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. 2024 Apr 6;24(1):378.
doi: 10.1186/s12879-024-09248-6.

Molecular epidemiology of carbapenem-resistant gram-negative bacilli in Ecuador

Claudia Soria-Segarra  1   2   3 , Carmen Soria-Segarra  4   5 , Marcos Molina-Matute  6 , Ivanna Agreda-Orellana  6 , Tamara Núñez-Quezada  7 , Kerly Cevallos-Apolo  8 , Marcela Miranda-Ayala  9 , Grace Salazar-Tamayo  10 , Margarita Galarza-Herrera  11 , Victor Vega-Hall  12 , José E Villacis  13 , José Gutiérrez-Fernández  14   15
Affiliations

Molecular epidemiology of carbapenem-resistant gram-negative bacilli in Ecuador

Claudia Soria-Segarra et al. BMC Infect Dis. .

Abstract

Introduction: Carbapenem-resistant gram-negative bacilli are a worldwide concern because of high morbidity and mortality rates. Additionally, the increasing prevalence of these bacteria is dangerous. To investigate the extent of antimicrobial resistance and prioritize the utility of novel drugs, we evaluated the molecular characteristics and antimicrobial susceptibility profiles of carbapenem-resistant Enterobacterales, Pseudomonas aeruginosa and Acinetobacter baumannii in Ecuador in 2022.

Methods: Ninety-five clinical isolates of carbapenem non-susceptible gram-negative bacilli were collected from six hospitals in Ecuador. Carbapenem resistance was confirmed with meropenem disk diffusion assays following Clinical Laboratory Standard Institute guidelines. Carbapenemase production was tested using a modified carbapenemase inactivation method. Antimicrobial susceptibility was tested with a disk diffusion assay, the Vitek 2 System, and gradient diffusion strips. Broth microdilution assays were used to assess colistin susceptibility. All the isolates were screened for the blaKPC, blaNDM, blaOXA-48, blaVIM and blaIMP genes. In addition, A. baumannii isolates were screened for the blaOXA-23, blaOXA-58 and blaOXA-24/40 genes.

Results: Carbapenemase production was observed in 96.84% of the isolates. The blaKPC, blaNDM and blaOXA-48 genes were detected in Enterobacterales, with blaKPC being predominant. The blaVIM gene was detected in P. aeruginosa, and blaOXA-24/40 predominated in A. baumannii. Most of the isolates showed co-resistance to aminoglycosides, fluoroquinolones, and trimethoprim/sulfamethoxazole. Both ceftazidime/avibactam and meropenem/vaborbactam were active against carbapenem-resistant gram-negative bacilli that produce serin-carbapenemases.

Conclusion: The epidemiology of carbapenem resistance in Ecuador is dominated by carbapenemase-producing K. pneumoniae harbouring blaKPC. Extensively drug resistant (XDR) P. aeruginosa and A. baumannii were identified, and their identification revealed the urgent need to implement strategies to reduce the dissemination of these strains.

Keywords: Carbapenem resistance; Carbapenemase genes; Ecuador; Gram-negative bacilli.

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Conflict of interest statement

The authors declare no competing interests.

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