemiol&#243;gico de los genotipos de nuestros aislamientos a lo largo del per&#237;odo de estudio. Un conocimiento pormenorizado de los patrones de distribuci&#243;n epidemiol&#243;gica de las EPC dentro de cada hospital es fundamental para optimizar la terap&#233;utica antimicrobiana. [ABSTRACT FROM AUTHOR]
– Name: AbstractSuppliedCopyright
  Label:
  Group: Ab
  Data: &lt;i&gt;Copyright of Revista Espa&#241;ola de Quimioterapia is the property of Sociedad Espanola de Quimioterapia and its content may not be copied or emailed to multiple sites without the copyright holder&#39;s express written permission. Additionally, content may not be used with any artificial intelligence tools or machine learning technologies. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract.&lt;/i&gt; (Copyright applies to all Abstracts.)
PLink https://search.ebscohost.com/login.aspx?direct=true&site=eds-live&db=lth&AN=137112632
RecordInfo BibRecord:
  BibEntity:
    Languages:
      – Code: eng
        Text: English
    PhysicalDescription:
      Pagination:
        PageCount: 9
        StartPage: 254
    Subjects:
      – SubjectFull: ENTEROBACTERIACEAE
        Type: general
      – SubjectFull: CARBAPENEMASE
        Type: general
      – SubjectFull: EPIDEMIOLOGY
        Type: general
      – SubjectFull: CARBAPENEMS
        Type: general
      – SubjectFull: ANTI-infective agents
        Type: general
      – SubjectFull: KLEBSIELLA pneumoniae
        Type: general
    Titles:
      – TitleFull: Description of carbapenemase-producing Enterobacteriaceae isolates in a Spanish tertiary hospital. Epidemiological analysis and clinical impact.
        Type: main
  BibRelationships:
    HasContributorRelationships:
      – PersonEntity:
          Name:
            NameFull: López-González, Laura
      – PersonEntity:
          Name:
            NameFull: Viñuela-Prieto, José Manuel
      – PersonEntity:
          Name:
            NameFull: Rodriguez-Avial, Icíar
      – PersonEntity:
          Name:
            NameFull: Manzano, Rocío
      – PersonEntity:
          Name:
            NameFull: Javier Candel, Francisco
    IsPartOfRelationships:
      – BibEntity:
          Dates:
            – D: 01
              M: 06
              Text: jun2019
              Type: published
              Y: 2019
          Identifiers:
            – Type: issn-print
              Value: 02143429
          Numbering:
            – Type: volume
              Value: 32
            – Type: issue
              Value: 3
          Titles:
            – TitleFull: Revista Española de Quimioterapia
              Type: main
ResultId 1