SPENCER SANDINO, MARIA DE LOS ANGELES
Preferred name
SPENCER SANDINO, MARIA DE LOS ANGELES
Main Affiliation
ORCID
0009-0002-3995-9297
Scopus Author ID
57210856239, 57220752577
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Item type:Publication, P-310. Evolutionary dynamics of the Chilean-Cordobes MRSA clone allowed the emergence of new MRSA clones in Chile(Oxford University Press (OUP), 2025-01-29) ;MartĂnez, Jose R W ;Campbell, Amy; ; Background The global spread of methicillin-resistant Staphylococcus aureus (MRSA) is associated with distinct clones predominating in specific geographical regions. Available evidence suggests that the Chilean-Cordobes clone (ChC), an ST5-SCCmecI lineage, has predominated in Chilean hospitals ever since its first description in 1998. However, we recently reported a gradual decrease in this lineage over time, with frequencies dropping from 94% (2000) to 52% (2016). To understand this clonal replacement event, we aimed to reconstruct the genomic evolution of the ChC in Latin America. Characterization of clades and sub-lineages of the ChC clone.Figure 1.Characterization of clades and sub-lineages of the ChC clone. A) Maximum clade credibility molecular clock analysis of the 596 MRSA genomes. A Bayesian molecular clock analysis was performed with BEAST using the isolation date of each genome as calibrator. The vertical lines show the scale of years. The colored strip showed the country of origin. The dots show the presence of mecA genotypes, heavy metal resistance genes (HMRGs), and SNPs in Sau1. The branches are colored based on the sub-lineage identification: ChC-I (magenta), ChC-II (orange), and ChC-III (green). B) Characterization of the ChC clades. The presence of each genetic element considered to characterize the clades are marked by a + symbol. C) Relative frequency of the ChC sub-lineages in Chile over time. The colored bars represent the relative frequency of each sub-lineage: ChC-I (magenta), ChC-II (orange), ChC-III (green), and unclassified (gray). Methods A total of 596 ChC MRSA isolates obtained from 6 Latin American countries between 1999-2018 were whole-genome sequenced and characterized using a Bayesian molecular clock analysis (MCA). Sub-lineages (SLs) observed in major divergence events were further characterized. Additionally, the frequency of each SL observed in our 1999-2018 collection was assessed in an independent group of genomes from 274 Chilean clinical MRSA isolates collected in 2022. Results Our MCA of ChC MRSA revealed 3 clades strongly related with different genomic traits, including: i) mecA genotype, ii) heavy metal resistance genes (HMRGs), and iii) changes in the Sau1 restriction-modification system (Sau1) (Fig. 1A). Each clade was classified as sub-lineage: ChC-I, ChC-II, and ChC-III (Fig. 1B). All the genomes from Argentina, Colombia, and Venezuela – countries where ChC was largely replaced - belonged to the ChC-II SL and harbored a Sau1 mutation (Fig. 1A). On the other hand, genomes obtained from Chile distributed in different SLs and exhibited a dynamic interchange over time (Fig. 1C). While between 1999-2003 most of the genomes belonged to SLs ChC-I and ChC-II, both SLs virtually disappeared in 2013-2018, period were >90% ChC genomes corresponded to ChC-III (Fig. 1C). In 2022, a majority of ChC MRSA had genomic features compatible with the ChC-III SL (Fig. 1C). Finally, the MCA revealed an evolutionary event within ChC-III dated in 2005, which was accompanied by the loss of HMRGs (Fig. 1A) Conclusion We describe the time evolution of several ChC clades, giving rise to sub-lineages that seem to play a role in the loss of dominance of the ChC MRSA clone in Chile and a consequent change in its epidemiology in the country. Disclosures JosĂ© M Munita, MD, MSD: Grant/Research Support|Pfizer: Grant/Research Support - Some of the metrics are blocked by yourconsent settings
Item type:Publication, P-186. Trends in Antimicrobial Resistance Among Adults Across 6 Hospitals in Argentina, Brazil, and Chile, 2018-2022(Oxford University Press (OUP), 2025-01-29) ;Siza, Charlene R ;Mahon, Garrett W ;Patel, Twisha S ;Garzon, Maria IBoszczowski, IcaroBackground In 2019, an estimated 1.27 million deaths were attributed to bacterial antimicrobial resistance (AR) globally. During the Coronavirus Disease 2019 (COVID-19) Pandemic, additional strain was placed on healthcare systems that may have led to further increases in AR. We evaluated AR prevalence before and after the onset of COVID-19 in 6 healthcare facilities (HCF) in South America. Methods We conducted an ecological evaluation of HCF-wide AR prevalence in 4 private and 2 public HCFs in Argentina, Brazil, and Chile; 2 HCFs per country. We calculated percentage of non-susceptible (NS) or resistant (R) to select antibiotics among clinical isolates of Acinetobacter baumannii, Pseudomonas aeruginosa, Enterococcus spp., and Enterobacterales cultured from adult acute care inpatients. We compared percentage-NS or -R between the periods pre- (March 2018–February 2020) and post- (March 2020–February 2022) onset of the COVID-19 pandemic. Chi-square or Fisher’s exact tests were used with statistical significance set at a two-tailed p< 0.05. Results When comparing 2020-2022 to 2018-2020, 2/6 hospitals showed statistically significant increases (+14.1–19.2%) in carbapenem-NS A. baumannii. For carbapenem-NS P. aeruginosa, 1/6 hospitals showed a significant increase (+76.6%) and 1/6 showed a significant decrease (-52.4%). For carbapenem-NS Enterobacterales, 2/6 hospitals had significant increases (+50.7–236.2%) and 1 exhibited a significant decrease (-91.7%). For vancomycin-R Enterococcus spp., 2/6 hospitals had significant increases (+43.9–400.0%) and 2/6 hospitals had significant decreases (-49.0-60.7%). For Enterobacterales-R to 3rd generation cephalosporins, 2/6 hospitals showed significant increases (+16.0–110.9%) and 1/6 hospitals had a significant decrease (-40.4%) (Table). Conclusion Among the isolates from our study hospitals, we noted not only significant increases but also significant decreases across multiple AR profiles associated with multi-drug resistance. These data suggest that the pandemic may have led to changes in resistance among both gram-negative and gram-positive bacteria. Given the variability in these changes, further evaluation of infection rates would be valuable to confirm these findings. Disclosures José M Munita, MD, MSD: Grant/Research Support|Pfizer: Grant/Research Support - Some of the metrics are blocked by yourconsent settings
Item type:Publication, Antimicrobial use and documented infection among hospitalized adults in South American acute care facilities during the coronavirus disease 2019 (COVID-19) pandemic(Public Library of Science (PLoS), 2026-02-27) ;Lauren F. Dempsey ;Hanako Osuka ;Olivia L. McGovern; Maria Isabel Garzon<jats:sec id="sec001"> <jats:title>Background</jats:title> <jats:p>Despite low bacterial and fungal infection rates, increased antimicrobial use (AU) among hospitalized patients has been reported during the Coronavirus Disease 2019 (COVID-19) pandemic. We evaluated whether COVID-19 was a driver of AU and documented bacterial or fungal infection.</jats:p> </jats:sec> <jats:sec id="sec002"> <jats:title>Methods</jats:title> <jats:p>We conducted a retrospective cohort study in two hospitals each in Argentina, Brazil, and Chile. We included hospitalized adults with and without COVID-19 admitted during the pandemic (March 2020-February 2021) as well as a cohort admitted prior to the pandemic (March 2019-February 2020) with similar age and length of hospitalization. We performed multivariable logistic regressions to compare 1) patients with COVID-19 to those without who were admitted during the pandemic, and 2) patients without COVID-19 who were admitted during the pandemic to a similar patient population before the pandemic to characterize the association of COVID-19 or admission during the pandemic with rates of AU and infections.</jats:p> </jats:sec> <jats:sec id="sec003"> <jats:title>Results</jats:title> <jats:p>A total of 1116 patients were included. During the pandemic, COVID-19 was not associated with receiving antimicrobials or receiving antimicrobials for a duration >48 hours, but it was associated with reduced likelihood of culture-positive bacterial or fungal infection (aOR=0.35, 95% CI: 0.19–0.64, p < 0.001). Compared to patients without COVID-19 admitted during the pandemic, patients admitted prior to the pandemic were more likely to have received antimicrobials (aOR=1.54, 95% CI: 1.15–2.07, p < 0.01), but there was no association with receiving antimicrobials for duration>48 hours or having a culture-positive bacterial or fungal infection.</jats:p> </jats:sec> <jats:sec id="sec004"> <jats:title>Conclusions</jats:title> <jats:p>COVID-19 was not associated with an increased likelihood of AU in this cohort of hospitalized adults.</jats:p> </jats:sec>1