Carbapenemase-Producing Enterobacteriaceae in Spain in 2012

Jesús Oteo; David Saez; Verónica Bautista; Sara Fernández-Romero; Juan Manuel Hernández-Molina; María Pérez-Vázquez; Belén Aracil; José Campos

doi:10.1128/AAC.01513-13

DOI: 10.1128/AAC.01513-13

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Fig 1
Yearly evolution (2009–2012) of carbapenemase-producing Enterobacteriaceae in Spain and number of individual hospitals reporting cases to the national surveillance program of the Instituto de Salud Carlos III.

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Table 1

Distribution of carbapenemase-producing Enterobacteriaceae in 2012 in Spain according to the national surveillance program of the Instituto de Salud Carlos III

Species	No. of isolates (%)
Species	With CBP^{^a}	OXA-48 group	VIM group	KPC group	IMP group	NDM group
K. pneumoniae	203 (85.6)	153	40	6	3	1
K. oxytoca	6 (2.5)	0	6	0	0	0
E. cloacae	16 (6.8)	7	6	1	2	0
E. aerogenes	2 (0.8)	2	0	0	0	0
E. coli	4 (1.7)	1	3	0	0	0
S. marcescens	1 (0.4)	0	0	1	0	0
M. morganii	1 (0.4)	0	1	0	0	0
C. freundii	1 (0.4)	0	1	0	0	0
Enterobacter spp.	3 (1.3)	0	3	0	0	0
Total	237	163	60	8	5	1

↵a CBP, carbapenemases.

Table 2

Susceptibility to carbapenem antibiotics in carbapenemase-producing Enterobacteriaceae isolated in Spain (2012)

Carbapenemase type (no. of isolates)	Carbapenem	MIC (μg/ml)			%^{^a}
Carbapenemase type (no. of isolates)	Carbapenem	Range	50%	90%	S	I	R
OXA-48 like (n = 163)	Ertapenem	2–>4	4	>4	0	0	100
	Imipenem	≤1–>8	2	>8	66.3	20.2	13.5
	Meropenem	≤1–>8	4	>8	30	47.9	22.1
VIM-1 (n = 60)	Ertapenem	1–>4	4	>4	0	10	90
	Imipenem	≤1–>8	4	>8	15	55	30
	Meropenem	≤1–>8	8	>8	18.3	40	41.7
IMP-like (n = 5)	Ertapenem	4–>4	>4	>4	0	0	100
	Imipenem	≤1–2	2	2	100	0	0
	Meropenem	2–>8	8	>8	20	60	20
KPC-like (n = 8)	Ertapenem	>4–>4	>4	>4	0	0	100
	Imipenem	4–>8	4	>8	0	75	25
	Meropenem	2–>8	8	>8	25	25	50

↵a S, susceptible isolates according to EUCAST breakpoints; I, intermediate isolates according to EUCAST breakpoints; R, resistant isolates according to EUCAST breakpoints.

Table 3

Distribution of Klebsiella pneumoniae MLST clones producing carbapenemases in Spain in 2012 according to the national surveillance program of the Instituto de Salud Carlos III

ST	Carbapenemase	No. of cases	No. of hospitals	Geographic source(s)
11	OXA-245	76	1	Málaga
	VIM-1	14	6	Madrid, Guadalajara
	OXA-48	12	7	Madrid
	KPC-2	3	3	Madrid, Ciudad Real
	NDM-1	1	1	Alicante
15	VIM-1	15	4	Madrid, Barcelona, Ávila
15	OXA-48	4	2	Madrid, Málaga
405	OXA-48	38	8	Madrid, Barcelona, Guadalajara
16	OXA-48	17	2	Asturias
147	VIM-1	5	1	Alicante
340	VIM-1	5	1	Madrid
437	OXA-245	3	1	Málaga
101	KPC-2	3	2	Madrid
464	IMP-8	3	1	Almeria
846	OXA-48	2	1	Madrid
13	OXA-48	1	1	Barcelona
1235	VIM-1	1	1	Guadalajara