Pseudomonas aeruginosa antibiotic susceptibility profiles, genomic epidemiology and resistance mechanisms : a nation-wide five-year time lapse analysis
Quesada, Maria Dolores (Institut Germans Trias i Pujol. Hospital Universitari Germans Trias i Pujol)
Wang, Yun Hao (Institut Germans Trias i Pujol. Hospital Universitari Germans Trias i Pujol)
Pitart, Cristina (Hospital Clínic i Provincial de Barcelona)
Marco, Francesc (Hospital Clínic i Provincial de Barcelona)
Prim, Núria (Hospital del Mar (Barcelona, Catalunya))
Horcajada, Juan Pablo (Hospital del Mar (Barcelona, Catalunya))
Padilla, Eduardo (Hospital del Mar (Barcelona, Catalunya))
del Barrio-Tofiño, Ester (Hospital Universitari Vall d'Hebron)
Viñado, Belén (Hospital Universitari Vall d'Hebron)
Larrosa, María Nieves (Hospital Universitari Vall d'Hebron)
Tubau, Fe (Hospital Universitari de Bellvitge)
Capilla, Silvia (Parc Taulí Hospital Universitari. Institut d'Investigació i Innovació Parc Taulí (I3PT))
Casabella Pernas, Antonio (Parc Taulí Hospital Universitari. Institut d'Investigació i Innovació Parc Taulí (I3PT))
Rivera, Alba (Institut d'Investigació Biomèdica Sant Pau)
Navarro Risueño, Ferran (Institut d'Investigació Biomèdica Sant Pau)
Universitat Autònoma de Barcelona

Date:	2023
Description:	13 pàg.
Abstract:	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. 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). 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). 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. MSD and the Instituto de Salud Carlos III, Ministerio de Ciencia e Innovación and Unión Europea- NextGenerationEU.
Rights:	Aquest document està subjecte a una llicència d'ús Creative Commons. Es permet la reproducció total o parcial, la distribució, i la comunicació pública de l'obra, sempre que no sigui amb finalitats comercials, i sempre que es reconegui l'autoria de l'obra original. No es permet la creació d'obres derivades.
Language:	Anglès
Document:	Article ; recerca ; Versió publicada
Subject:	COVID-19 ; Electronic health records ; PASC ; Post-acute sequelae of SARS-CoV-2 ; SARS-CoV-2
Published in:	The Lancet Regional Health - Europe, Vol. 34 (2023) , p. 100736, ISSN 2666-7762

DOI: 10.1016/j.lanepe.2023.100736
PMID: 37753216

13 p, 2.1 MB

The record appears in these collections:
Research literature > UAB research groups literature > Research Centres and Groups (research output) > Health sciences and biosciences > Institut d'Investigació en Ciencies de la Salut Germans Trias i Pujol (IGTP)
Research literature > UAB research groups literature > Research Centres and Groups (research output) > Health sciences and biosciences > Parc Taulí Research and Innovation Institute (I3PT
Research literature > UAB research groups literature > Research Centres and Groups (research output) > Health sciences and biosciences > Institut de Recerca Sant Pau
Articles > Research articles
Articles > Published articles