Prevalence of carbapenemase production among Enterobacterales with reduced susceptibility to meropenem in patients at Hospital de Clínicas de Porto Alegre (HCPA) between 2019 and 2024.

Antimicrobial resistance (AMR) represents one of the major threats to global public health, particularly in hospital settings. Among the most concerning pathogens are carbapenemase-producing Enterobacterales (CPE), which compromise the effectiveness of last-line antibiotics such as meropenem. This study aimed to analyze the prevalence of carbapenemase production among Enterobacterales classified as resistant or susceptible, increased exposure to meropenem at the Hospital de Clínicas de Porto Alegre (HCPA) between 2019 and 2024. This descriptive, retrospective study was based on laboratory data obtained through a structured query of the microbiology database, without access to clinical or identifiable patient information. Carbapenemase detection was performed using the NG-Test® Carba 5 and high-resolution melting quantitative polymerase chain reaction (HRM-qPCR). Data were anonymized and analyzed using absolute and relative frequencies. Temporal analysis revealed a shift in the carbapenememase profile over the study period, characterized by a progressive decline in KPC-producing isolates in the post-pandemic years and a concomitant increase in NDM-producing Enterobacterales, indicating a significant epidemiological change. This study contributes to understanding the evolving epidemiology of CPE and supports improved surveillance and clinical management strategies in the context of AMR.