Carbapenemase-Producing Enterobacteriaceae in Spain in 2012

cus sequence types (MLST) and carbapenemase types, including ST15–VIM-1, ST11–OXA-48, ST405–OXA-48, ST101–KPC-2, and ST11–VIM-1. The number of CPE cases in Spain has increased sharply in recent years, due mainly to the emergence of OXA-48. In recent years, Enterobacteriaceae isolates, mainly Klebsiellapneumoniae, have increased their potential to become exten-sively drug resistant by acquiring resistance to carbapenems (1–3), due mainly to the production of carbapenemases. In general, carbapenemases hydrolyze all -lactam antibiotics (1–3). The most clinically important carbapenemases produced by Enterobacteriaceae are the class B metallo--lactamases (MBLs), represented by VIM, IMP, and NDM types, the class A enzymes of the KPC type, and the class D enzymes, represented by the OXA-48 type (3). In Spain, the number of reports on carbap-enemase-producing Enterobacteriaceae (CPE) has increased in re-cent years (4–10). However, comprehensive assessment of the im-pact of CPE in Spain is still missing