Molecular detection of carbapenemases in critical microorganisms since the onset of the COVID-19 pandemic in Peru.

Objective: Identify and characterize carbapenemase genes in bacterial isolates of Enterobacterales, Acinetobacter baumannii, and Pseudomonas aeruginosa collected through the National Surveillance of Antimicrobial Resistance (AMR) Program during the COVID-19 pandemic in Peru. Methods: This retrospective, observational study analysed 2049 submitted due to suspected portability of carbapenemase genes, collected between January 2020 and August 2022. Samples were obtained from 61 hospitals in 18 of the 25 regions of Peru (72%) that participated in the National Surveillance AMR Program. Results: Among the isolates, 860 were Enterobacterales, 771 were A. baumannii, and 418 were P. aeruginosa. Carbapenemase genes were detected in 1735 isolates (84,6%). The most prevalent genes identified were bla NDM (561, 78.13%) in Enterobacterales, bla OXA-24-like (488, 67.8%) in A. baumannii, and bla IMP (188, 63.3%) in P. aeruginosa. Notably, rare occurrences of bla NDM were identified in P. aeruginosa (5, 1.7%). Combinations of carbapenemase genes were identified including bla IMP + bla VIM  in P. aeruginosa, with a rising trend, but also bla KPC + bla NDM (7, 1%) bla NDM + bla OXA-48-like (1, 0.14%), bla NDM + bla IMP (2, 0.3%), and bla NDM + bla VIM (2, 0.3%) in Enterobacterales; and bla OXA-23 + bla OXA-24-like (11, 1.5%), bla NDM + bla OXA-24-like (2, 0.3%), and bla NDM + bla OXA-58-like (1, 0.1%) in A. baumannii. Conclusion: This study highlights the significant detection of carbapenemase genes and their combinations in Peru during the COVID-19 pandemic. These findings underscore the urgent need for enhanced AMR surveillance, antimicrobial stewardship, and targeted infection control strategies to address this critical public health threat.