Publication: Colonización por enterobacterias productoras de carbapenamasas durante el proyecto europeo R-GNOSIS: epidemiología, estructura poblacional y caracterización molecular
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2019-06-14
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Universidad Complutense de Madrid
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Abstract
La aparición y diseminación incontrolada de enterobacterias productoras de carbapenemasas (EPC) es uno de los principales problemas de Salud Pública en todo el mundo. Los genes responsables de la producción de carbapenemasas suelen estar asociados a elementos genéticos móviles que facilitan su transferencia entre distintas especies de enterobacterias. Estas enzimas son capaces de hidrolizar casi todos los antibióticos β-lactámicos y, por lo general, se asocian a altas tasas de resistencia a otras familias de antimicrobianos. En España, la incidencia de EPC está alcanzando niveles endémicos en el ámbito nosocomial. En nuestro entorno, las EPC más frecuentes son Klebsiella pneumoniae productora de OXA-48 y VIM. La prevalencia de enterobacterias productoras de KPCy en particular de NDM es menor, aunque está aumentando en algunas regiones. La epidemiología de OXA-48 se ha asociado en gran medida a la expansión global de clones de alto riesgo de K. pneumoniae bien adaptados al medio hospitalario y a la diseminación de plásmidos relacionados con IncL/M-pOXA-48a. Sin embargo,actualmente la diseminación de estos plásmidos portadores de OXA-48 en otras especies de bacterias gram negativas, y particularmente en E. coli, está contribuyendo también a la endemicidad de esta carbapenemasa en el ámbito hospitalario y representa una grave amenaza para la Salud Pública...
The emergence and uncontrolled dissemination of carbapenemase-producing Enterobacteriaceae (CPE) has caused great concern to public healthcare systems worldwide. Genes associated with carbapenemase production are often contained on mobile genetic elements that facilitate transfer among different Enterobacteriaceae species. These enzymes are able to hydrolyze nearly all β-lactam antibiotics and are usually associated with co-resistance to other antimicrobials. In Spain, the incidence of CPE is reaching endemic levels in the nosocomial environment. The most predominant CPE are OXA-48 and VIM-producing Klebsiella pneumoniae. Prevalence of KPC and particularly NDM-producing Enterobacteriaceae is lower but is increasing in certain areas.The epidemiology of OXA-48 has been largely associated with both global expansion of hospital-adapted K. pneumoniae clones and the dissemination of plasmids related to IncL/M-pOXA-48a. Nevertheless, the current spread of OXA-48-encoding plasmids into other Gram-negative bacteria species, particularly E. coli, is also contributing in the endemicity of this carbapenemase in hospital setting and depicts a great public health threat...
The emergence and uncontrolled dissemination of carbapenemase-producing Enterobacteriaceae (CPE) has caused great concern to public healthcare systems worldwide. Genes associated with carbapenemase production are often contained on mobile genetic elements that facilitate transfer among different Enterobacteriaceae species. These enzymes are able to hydrolyze nearly all β-lactam antibiotics and are usually associated with co-resistance to other antimicrobials. In Spain, the incidence of CPE is reaching endemic levels in the nosocomial environment. The most predominant CPE are OXA-48 and VIM-producing Klebsiella pneumoniae. Prevalence of KPC and particularly NDM-producing Enterobacteriaceae is lower but is increasing in certain areas.The epidemiology of OXA-48 has been largely associated with both global expansion of hospital-adapted K. pneumoniae clones and the dissemination of plasmids related to IncL/M-pOXA-48a. Nevertheless, the current spread of OXA-48-encoding plasmids into other Gram-negative bacteria species, particularly E. coli, is also contributing in the endemicity of this carbapenemase in hospital setting and depicts a great public health threat...
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Tesis de la Universidad Complutense de Madrid, Facultad de Farmacia, Departamento de Microbiología y Parasitología, leída el 20-11-2018