Infection outbreaks caused by carbapenemase-producing Enterobacterales: An epidemiological surveillance study in public hospitals in Chile, 2017-2024.
CPE outbreaks in Chile increased during the pandemic but returned to pre-pandemic levels afterward, with a notable decrease in outbreak duration.
Where it sits
this study against the rest of the pe 22-28 corpusSummary and findings
This study characterizes outbreaks of carbapenemase-producing Enterobacterales (CPE) in public hospitals in Chile from 2017 to 2024. A total of 72 outbreaks were reported, with 945 associated cases and 21 attributable deaths. The median outbreak size peaked at 7 cases during the pandemic and decreased back to 4 cases post-pandemic.
Abstract
<h4>Background</h4>Infectious outbreaks caused by carbapenemase-producing Enterobacterales (CPE) in hospitals constitute a global health threat.<h4>Objective</h4>To characterise CPE infectious outbreaks in public hospitals in Chile during 2017-2024.<h4>Methods</h4>Retrospective epidemiological surveillance study using national public health data across three periods: baseline pre-pandemic (2017-2019), pandemic (2020-2022), and post-pandemic (2023-2024).<h4>Results</h4>Seventy-two CPE outbreaks, 945 associated cases and 21 attributable deaths were notified. Median CPE outbreak size in the pre-pandemic period (4 cases) peaked during the pandemic (7 cases) and recovered afterwards post-pandemic (4 cases). Median outbreak duration decreased over time (pre-pandemic period: 75 days; pandemic: 45 days; post-pandemic: 9 days). <i>Klebsiella pneumoniae</i> was the primary cause (83.3% of outbreaks, 92.6% of cases) and KPC the most common carbapenemase detected (54.2% of outbreaks, 53.7% of cases). OXA-48-like and KPC + NDM co-production were observed from 2021 onwards, and IMP was first identified in 2024.<h4>Conclusions</h4>The size of CPE outbreaks in Chilean public hospitals increased significantly during the pandemic and shrunk back to pre-pandemic values afterwards. CPE outbreak duration decreased sharply from the pandemic onwards. Since 2021, carbapenemases detected in CPE hospital outbreaks have diversified in Chile.