Please use this identifier to cite or link to this item:http://hdl.handle.net/20.500.12105/16535
Title
Pseudomonas aeruginosa antibiotic susceptibility profiles, genomic epidemiology and resistance mechanisms: a nation-wide five-year time lapse analysis
Author(s)
Sastre-Femenia, Miquel Àngel | Fernández-Muñoz, Almudena | Gomis-Font, María Antonia | Taltavull, Biel | López-Causapé, Carla | Arca-Suárez, Jorge | Martínez-Martínez, Luis | Cantón, Rafael | Larrosa, Nieves | Oteo-Iglesias, Jesus ISCIII | Zamorano, Laura | Oliver, Antonio | GEMARA-SEIMC/CIBERINFEC Pseudomonas study Group
Date issued
2023-11
Citation
Lancet Reg Health Eur. 2023 Nov;34:100736.
Language
Inglés
Document type
research article
Abstract
Background: Pseudomonas aeruginosa healthcare-associated infections are one of the top antimicrobial resistance threats world-wide. In order to analyze the current trends, we performed a Spanish nation-wide high-resolution analysis of the susceptibility profiles, the genomic epidemiology and the resistome of P. aeruginosa over a five-year time lapse. Methods: A total of 3.180 nonduplicated P. aeruginosa clinical isolates from two Spanish nation-wide surveys performed in October 2017 and 2022 were analyzed. MICs of 13 antipseudomonals were determined by ISO-EUCAST. Multidrug resistance (MDR)/extensively drug resistance (XDR)/difficult to treat resistance (DTR)/pandrug resistance (PDR) profiles were defined following established criteria. All XDR/DTR isolates were subjected to whole genome sequencing (WGS). Findings: A decrease in resistance to all tested antibiotics, including older and newer antimicrobials, was observed in 2022 vs 2017. Likewise, a major reduction of XDR (15.2% vs 5.9%) and DTR (4.2 vs 2.1%) profiles was evidenced, and even more patent among ICU isolates [XDR (26.0% vs 6.0%) and DTR (8.9% vs 2.6%)] (p < 0.001). The prevalence of Extended-spectrum β-lactamase/carbapenemase production was slightly lower in 2022 (2.1%. vs 3.1%, p = 0.064). However, there was a significant increase in the proportion of carbapenemase production among carbapenem-resistant strains (29.4% vs 18.1%, p = 0.0246). While ST175 was still the most frequent clone among XDR, a slight reduction in its prevalence was noted (35.9% vs 45.5%, p = 0.106) as opposed to ST235 which increased significantly (24.3% vs 12.3%, p = 0.0062). Interpretation: While the generalized decrease in P. aeruginosa resistance, linked to a major reduction in the prevalence of XDR strains, is encouraging, the negative counterpart is the increase in the proportion of XDR strains producing carbapenemases, associated to the significant advance of the concerning world-wide disseminated hypervirulent high-risk clone ST235. Continued high-resolution surveillance, integrating phenotypic and genomic data, is necessary for understanding resistance trends and analyzing the impact of national plans on antimicrobial resistance.
Subject
Online version
DOI
Collections
- Investigación > IIS > IdisBa - Instituto de Investigación Sanitaria Illes Balears (Baleares)
- Investigación > IIS > IMIBIC - Instituto Maimónides de Investigación Biomédica de Córdoba (Andalucía)
- Investigación > ISCIII > Centro Nacional de Microbiología (CNM)
- Investigación > IIS > INIBIC - Instituto de Investigación Biomédica A Coruña (Galicia)
- Investigación > IIS > IR-HUVH - Instituto de Investigación Hospital Universitari Vall d’Hebron (Cataluña)
- Investigación > IIS > IRYCIS - Instituto Ramón y Cajal de Investigación Sanitaria (Madrid)
Files in this item
- Name:
- TableS1_PseudomonasAeruginosaA ...
- Size:
- 305.6Kb
- Format:
- Description:
- Supplementary material 1
- Name:
- TableS2_PseudomonasAeruginosaA ...
- Size:
- 321.0Kb
- Format:
- Microsoft Excel 2007
- Description:
- Supplementary material 2
- Name:
- TableS3_PseudomonasAeruginosaA ...
- Size:
- 324.3Kb
- Format:
- Description:
- Supplementary material 3
- Name:
- Figures_PseudomonasAeruginosaA ...
- Size:
- 1.411Mb
- Format:
- Description:
- Supplementary material 4