Prevalence and molecular characterization of carbapenem-resistant Enterobacterales in patients from a public referral hospital in a non-metropolitan region of Brazil during and post the SARS-CoV-2 pandemic
Antimicrobial resistance (AMR) poses a global threat, with carbapenem-resistant Enterobacterales (CRE) representing a significant concern due to limited therapeutic options. This study investigated the prevalence of carbapenemase genes in CRE strains isolated from tracheal aspirates of patients at a...
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| Veröffentlicht in: | Brazilian journal of microbiology 2024-12, Vol.55 (4), p.3873-3884 |
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| creator | Fochat, Romário Costa de Lelis Araújo, Ana Clara Pereira Júnior, Olavo dos Santos Silvério, Marcelo Silva Nassar, Alessandra Figueiredo de Castro Junqueira, Maria de Lourdes Silva, Marcio Roberto Garcia, Patrícia Guedes |
| description | Antimicrobial resistance (AMR) poses a global threat, with carbapenem-resistant Enterobacterales (CRE) representing a significant concern due to limited therapeutic options. This study investigated the prevalence of carbapenemase genes in CRE strains isolated from tracheal aspirates of patients at a Brazilian university hospital between January 2020 and August 2023. Bacterial identification was conducted using MALDI-TOF, while carbapenemase genes were detected by qPCR. Demographic and clinical data were collected, and univariate analysis was performed using the chi-square test (
p
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| doi_str_mv | 10.1007/s42770-024-01531-7 |
| format | Article |
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p
< 0.05). Variables with
p
≤ 0.10 were further investigated using the chi-square test for linear trend, along with stratified analysis. Out of 1,133 samples, 111 (9.79%) showed CRE growth, with 46 isolates included in the final sample, predominantly comprising
Klebsiella pneumoniae
(65.21%) and
Serratia marcescens
(19.57%). The
bla
KPC
gene was prevalent (78.26%), while
bla
NDM
was detected in 21.74% of cases. The identified population was predominantly male (67.39%), elderly (69.57%), white (56.52%), unmarried (63.04%), and had a low level of education (56.52%). Most patients (69.57%) were in the intensive care unit and remained hospitalized for more than 30 days (76.08%). There was a significant inverse trend between
Klebsiella pneumoniae
and age (
p
= 0.045), as well as a direct linear trend between
bla
NDM
and the annual increase in COVID-19 cases in Brazil (
p
= 0.050). A high probability of finding non-
Klebsiella pneumoniae
bacteria was observed in patients with prolonged hospital stays, independent of COVID-19 (
p
= 0.006) and the type of resistance genes (
p
= 0.020). The persistent prevalence of CRE, especially with
bla
KPC
, underscores the urgency of effective control measures.</description><identifier>ISSN: 1517-8382</identifier><identifier>ISSN: 1678-4405</identifier><identifier>EISSN: 1678-4405</identifier><identifier>DOI: 10.1007/s42770-024-01531-7</identifier><identifier>PMID: 39352656</identifier><language>eng</language><publisher>Cham: Springer International Publishing</publisher><subject>Adolescent ; Adult ; Aged ; Aged, 80 and over ; Anti-Bacterial Agents - pharmacology ; Bacterial Proteins - genetics ; beta-Lactamases - genetics ; Biomedical and Life Sciences ; Brazil - epidemiology ; Carbapenem-Resistant Enterobacteriaceae - drug effects ; Carbapenem-Resistant Enterobacteriaceae - genetics ; Carbapenem-Resistant Enterobacteriaceae - isolation & purification ; Carbapenems - pharmacology ; COVID-19 - epidemiology ; Enterobacteriaceae Infections - epidemiology ; Enterobacteriaceae Infections - microbiology ; Female ; Food Microbiology ; Hospitals, Public ; Humans ; Life Sciences ; Male ; Medical Microbiology ; Medicine and Public Health - Research Paper ; Microbial Ecology ; Microbial Genetics and Genomics ; Microbial Sensitivity Tests ; Microbiology ; Middle Aged ; Mycology ; Prevalence ; SARS-CoV-2 - drug effects ; SARS-CoV-2 - genetics ; Young Adult</subject><ispartof>Brazilian journal of microbiology, 2024-12, Vol.55 (4), p.3873-3884</ispartof><rights>The Author(s) under exclusive licence to Sociedade Brasileira de Microbiologia 2024 Springer Nature or its licensor (e.g. a society or other partner) holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law.</rights><rights>2024. The Author(s) under exclusive licence to Sociedade Brasileira de Microbiologia.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><cites>FETCH-LOGICAL-c228t-ba2d30d4f95d8e298ef8230d9a02e045a5b16ae468b21d63e974e625270fdc073</cites><orcidid>0000-0002-0795-6422</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://link.springer.com/content/pdf/10.1007/s42770-024-01531-7$$EPDF$$P50$$Gspringer$$H</linktopdf><linktohtml>$$Uhttps://link.springer.com/10.1007/s42770-024-01531-7$$EHTML$$P50$$Gspringer$$H</linktohtml><link.rule.ids>314,777,781,27905,27906,41469,42538,51300</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/39352656$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Fochat, Romário Costa</creatorcontrib><creatorcontrib>de Lelis Araújo, Ana Clara</creatorcontrib><creatorcontrib>Pereira Júnior, Olavo dos Santos</creatorcontrib><creatorcontrib>Silvério, Marcelo Silva</creatorcontrib><creatorcontrib>Nassar, Alessandra Figueiredo de Castro</creatorcontrib><creatorcontrib>Junqueira, Maria de Lourdes</creatorcontrib><creatorcontrib>Silva, Marcio Roberto</creatorcontrib><creatorcontrib>Garcia, Patrícia Guedes</creatorcontrib><title>Prevalence and molecular characterization of carbapenem-resistant Enterobacterales in patients from a public referral hospital in a non-metropolitan region of Brazil during and post the SARS-CoV-2 pandemic</title><title>Brazilian journal of microbiology</title><addtitle>Braz J Microbiol</addtitle><addtitle>Braz J Microbiol</addtitle><description>Antimicrobial resistance (AMR) poses a global threat, with carbapenem-resistant Enterobacterales (CRE) representing a significant concern due to limited therapeutic options. This study investigated the prevalence of carbapenemase genes in CRE strains isolated from tracheal aspirates of patients at a Brazilian university hospital between January 2020 and August 2023. Bacterial identification was conducted using MALDI-TOF, while carbapenemase genes were detected by qPCR. Demographic and clinical data were collected, and univariate analysis was performed using the chi-square test (
p
< 0.05). Variables with
p
≤ 0.10 were further investigated using the chi-square test for linear trend, along with stratified analysis. Out of 1,133 samples, 111 (9.79%) showed CRE growth, with 46 isolates included in the final sample, predominantly comprising
Klebsiella pneumoniae
(65.21%) and
Serratia marcescens
(19.57%). The
bla
KPC
gene was prevalent (78.26%), while
bla
NDM
was detected in 21.74% of cases. The identified population was predominantly male (67.39%), elderly (69.57%), white (56.52%), unmarried (63.04%), and had a low level of education (56.52%). Most patients (69.57%) were in the intensive care unit and remained hospitalized for more than 30 days (76.08%). There was a significant inverse trend between
Klebsiella pneumoniae
and age (
p
= 0.045), as well as a direct linear trend between
bla
NDM
and the annual increase in COVID-19 cases in Brazil (
p
= 0.050). A high probability of finding non-
Klebsiella pneumoniae
bacteria was observed in patients with prolonged hospital stays, independent of COVID-19 (
p
= 0.006) and the type of resistance genes (
p
= 0.020). The persistent prevalence of CRE, especially with
bla
KPC
, underscores the urgency of effective control measures.</description><subject>Adolescent</subject><subject>Adult</subject><subject>Aged</subject><subject>Aged, 80 and over</subject><subject>Anti-Bacterial Agents - pharmacology</subject><subject>Bacterial Proteins - genetics</subject><subject>beta-Lactamases - genetics</subject><subject>Biomedical and Life Sciences</subject><subject>Brazil - epidemiology</subject><subject>Carbapenem-Resistant Enterobacteriaceae - drug effects</subject><subject>Carbapenem-Resistant Enterobacteriaceae - genetics</subject><subject>Carbapenem-Resistant Enterobacteriaceae - isolation & purification</subject><subject>Carbapenems - pharmacology</subject><subject>COVID-19 - epidemiology</subject><subject>Enterobacteriaceae Infections - epidemiology</subject><subject>Enterobacteriaceae Infections - microbiology</subject><subject>Female</subject><subject>Food Microbiology</subject><subject>Hospitals, Public</subject><subject>Humans</subject><subject>Life Sciences</subject><subject>Male</subject><subject>Medical Microbiology</subject><subject>Medicine and Public Health - Research Paper</subject><subject>Microbial Ecology</subject><subject>Microbial Genetics and Genomics</subject><subject>Microbial Sensitivity Tests</subject><subject>Microbiology</subject><subject>Middle Aged</subject><subject>Mycology</subject><subject>Prevalence</subject><subject>SARS-CoV-2 - drug effects</subject><subject>SARS-CoV-2 - genetics</subject><subject>Young Adult</subject><issn>1517-8382</issn><issn>1678-4405</issn><issn>1678-4405</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2024</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp9kctu1TAQhiNUREvhBVggL7sx-BLHybIcHS5SJRAFttbEmfS4SuxgO0jtO_JO-Fxgycqj0ff_M56_ql5x9oYzpt-mWmjNKBM1ZVxJTvWT6oI3uqV1zdRZqRXXtJWtOK-ep3TPmFCsFs-qc9lJJRrVXFS_v0T8BRN6iwT8QOYwoV0niMTuIILNGN0jZBc8CSOxEHtY0ONMIyaXMvhMtr5AoT-wxSkR58lSJOhzImMMMwGyrP3kLIk4YiwQ2YW0uFyKwgLxwdMZcwxLmErXF-7uNPFdhEc3kWGNzt8dNlxCyiTvkNxef72lm_CDijLODzg7-6J6OsKU8OXpvay-v99-23ykN58_fNpc31ArRJtpD2KQbKjHTg0tiq7FsRWl0QETyGoFqucNYN20veBDI7HTNTZCCc3GwTItL6uro-8Sw88VUzazSxanCTyGNRnJOW9kVwQFFUfUxpBSOYBZopshPhjOzD5Gc4zRlBjNIUazF70--a_9jMM_yd_cCiCPQFr2h8Fo7sMaffnz_2z_APbwrOc</recordid><startdate>202412</startdate><enddate>202412</enddate><creator>Fochat, Romário Costa</creator><creator>de Lelis Araújo, Ana Clara</creator><creator>Pereira Júnior, Olavo dos Santos</creator><creator>Silvério, Marcelo Silva</creator><creator>Nassar, Alessandra Figueiredo de Castro</creator><creator>Junqueira, Maria de Lourdes</creator><creator>Silva, Marcio Roberto</creator><creator>Garcia, Patrícia Guedes</creator><general>Springer International Publishing</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0002-0795-6422</orcidid></search><sort><creationdate>202412</creationdate><title>Prevalence and molecular characterization of carbapenem-resistant Enterobacterales in patients from a public referral hospital in a non-metropolitan region of Brazil during and post the SARS-CoV-2 pandemic</title><author>Fochat, Romário Costa ; de Lelis Araújo, Ana Clara ; Pereira Júnior, Olavo dos Santos ; Silvério, Marcelo Silva ; Nassar, Alessandra Figueiredo de Castro ; Junqueira, Maria de Lourdes ; Silva, Marcio Roberto ; Garcia, Patrícia Guedes</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c228t-ba2d30d4f95d8e298ef8230d9a02e045a5b16ae468b21d63e974e625270fdc073</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2024</creationdate><topic>Adolescent</topic><topic>Adult</topic><topic>Aged</topic><topic>Aged, 80 and over</topic><topic>Anti-Bacterial Agents - pharmacology</topic><topic>Bacterial Proteins - genetics</topic><topic>beta-Lactamases - genetics</topic><topic>Biomedical and Life Sciences</topic><topic>Brazil - epidemiology</topic><topic>Carbapenem-Resistant Enterobacteriaceae - drug effects</topic><topic>Carbapenem-Resistant Enterobacteriaceae - genetics</topic><topic>Carbapenem-Resistant Enterobacteriaceae - isolation & purification</topic><topic>Carbapenems - pharmacology</topic><topic>COVID-19 - epidemiology</topic><topic>Enterobacteriaceae Infections - epidemiology</topic><topic>Enterobacteriaceae Infections - microbiology</topic><topic>Female</topic><topic>Food Microbiology</topic><topic>Hospitals, Public</topic><topic>Humans</topic><topic>Life Sciences</topic><topic>Male</topic><topic>Medical Microbiology</topic><topic>Medicine and Public Health - Research Paper</topic><topic>Microbial Ecology</topic><topic>Microbial Genetics and Genomics</topic><topic>Microbial Sensitivity Tests</topic><topic>Microbiology</topic><topic>Middle Aged</topic><topic>Mycology</topic><topic>Prevalence</topic><topic>SARS-CoV-2 - drug effects</topic><topic>SARS-CoV-2 - genetics</topic><topic>Young Adult</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Fochat, Romário Costa</creatorcontrib><creatorcontrib>de Lelis Araújo, Ana Clara</creatorcontrib><creatorcontrib>Pereira Júnior, Olavo dos Santos</creatorcontrib><creatorcontrib>Silvério, Marcelo Silva</creatorcontrib><creatorcontrib>Nassar, Alessandra Figueiredo de Castro</creatorcontrib><creatorcontrib>Junqueira, Maria de Lourdes</creatorcontrib><creatorcontrib>Silva, Marcio Roberto</creatorcontrib><creatorcontrib>Garcia, Patrícia Guedes</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Brazilian journal of microbiology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Fochat, Romário Costa</au><au>de Lelis Araújo, Ana Clara</au><au>Pereira Júnior, Olavo dos Santos</au><au>Silvério, Marcelo Silva</au><au>Nassar, Alessandra Figueiredo de Castro</au><au>Junqueira, Maria de Lourdes</au><au>Silva, Marcio Roberto</au><au>Garcia, Patrícia Guedes</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Prevalence and molecular characterization of carbapenem-resistant Enterobacterales in patients from a public referral hospital in a non-metropolitan region of Brazil during and post the SARS-CoV-2 pandemic</atitle><jtitle>Brazilian journal of microbiology</jtitle><stitle>Braz J Microbiol</stitle><addtitle>Braz J Microbiol</addtitle><date>2024-12</date><risdate>2024</risdate><volume>55</volume><issue>4</issue><spage>3873</spage><epage>3884</epage><pages>3873-3884</pages><issn>1517-8382</issn><issn>1678-4405</issn><eissn>1678-4405</eissn><abstract>Antimicrobial resistance (AMR) poses a global threat, with carbapenem-resistant Enterobacterales (CRE) representing a significant concern due to limited therapeutic options. This study investigated the prevalence of carbapenemase genes in CRE strains isolated from tracheal aspirates of patients at a Brazilian university hospital between January 2020 and August 2023. Bacterial identification was conducted using MALDI-TOF, while carbapenemase genes were detected by qPCR. Demographic and clinical data were collected, and univariate analysis was performed using the chi-square test (
p
< 0.05). Variables with
p
≤ 0.10 were further investigated using the chi-square test for linear trend, along with stratified analysis. Out of 1,133 samples, 111 (9.79%) showed CRE growth, with 46 isolates included in the final sample, predominantly comprising
Klebsiella pneumoniae
(65.21%) and
Serratia marcescens
(19.57%). The
bla
KPC
gene was prevalent (78.26%), while
bla
NDM
was detected in 21.74% of cases. The identified population was predominantly male (67.39%), elderly (69.57%), white (56.52%), unmarried (63.04%), and had a low level of education (56.52%). Most patients (69.57%) were in the intensive care unit and remained hospitalized for more than 30 days (76.08%). There was a significant inverse trend between
Klebsiella pneumoniae
and age (
p
= 0.045), as well as a direct linear trend between
bla
NDM
and the annual increase in COVID-19 cases in Brazil (
p
= 0.050). A high probability of finding non-
Klebsiella pneumoniae
bacteria was observed in patients with prolonged hospital stays, independent of COVID-19 (
p
= 0.006) and the type of resistance genes (
p
= 0.020). The persistent prevalence of CRE, especially with
bla
KPC
, underscores the urgency of effective control measures.</abstract><cop>Cham</cop><pub>Springer International Publishing</pub><pmid>39352656</pmid><doi>10.1007/s42770-024-01531-7</doi><tpages>12</tpages><orcidid>https://orcid.org/0000-0002-0795-6422</orcidid></addata></record> |
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| identifier | ISSN: 1517-8382 |
| ispartof | Brazilian journal of microbiology, 2024-12, Vol.55 (4), p.3873-3884 |
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| source | MEDLINE; PubMed Central; SpringerLink Journals - AutoHoldings |
| subjects | Adolescent Adult Aged Aged, 80 and over Anti-Bacterial Agents - pharmacology Bacterial Proteins - genetics beta-Lactamases - genetics Biomedical and Life Sciences Brazil - epidemiology Carbapenem-Resistant Enterobacteriaceae - drug effects Carbapenem-Resistant Enterobacteriaceae - genetics Carbapenem-Resistant Enterobacteriaceae - isolation & purification Carbapenems - pharmacology COVID-19 - epidemiology Enterobacteriaceae Infections - epidemiology Enterobacteriaceae Infections - microbiology Female Food Microbiology Hospitals, Public Humans Life Sciences Male Medical Microbiology Medicine and Public Health - Research Paper Microbial Ecology Microbial Genetics and Genomics Microbial Sensitivity Tests Microbiology Middle Aged Mycology Prevalence SARS-CoV-2 - drug effects SARS-CoV-2 - genetics Young Adult |
| title | Prevalence and molecular characterization of carbapenem-resistant Enterobacterales in patients from a public referral hospital in a non-metropolitan region of Brazil during and post the SARS-CoV-2 pandemic |
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