TY - JOUR T1 - Detection of carbapenemases and other mechanisms of enzymatic resistance to β-lactams in Enterobacteriaceae with diminished susceptibility to carbapenems in a tertiary care hospital JO - Enfermedades Infecciosas y Microbiología Clínica T2 - AU - Gómara,Marta AU - López-Calleja,Ana Isabel AU - Iglesia,Berta María Pilar Vela AU - Cerón,Isabel Ferrer AU - López,Antonio Rezusta AU - Pinilla,María José Revillo SN - 0213005X M3 - 10.1016/j.eimc.2017.07.006 DO - 10.1016/j.eimc.2017.07.006 UR - https://www.elsevier.es/es-revista-enfermedades-infecciosas-microbiologia-clinica-28-articulo-detection-carbapenemases-other-mechanisms-enzymatic-S0213005X17302161 AB - IntroductionOur objective was to characterize the enzymatic β-lactam resistance in clinical Enterobacteriaceae isolates with diminished susceptibility to carbapenems from 2013 to 2014 at Hospital Universitario Miguel Servet. Material/methodsA total of 63 clinical isolates were analyzed for the presence of carbapenemases (KPC, OXA-48 and MBL), ESBLs and AmpC enzymes by combined disk methods and PCR detection of carbapenemase-encoding and beta-lactamase-encoding genes. ResultsFifteen isolates had a phenotypic test compatible with carbapenemase production; two of these were confirmed by PCR as OXA-48 producers. ESBL detection was positive in 27 isolates (43%); plasmid-mediated AmpC was detected in nine isolates (14.2%) and derepressed AmpC β-lactamase was present in 18 isolates (28%). ConclusionDuring the study period, the decreased susceptibility to carbapenems in Enterobacteriaceae in our area was not due to true carbapenemases but rather to β-lactamase activity (82.5% were ESBL or AmpC producers), probably in combination with decreased permeability of the outer membrane. ER -