Molecular Epidemiology and Risk Factors of Carbapenemase-Producing Isolates in Portuguese Hospitals: Results From European Survey on Carbapenemase-Producing (EuSCAPE).

In Portugal, the epidemiological stage for the spread of carbapenemase-producing (CPE) increased from sporadic isolates or single hospital clones (2010-2013), to hospital outbreaks, later. Here we report data from a 6-month study performed under the European Survey on Carbapenemase-Producing (EuSCAPE). During the study period, 67 isolates (61 and 6 ) non-susceptible to carbapenems were identified in participant hospital laboratories. We detected 37 (including one new variant: ), 1 , and 1 plus , alone or in combination with other genes. Bioinformatics analysis of the KPC-21-producing identified the new variant in a 12,748 bp length plasmid. The gene was harbored on a non-Tn element, presenting upstream a partial IS (ΔISΔ) with the related left IR (IR) and downstream a truncated Tn3 transposon. PFGE and MLST analysis showed an important diversity, as isolates belonged to distinct PFGE and STs profiles. In this study, we highlighted the presence of the high-risk clone sequence-type (ST) 131 clade C/H30. This worldwide disseminated lineage was already detected in Portugal among other antibiotic resistance reservoirs. This study highlights the intra- and inter-hospital spread and possible intercontinental circulation of CPE isolates.