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Volume 28, Number 11—November 2022
Online Report

Increased Detection of Carbapenemase-Producing Enterobacterales Bacteria in Latin America and the Caribbean during the COVID-19 Pandemic

Genara Romero Thomas, Alejandra Corso, Fernando Pasterán, Justina Shal, Aldo Sosa, Marcelo Pillonetto, Renata Tigulini de Souza Peral, Juan Carlos Hormazábal, Pamela Araya, Sandra Yamile Saavedra, Mariá Victoria Ovalle, María Antonieta Jiménez Pearson, Grettel Chanto Chacón, Eric Carbon, Carmen Julia Mazariegos Herrera, Selene del Carmen González Velásquez, Carolina Satan-Salazar, Fernando Villavicencio, Nancy Melgarejo Touchet, Sofía Busignani, Maritza Mayta-Barrios, Juan Ramírez-Illescas, Mariana López Vega, Cristina Mogdasy, Verónica Rosas, Nuris Salgado, Rodolfo Quiroz, Nathalie El-Omeiri, Marcelo Fabián Galas, Pilar Ramón-Pardo, and Roberto Gustavo MelanoComments to Author 
Author affiliations: Pan American Health Organization, Washington, DC, USA (G. Romero Thomas, R. Quiroz, N. El-Omeiri, M.F. Galas, P. Ramón-Pardo, R.G. Melano); Instituto Nacional de Enfermedades Infecciosas–ANLIS “Dr. C.G. Malbrán,” Argentina (A. Corso, F. Pasterán); Central Medical Laboratory, Belize City, Belize (J. Shal, A. Sosa); Laboratório Centrais de Saúde Pública do Paraná, Curitiba-PR, Brazil (M. Pillonetto); General Coordination of Public Health Laboratories, Brasilia-DF, Brazil (R. Tigulini de Souza Peral); Instituto de Salud Pública, Santiago, Chile (J.C. Hormazábal, P. Araya); Instituto Nacional de Salud, Bogotá, Colombia (S.Y. Saavedra, M.V. Ovalle); Instituto Costarricense de Investigación y Enseñanza en Nutrición y Salud, Cartago, Costa Rica (M.A. Jiménez Pearson, G. Chanto Chacón); Princess Margaret Hospital/Dominica-China Friendship Hospital Laboratory, Roseau, Dominica (E. Carbon); Laboratorio Nacional de Salud, Bárcena, Guatemala (C.J. Mazariegos Herrera); Unidad Central de Referencia Vigilancia Epidemiológica, Bárcena (S.C. González Velásquez); Instituto Nacional de Investigación en Salud Pública, Quito, Ecuador (C. Satán-Salazar, F. Villavicencio); Laboratorio Central de Salud Pública, Asunción, Paraguay (N. Melgarejo Touchet, S. Busignani); Instituto Nacional de Salud, Lima, Peru (M. Mayta-Barrios, J. Ramírez-Illescas); Departamento de Laboratorios de Salud Pública, Montevideo, Uruguay (M. López Vega, C. Mogdasy); Instituto Nacional de Higiene “Rafael Rangel”, Caracas, Venezuela (V. Rosas, N. Salgado); Public Health Ontario Laboratory, Toronto, Ontario, Canada (R.G. Melano)

Main Article

Table

Summary of findings in countries reporting changes in the prevalence of some carbapenemase genes in study of increased detection of carbapenemase-producing Enterobacterales bacteria in Latin America and the Caribbean during the COVID-19 pandemic*

Country Period Findings
Argentina, Instituto Nacional de Enfermedades Infecciosas–ANLIS “Dr. C.G. Malbrán”
 Pandemic, May 2020–Jun 2021
 First detection of double carbapenemase genes (52/196), 60% of which harbored blaKPC + blaNDM (mainly in Klebsiella pneumoniae 31/32). Further studies of K. pneumoniae (n = 77) revealed 74/77 isolates with blaKPC + blaNDM and 3/77 isolates with blaKPC + blaIMP.
Brazil, Laboratório Centrais de Saúde Pública do Paraná, LACEN-PR
 Prepandemic, Jul 2017–Feb 2019 CRE (n = 3,712). Carbapenemase genes detected: 73.6% (2,731/3,712); isolates carrying blaKPC + blaNDM: 2% (55/2,731).
Pandemic, Mar 2020–Oct 2021
 CRE (n = 5,300), increase of 42.8%. Carbapenemase genes detected: 88.4% (4,683/5,300); isolates carrying blaKPC + blaNDM: 4.7% (219/4,683). K. pneumoniae represented 49% (107/219) of bacteria.
Colombia, Instituto Nacional de Salud
 Prepandemic, Jan 2018–Dec 2019 CPE (n = 262); isolates carrying blaKPC + blaNDM + blaVIM: 1.1% (3/262); first detection in 2018.
Pandemic, Jan 2020–Dec 2021
 CPE (n = 557), increase of 112.6%. Isolates carrying blaKPC + blaNDM + blaVIM: 3.6% (20/557).
Uruguay, Departamento de Laboratorios de Salud Pública
 Prepandemic, Jan 2017–Dec 2019 <1% (5/530) of Enterobacterales carrying blaKPC + blaNDM.
Pandemic, Jan 2020–Jun 2021
 5.6% (18/321) of Enterobacterales carrying blaKPC + blaNDM.
Guatemala, Laboratorio Nacional de Salud
 Pandemic, Nov 2020 First detection of blaOXA-48–like (blaOXA-232 and blaOXA-181) in K. pneumoniae (n = 4) and Escherichia coli (n = 1) confirmed by whole-genome sequencing.
Pandemic, Apr 2021
 First detection of blaKPC + blaNDM in Enterobacter cloacae complex (n = 2).
Paraguay, Laboratorio Centra de Salud Pública
 Pandemic, Feb–Sep 2021
 First detection of blaKPC + blaNDM in K. pneumoniae (n = 6) and blaOXA-48-like + blaNDM in E. cloacae (n = 1)).
Peru, Instituto Nacional de Salud
 Pandemic, Jul–Oct 2021
 First detection of blaKPC + blaNDM in K. pneumoniae (n = 2) and blaOXA-48–like + blaNDM in E. coli (n = 1).
Ecuador, Instituto Nacional de Investigación en Salud Pública-“Dr. Leopoldo Izquieta Pérez”
 Pandemic, Jan–Feb 2021
 First detection of blaKPC + blaNDM in K. pneumoniae (n = 1) and blaOXA-48–like + blaNDM in E. coli (n =1).
Venezuela, Instituto Nacional de Higiene “Rafael Rangel”
 Pandemic, Oct 2021
 First detection of blaKPC + blaNDM in K. pneumoniae (n = 1).
Costa Rica, Instituto Costarricense de Investigación y Enseñanza en Nutrición y Salud
 Pandemic, Dec 2021
 First detection of blaIMP + blaNDM in E. cloacae complex (n = 1).
Belize, Central Medical Laboratory
 Pandemic, Jan–May 2021
 First detection of blaNDM in K. pneumoniae (n = 4) and E. coli (n = 2).
Dominica, Princess Margaret Hospital Medical Laboratory
 Pandemic, Dec 2020–Mar 2021
 First detection of blaNDM in K. pneumoniae (n = 2) and E. coli (n = 1).
Chile, Instituto de Salud Pública Pandemic, Apr–Jul 2021 First detection of blaOXA-48–like in K. pneumoniae (n = 22) and E. coli (n = 1).

*CPE, carbapenemase-producing Enterobacterales; CRE, carbapenem-resistant Enterobacterales; bla, β-lactamase gene; KPC, Klebsiella pneumoniae carbapenemase; OXA, oxacillinase; NDM, New Delhi metallo-β-lactamase; VIM, Verona integron–encoded metallo-β-lactamase; IMP, imipenemase.

Main Article

Page created: September 23, 2022
Page updated: October 24, 2022
Page reviewed: October 24, 2022
The conclusions, findings, and opinions expressed by authors contributing to this journal do not necessarily reflect the official position of the U.S. Department of Health and Human Services, the Public Health Service, the Centers for Disease Control and Prevention, or the authors' affiliated institutions. Use of trade names is for identification only and does not imply endorsement by any of the groups named above.
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