Carbapenemases producing gram-negative bacteria surveillance in Latin America and the caribbean: a retrospective observational study from 2015 to 2020.

Abstract

The rise of multidrug-resistant (MDR) bacteria represents a public health threat, with carbapenem resistance exacerbating this challenge. This study investigates carbapenemase-producing bacteria (CPB) across the Latin America and the Caribbean (LAC) region. A retrospective observational study was conducted across 12 LAC countries from 2015 to 2020. A total of 58,909 isolates were analyzed utilizing polymerase chain reaction (PCR) to detect key carbapenemases in Enterobacterales, <i>Pseudomonas aeruginosa</i>, and <i>Acinetobacter baumannii</i> complex (ABC). 47,804/58,909 (81.14%) carbapenemases were identified, with Brazil accounting for 73% of these. The majority were reported in carbapenem-resistant Enterobacterales-CRE (65.33%; 31,230/47,804), followed by carbapenem-resistant ABC-CRAB (22.05%; 10,542/47,804), and carbapenem-resistant <i>P. aeruginosa</i>-CRPA (6050/47,804; 12.66%). Among CRE, <i>bla</i> _KPC was the most detected gene (78.67%; 24,569/31,230), with <i>Klebsiella pneumoniae</i> being the most commonly associated species (75.9%). A relevant upward trend in <i>bla</i> _NDM was observed. CRPA exhibited diverse profiles, with <i>bla</i> _VIM (47.64%) being the most common. In CRAB, <i>bla</i> _OXA-23 was found in 88.80% (9361/10,542) of isolates. Carbapenemase co-production was detected in 2.60% (1190/47,804) of isolates, with CRPA <i>bla</i> _IMP + <i>bla</i> _VIM being the most frequent. This study highlights a high prevalence of CPB in LAC, with a stable trend in <i>bla</i> _KPC but a rising trend in <i>bla</i> _NDM. These findings underscore the urgent need for strengthened surveillance and public health interventions to combat carbapenemase-mediated resistance in the region. None.