Pseudomonas aeruginosa antibiotic susceptibility profiles, genomic epidemiology and resistance mechanisms: a nation-wide five-year time lapse analysis

Mostra el registre complet Registre parcial de l'ítem

• dc.contributor.author Sastre-Femenia, Miquel Àngel
• dc.contributor.author Fernández Muñoz, Almudena
• dc.contributor.author Gomis Font, María A.
• dc.contributor.author Taltavull, Biel
• dc.contributor.author López-Causapé, Carla
• dc.contributor.author Arca-Suárez, Jorge
• dc.contributor.author Martínez-Martínez, Luis
• dc.contributor.author Cantón, Rafael
• dc.contributor.author Larrosa, María Nieves
• dc.contributor.author Oteo Iglesias, Jesús
• dc.contributor.author Zamorano, Laura
• dc.contributor.author Oliver, Antonio
• dc.contributor.author GEMARA-SEIMC/CIBERINFEC Pseudomonas study Group
• dc.date.accessioned 2025-07-21T06:00:01Z
• dc.date.available 2025-07-21T06:00:01Z
• dc.date.issued 2023
• dc.description.abstract Background: Pseudomonas aeruginosa healthcare-associated infections are one of the top antimicrobial resistance threats world-wide. In order to analyze the current trends, we performed a Spanish nation-wide high-resolution analysis of the susceptibility profiles, the genomic epidemiology and the resistome of P. aeruginosa over a five-year time lapse. Methods: A total of 3.180 nonduplicated P. aeruginosa clinical isolates from two Spanish nation-wide surveys performed in October 2017 and 2022 were analyzed. MICs of 13 antipseudomonals were determined by ISO-EUCAST. Multidrug resistance (MDR)/extensively drug resistance (XDR)/difficult to treat resistance (DTR)/pandrug resistance (PDR) profiles were defined following established criteria. All XDR/DTR isolates were subjected to whole genome sequencing (WGS). Findings: A decrease in resistance to all tested antibiotics, including older and newer antimicrobials, was observed in 2022 vs 2017. Likewise, a major reduction of XDR (15.2% vs 5.9%) and DTR (4.2 vs 2.1%) profiles was evidenced, and even more patent among ICU isolates [XDR (26.0% vs 6.0%) and DTR (8.9% vs 2.6%)] (p < 0.001). The prevalence of Extended-spectrum β-lactamase/carbapenemase production was slightly lower in 2022 (2.1%. vs 3.1%, p = 0.064). However, there was a significant increase in the proportion of carbapenemase production among carbapenem-resistant strains (29.4% vs 18.1%, p = 0.0246). While ST175 was still the most frequent clone among XDR, a slight reduction in its prevalence was noted (35.9% vs 45.5%, p = 0.106) as opposed to ST235 which increased significantly (24.3% vs 12.3%, p = 0.0062). Interpretation: While the generalized decrease in P. aeruginosa resistance, linked to a major reduction in the prevalence of XDR strains, is encouraging, the negative counterpart is the increase in the proportion of XDR strains producing carbapenemases, associated to the significant advance of the concerning world-wide disseminated hypervirulent high-risk clone ST235. Continued high-resolution surveillance, integrating phenotypic and genomic data, is necessary for understanding resistance trends and analyzing the impact of national plans on antimicrobial resistance. Funding: MSD and the Instituto de Salud Carlos III, Ministerio de Ciencia e Innovación and Unión Europea-NextGenerationEU.
• dc.format.mimetype application/pdf
• dc.identifier.citation Sastre-Femenia MÀ, Fernández-Muñoz A, Gomis-Font MA, Taltavull B, López-Causapé C, Arca-Suárez J, et al. Pseudomonas aeruginosa antibiotic susceptibility profiles, genomic epidemiology and resistance mechanisms: a nation-wide five-year time lapse analysis. Lancet Reg Health Eur. 2023 Sep 19;34:100736. DOI: 10.1016/j.lanepe.2023.100736
• dc.identifier.doi http://dx.doi.org/10.1016/j.lanepe.2023.100736
• dc.identifier.issn 2666-7762
• dc.identifier.uri http://hdl.handle.net/10230/70953
• dc.language.iso eng
• dc.publisher Elsevier
• dc.relation.ispartof Lancet Reg Health Eur. 2023 Sep 19;34:100736
• dc.rights © 2023 The Authors. Published by Elsevier Ltd. This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).
• dc.rights.accessRights info:eu-repo/semantics/openAccess
• dc.rights.uri http://creativecommons.org/licenses/by-nc-nd/4.0/
• dc.subject.keyword COVID-19
• dc.subject.keyword Electronic health records
• dc.subject.keyword PASC
• dc.subject.keyword Post-acute sequelae of SARS-CoV-2
• dc.subject.keyword SARS-CoV-2
• dc.title Pseudomonas aeruginosa antibiotic susceptibility profiles, genomic epidemiology and resistance mechanisms: a nation-wide five-year time lapse analysis
• dc.type info:eu-repo/semantics/article
• dc.type.version info:eu-repo/semantics/publishedVersion