A decade of epidemiology and incidence of carbapenemase-producing bacteria in a tertiary hospital in southern Europe

Abstract

Background

Carbapenemase-producing Enterobacterales (CPE) are a growing issue that healthcare systems all over the world are facing and which have been producing clinical cases for >20 years, with a spike in incidence in the last decade. In the Universitary Hospital of La Paz (HULP), the first CPE outbreak occurred in 2011 and incidence has been variable since then.

Aim

To conduct an epidemiological analysis of the distribution and microbiological characteristics of the four main types of carbapenemases (OXA-48, VIM, KPC, and NDM) obtained from bacteria isolated in the HULP, a tertiary hospital north of the city of Madrid, between 2012 and 2022.

Methods

An observational retrospective analysis was performed to attain the incidence characteristics of CPE and their associated outbreaks. The study used data from 5723 individual cases for which the sex and age of the patient, type of sample, isolated bacteria, type of carbapenemase, type of case (infection or colonization) and where and when the isolate was obtained.

Results

Since the first outbreak of CPE was detected in 2011, contain-and-response protocols were put in place to avoid the spread of CPE within the hospital setting.

Conclusion

The implementation of CPE infection preventention and control guidance since 2013 and (in 2022) updated protocols has impacted the number of cases, but further incidence studies should be conducted to analyse the effectiveness of these measures and assess the patterns of carbapenemase genes over time.