Carbapenemase-producing Enterobacterales (CPE) are significant contributors to the global public health threat of antimicrobial resistance. OXA-48-like enzymes and their variants are unique carbapenemases with low or null hydrolytic activity toward carbapenems but no intrinsic activity against expanded-spectrum cephalosporins. CPEs have been classified by the WHO as high-priority pathogens given their association with morbidity and mortality and the scarce number of effective antibiotic treatments. In Spain, the frequency of OXA-48 CPE outbreaks is higher than in other European countries, representing the major resistance mechanism of CPEs. Horizontal transfer of plasmids and poor effective antibiotic treatment are additional threats to the correct prevention and control of these hospital outbreaks. One of the most important risk factors is antibiotic pressure, specifically carbapenem overuse. We explored the use of these antibiotics in Spain and analyzed the frequency, characteristics and prevention of CPE outbreaks. Future antibiotic stewardship programs along with specific preventive measures in hospitalized patients must be reinforced and updated in Spain.

中文翻译：

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西班牙医院中产生OXA-48碳青霉烯酶的肠杆菌：关于耐药性上升的最新综合综述

产生碳青霉烯酶的肠杆菌（CPE）是全球公众对抗菌素耐药性公共卫生威胁的重要因素。OXA-48-like酶及其变体是独特的碳青霉烯酶，对碳青霉烯的水解活性低或为零，而对广谱头孢菌素没有内在活性。世界卫生组织已将CPE归类为高优先病原体，因为它们与发病率和死亡率以及有效抗生素治疗的稀缺性有关。在西班牙，OXA-48 CPE爆发的频率高于其他欧洲国家，这是CPE的主要抵抗机制。质粒的水平转移和无效的抗生素治疗是对这些医院暴发的正确预防和控制的进一步威胁。最重要的危险因素之一是抗生素压力，尤其是碳青霉烯的过度使用。我们探索了在西班牙使用这些抗生素的情况，并分析了CPE爆发的频率，特征和预防。西班牙必须加强和更新未来的抗生素管理计划以及针对住院患者的具体预防措施。