QUESILLE VILLALOBOS, ANA MARIAANA MARIAQUESILLE VILLALOBOSCamila SolarJose R. W. MartínezRIVAS JIMENEZ, LINA MARIALINA MARIARIVAS JIMENEZValeria QuirozAna M. GonzálezRoberto Riquelme-NeiraJuan A. UgaldeAnne PetersOscar Ortega-RecaldeARAOS BRALIC, RAFAEL IGNACIORAFAEL IGNACIOARAOS BRALICPatricia GarcíaFrancois LebretonMUNITA SEPULVEDA, JOSE MANUELJOSE MANUELMUNITA SEPULVEDADIAZ ORTIZ, SANDRA LORENASANDRA LORENADIAZ ORTIZPranita D. Tamma2025-02-262025-02-262025-01-31https://investigadores.udd.cl/handle/123456789/1069710.1128/aac.01205-24Carbapenemase-producing carbapenem-resistant Enterobacterales (CP-CRE) represent a significant global threat. The emergence of dual CP-CRE is particularly alarming, as they can potentially compromise the efficacy of newer antibiotics, further decreasing therapeutic alternatives. Herein, we report the emergence of multiple species of CP-CRE recovered from invasive infections in Chile that simultaneously harbor and provide an in-depth genomic characterization of these worrisome pathogens. We collected carbapenem-resistant Enterobacterales (CRE) isolates from invasive infections over a 4-year period, across 11 healthcare centers in Chile. Bacterial species and the presence of carbapenemase genes were confirmed using MALDI-TOF and PCR assays, respectively. Antimicrobial susceptibility testing was conducted through disk diffusion and broth microdilution methods. Dual CP-CRE isolates were subjected to short- and long-read whole genome sequencing to perform a detailed genomic characterization of the isolates and of the mobile genetic elements harboring the enzymes. From a total of 1,335 CRE isolates, we observed an increase in the prevalence of CP-CRE, from 11% in 2019 to 38% in 2022. A total of 11 dual CP-CRE isolates were recovered, all of them harboringanti-bacterial agentsbacterial proteinsbeta-lactamasescarbapenem-resistant enterobacteriaceaecarbapenemschileenterobacteriaceae infectionshumansklebsiella pneumoniaemicrobial sensitivity testsplasmidswhole genome sequencingantiinfective agentbacterial proteinbeta lactamasecarbapenem derivativecarbapenemasecarbapenem-resistant enterobacteriaceaechiledrug effectdrug therapyenterobacteriaceae infectionepidemiologygeneticshumanisolation and purificationklebsiella pneumoniaemicrobial sensitivity testmicrobiologyplasmidwhole genome sequencingjournal-article