Departamento de Microbiologíahttps://hdl.handle.net/10481/237132024-03-29T15:32:28Z2024-03-29T15:32:28ZCARB-ES-19 Multicenter Study of Carbapenemase-Producing Klebsiella pneumonia e and Escherichia coli From All Spanish Provinces Reveals Interregional Spread of High-Risk Clones Such as ST307/OXA-48 and ST512/KPC-3Cañada-García, Javier EMoure, ZairaSola-Campoy, Pedro JDelgado-Valverde, MercedesCano, María EGijón, DesirèeGonzález, MónicaGracia-Ahufinger, IreneLarrosa, NievesMulet, XavierPitart, CristinaRivera, AlbaBou, GermánCalvo, JorgeCantón, RafaelGonzález-López, Juan JoséMartínez-Martínez, LuisNavarro, FerranOliver, AntonioPalacios-Baena, Zaira RPascual, ÁlvaroRuiz-Carrascoso, GuillermoVila, JordiAracil, BelénPérez-Vázquez, MaríaOteo-Iglesias, JesúsGEMARA/GEIRAS-SEIMC/REIPI CARB-ES-19 Study Grouphttps://hdl.handle.net/10481/902102024-03-22T11:38:37ZCARB-ES-19 Multicenter Study of Carbapenemase-Producing Klebsiella pneumonia e and Escherichia coli From All Spanish Provinces Reveals Interregional Spread of High-Risk Clones Such as ST307/OXA-48 and ST512/KPC-3
Cañada-García, Javier E; Moure, Zaira; Sola-Campoy, Pedro J; Delgado-Valverde, Mercedes; Cano, María E; Gijón, Desirèe; González, Mónica; Gracia-Ahufinger, Irene; Larrosa, Nieves; Mulet, Xavier; Pitart, Cristina; Rivera, Alba; Bou, Germán; Calvo, Jorge; Cantón, Rafael; González-López, Juan José; Martínez-Martínez, Luis; Navarro, Ferran; Oliver, Antonio; Palacios-Baena, Zaira R; Pascual, Álvaro; Ruiz-Carrascoso, Guillermo; Vila, Jordi; Aracil, Belén; Pérez-Vázquez, María; Oteo-Iglesias, Jesús; GEMARA/GEIRAS-SEIMC/REIPI CARB-ES-19 Study Group
Objectives: CARB-ES-19 is a comprehensive, multicenter, nationwide study integrating whole-genome sequencing (WGS) in the surveillance of carbapenemase-producing K. pneumoniae (CP-Kpn) and E. coli (CP-Eco) to determine their incidence, geographical distribution, phylogeny, and resistance mechanisms in Spain.
Methods: In total, 71 hospitals, representing all 50 Spanish provinces, collected the first 10 isolates per hospital (February to May 2019); CPE isolates were first identified according to EUCAST (meropenem MIC > 0.12 mg/L with immunochromatography, colorimetric tests, carbapenem inactivation, or carbapenem hydrolysis with MALDI-TOF). Prevalence and incidence were calculated according to population denominators. Antibiotic susceptibility testing was performed using the microdilution method (EUCAST). All 403 isolates collected were sequenced for high-resolution single-nucleotide polymorphism (SNP) typing, core genome multilocus sequence typing (cgMLST), and resistome analysis.
Results: In total, 377 (93.5%) CP-Kpn and 26 (6.5%) CP-Eco isolates were collected from 62 (87.3%) hospitals in 46 (92%) provinces. CP-Kpn was more prevalent in the blood (5.8%, 50/853) than in the urine (1.4%, 201/14,464). The cumulative incidence for both CP-Kpn and CP-Eco was 0.05 per 100 admitted patients. The main carbapenemase genes identified in CP-Kpn were bla OXA-48 (263/377), bla KPC-3 (62/377), bla VIM-1 (28/377), and bla NDM-1 (12/377). All isolates were susceptible to at least two antibiotics. Interregional dissemination of eight high-risk CP-Kpn clones was detected, mainly ST307/OXA-48 (16.4%), ST11/OXA-48 (16.4%), and ST512-ST258/KPC (13.8%). ST512/KPC and ST15/OXA-48 were the most frequent bacteremia-causative clones. The average number of acquired resistance genes was higher in CP-Kpn (7.9) than in CP-Eco (5.5).
Conclusion: This study serves as a first step toward WGS integration in the surveillance of carbapenemase-producing Enterobacterales in Spain. We detected important epidemiological changes, including increased CP-Kpn and CP-Eco prevalence and incidence compared to previous studies, wide interregional dissemination, and increased dissemination of high-risk clones, such as ST307/OXA-48 and ST512/KPC-3.
This research was supported by grants from the Instituto
de Salud Carlos III (numbers PI18CIII/00030 and
PI21CIII/00039). It was also supported by Plan Nacional
de I + D + i 2013–2016, Instituto de Salud Carlos III,
Subdirección General de Redes y Centros de Investigación
Cooperativa, Ministerio de Economía y Competitividad,
Spanish Network for Research in Infectious Diseases (grants
RD16CIII/0004/0002, RD16/0016/0001, RD16/0016/0003,
RD16/0016/0004, RD16/0016/0006, RD16/0016/0007,
RD16/0016/0008, RD16/0016/0010, and RD16/0016/0011).
Cofinanced by the European Development Regional Fund “A way
to achieve Europe,” Operative Program Intelligent Growth 2014–
2020. CIBER – Consorcio Centro de Investigación Biomédica
en Red (CB21/13/00095, CB21/13/00012, CB21/13/00049,
CB21/13/00054, CB21/13/00055, CB21/13/00068, CB21/13/00081,
CB21/13/00084, and CB21/13/00099) (CIBERINFEC) and
Instituto de Salud Carlos III, Ministerio de Ciencia e
Innovación and Unión Europea – NextGenerationEU also
supported this work.
Comparison between urine culture profile and morphology classification using fluorescence parameters of the Sysmex UF-1000i urine flow cytometerJiménez-Guerra, GemmaHeras-Cañas, VíctorValera-Arcas, M.D.Rodríguez-Granger, JavierNavarro, J.M.Gutiérrez Fernández, Joséhttps://hdl.handle.net/10481/902052024-03-22T11:09:25ZComparison between urine culture profile and morphology classification using fluorescence parameters of the Sysmex UF-1000i urine flow cytometer
Jiménez-Guerra, Gemma; Heras-Cañas, Víctor; Valera-Arcas, M.D.; Rodríguez-Granger, Javier; Navarro, J.M.; Gutiérrez Fernández, José
Aims: To determine the usefulness of the fluorescence parameters generated by Sysmex UF-1000i flow cytometer for the rapid diagnosis of urinary tract infection by bacilli or cocci.
Methods and results: Urine samples (n = 1924) were studied by culture and microbiology and subsequently by cytometry, using BACT-Morph software and considering forward-scattered light (FSC) and fluorescent light scatter fluorescence parameters. BACT-Morph software showed moderate diagnostic accuracy (78·4%) to detect rod-shaped bacteria, with sensitivity of 82·4% and specificity of 62·5%. Forward-scattered (B_FSC) values of the bacterial channel were significant higher for the Gram-positive cocci category (P < 0·001). A cut-off of B_FSC ≥24·2, expressed in arbitrary units (analytical channel, ch), provided higher sensitivity (90·0%) but lower specificity (38·9%), and the diagnostic accuracy for Gram-positive cocci classification reached 62·0%.
Conclusions: Utilization of BACT-Morph software and bacterial channel fluorescence parameters (B_FSC ≥24·2 ch) offered an approximate discrimination of bacilli and cocci but the specificity was low, especially for FSC.
Significance and impact of the study: Further research is needed to establish the usefulness of flow cytometry for aetiological diagnosis.
Streptococcus agalactiae: prevention and vaccine developmentPuertas-Prieto, A.Lara-Oya, A.Liébana Martos, C.Rodríguez-Granger, J.Cobo, F.Sampedro, A.Padilla, A.Gutiérrez Fernández, JoséManzanares-Galán, S.Cueto-López, M.Rosa-Fraile, M.Navarro-Mari, J.M.https://hdl.handle.net/10481/902032024-03-22T11:02:49ZStreptococcus agalactiae: prevention and vaccine development
Puertas-Prieto, A.; Lara-Oya, A.; Liébana Martos, C.; Rodríguez-Granger, J.; Cobo, F.; Sampedro, A.; Padilla, A.; Gutiérrez Fernández, José; Manzanares-Galán, S.; Cueto-López, M.; Rosa-Fraile, M.; Navarro-Mari, J.M.
Streptococcus agalactiae, group B Streptococcus (SGB), is the most important cause of morbi-mortality among newborn population, and an important pathogen among immunossupressed adult patients. Despite the advances in the treatment and prevention of neonatal infections as a consequence of implementation of national and international recommendations for prevention of infection, there are still some improvements for the final control of the disease. In this sense, the vaccination against SGB could be an effective measure for the prevention of disease in those cases where intrapartum prophylaxis is not useful and in adult patients with risk factors for invasive infection due to SGB. This review summarizes the efforts made until now in order to establish the control of the infection, and brings some information on the current state-of-the art of vaccines against SGB, in which different strategies in their design have been used.; Streptococcus agalactiae, estreptococo del grupo B (EGB),
es la mayor causa de morbi-mortalidad entre los neonatos y
un patógeno importante entre los pacientes adultos inmuno deprimidos. A pesar de los avances en la prevención y trata miento de la infección neonatal, fruto de la implantación de
las recomendaciones nacionales e internacionales que en las
últimas dos décadas se han desarrollado para ello, aún quedan
pendientes mejoras para el control definitivo de la enferme dad. En este sentido, la vacunación frente a EGB podría ser una
medida eficaz para la prevención de la infección en aquellos
casos donde la profilaxis intraparto no es útil y en pacientes
adultos con factores de riesgo de desarrollar infección invasi va por EGB. Esta revisión resume los esfuerzos llevados a cabo
para controlar esta infección y aporta información sobre el es tado actual de las vacunas frente a EGB empleando diferentes
estrategias en su diseño
Infección emergente por Moraxella osloensis. A propósito de la infección genitalGómez-Camarasa, CristinaFernández Parra, JorgeNavarro Marí, José MaríaGutiérrez Fernández, Joséhttps://hdl.handle.net/10481/902002024-03-22T10:59:27ZInfección emergente por Moraxella osloensis. A propósito de la infección genital
Gómez-Camarasa, Cristina; Fernández Parra, Jorge; Navarro Marí, José María; Gutiérrez Fernández, José
Staphylococcus aureus Nasal Colonization in Spanish Children. The COSACO Nationwide Surveillance StudyDel Rosal, TeresaMéndez-Echevarría, AnaGarcia-Vera, CésarEscosa-Garcia, LuisAgud, MartinChaves, FernandoRomán, FedericoGutiérrez Fernández, JoséRuiz de Gopegui, EnriqueRuiz-Carrascoso, GuillermoRuiz-Gallego, Maria Del CarmenBernet, AlbertQuevedo, Sara MariaFernández-Verdugo, Ana MariaDíez-Sebastian, JesúsCalvo, CritinaCOSACO Study Grouphttps://hdl.handle.net/10481/901992024-03-22T10:56:02ZStaphylococcus aureus Nasal Colonization in Spanish Children. The COSACO Nationwide Surveillance Study
Del Rosal, Teresa; Méndez-Echevarría, Ana; Garcia-Vera, César; Escosa-Garcia, Luis; Agud, Martin; Chaves, Fernando; Román, Federico; Gutiérrez Fernández, José; Ruiz de Gopegui, Enrique; Ruiz-Carrascoso, Guillermo; Ruiz-Gallego, Maria Del Carmen; Bernet, Albert; Quevedo, Sara Maria; Fernández-Verdugo, Ana Maria; Díez-Sebastian, Jesús; Calvo, Critina; COSACO Study Group
Objective: To assess the prevalence and risk factors for S. aureus and methicillin-resistant S. aureus (MRSA) nasal colonization in Spanish children.
Methods: Cross-sectional study of patients <14 years from primary care centers all over Spain. Clinical data and nasal aspirates were collected from March to July 2018.
Results: A total of 1876 patients were enrolled. Prevalence of S. aureus and MRSA colonization were 33% (95% CI 30.9-35.1) and 1.44% (95% CI 0.9-2), respectively. Thirty-three percent of the children (633/1876) presented chronic conditions, mainly atopic dermatitis, asthma and/or allergy (524/633). Factors associated with S. aureus colonization were age ≥5 years (OR 1.10, 95% CI 1.07-1.12), male sex (OR 1.43, 95% CI 1.17-1.76), urban setting (OR 1.46, 95% CI 1.08-1.97) and the presence of asthma, atopic dermatitis or allergies (OR 1.25; 95% CI: 1.093-1.43). Rural residence was the only factor associated with MRSA colonization (OR 3.62, 95% CI 1.57-8.36). MRSA was more frequently resistant than methicillin-susceptible S. aureus to ciprofloxacin [41.2% vs 2.6%; p<0.0001], clindamycin [26% vs 16.9%; p=0.39], and mupirocin [14.3% vs 6.7%; p=0.18]. None of the MRSA strains was resistant to tetracycline, fosfomycin, vancomycin or daptomycin.
Conclusions: The main risk factors for S. aureus colonization in Spanish children are being above five years of age, male gender, atopic dermatitis, asthma or allergy, and residence in urban areas. MRSA colonization is low, but higher than in other European countries and is associated with rural settings.