Dynamics and characterization of carbapenemase-producing Enterobacterales isolated from clinical specimens in a private healthcare center in Lima, Peru, from 2018 to 2019.

INTRODUCTION

Antimicrobial resistance is a major and growing concern worldwide. The study aimed to describe the occurrence and characterize the antimicrobial resistance profile of carbapenemase-producing Enterobacterales (CPE) isolated from clinical specimens at a private healthcare center in Lima, Peru, between January 2018 and December 2019.

METHODOLOGY: A total of 59 bacterial isolates were identified as CPE using the modified carbapenem inactivation method. Bacterial identification and antimicrobial susceptibility testing were performed using the Vitek 2 system, and colistin susceptibility was determined using the compact antimicrobial susceptibility panel. Five carbapenemase encoding genes, including blaNDM, blaIMP, blaVIM, blaOXA-48, and blaKPC, were screened using PCR and lateral flow assay. Also, carbapenemases were screened using the boronic acid- and EDTA-based disk synergy methods. The dynamics of CPE were described every month.

RESULTS

Carbapenemase-producing Klebsiella pneumoniae was the most prevalent agent (83.1%), followed by Providencia spp. (6.8%), Escherichia coli (5.1%), Enterobacter cloacae (3.4%), and Citrobacter freundii (1.6%). The isolation of blaNDM-carrying CPE was frequent and increased during the second half of 2019, while blaKPC carriers were detected in the second half of 2018. One CPE carrying blaOXA-48 was detected in June 2019. No other carbapenemase-encoding genes were detected.

CONCLUSIONS

This report is among the first to document CPE in private health care institutions in Lima, Peru. Results suggest that the emergence and spread of carbapenemases are becoming a latent and growing threat in private healthcare settings.