Carbapenemases producing gram-negative bacteria surveillance in Latin America and the caribbean: a retrospective...

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, Pseudomonas aeruginosa, and Acinetobacter baumannii 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 P. aeruginosa-CRPA (6050/47,804; 12.66%). Among CRE, bla _KPC was the most detected gene (78.67%; 24,569/31,230), with Klebsiella pneumoniae being the most commonly associated species (75.9%). A relevant upward trend in bla _NDM was observed. CRPA exhibited diverse profiles, with bla _VIM (47.64%) being the most common. In CRAB, bla _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 bla _IMP + bla _VIM being the most frequent.

This study highlights a high prevalence of CPB in LAC, with a stable trend in bla _KPC but a rising trend in bla _NDM. These findings underscore the urgent need for strengthened surveillance and public health interventions to combat carbapenemase-mediated resistance in the region.

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