[Epidemiology of the carbapenemase-producing Enterobacteriaceae spread in a community acute hospital and a non-acute rehabilitation hospital in Madrid]. / Epidemiología de la diseminación de enterobacterias productoras de carbapenemasas en un hospital comarcal y un hospital de media estancia en Madrid.

ABSTRACT

OBJECTIVE: In Spain, the overall prevalence of carbapenem-resistant Enterobacteriaceae (CRE) is increasing. We describe the epidemiological, clinical and microbiological characteristics features of patients with colonization or infection due to CRE in two hospitals in the north-west of Madrid during two years. One hospital was a community acute hospital and the second one was a non-acute rehabilitation hospital. METHODS: A total of 197 CPE isolates were detected during 2013-2014. Microbiological, epidemiological and clinical data were collected, since the first isolate was found in March 2013. RESULTS: A 33.5% of patients with CRE had symptomatic infection and the remaining 66.5% were colonizations. Klebsiella pneumoniae (87.8%) was the most prevalent species and OXA-48 the most frequent carbapenemase (91.9%). We found intra-interhospital spread and some differences in the epidemiology of CRE depending on the hospital, such as more genetic variability in the non-acute rehabilitation hospital. CONCLUSIONS: Studying the CRE transmission we founded an increased incidence in a short period of time and a rapid dissemination of strains between both hospitals. This highlights the need to standardize screening measures for potential carriers and infection control programs in our hospitals.