Abstract
The present study evaluated the antimicrobial susceptibility profile, β-lactamase production, and genetic diversity of Enterobacteriaceae, Pseudomonas aeruginosa, and Acinetobacter spp. using phenotypic identification, antimicrobial susceptibility testing, and β-lactamase phenotypic detection. Isolates were obtained from patients in an intensive care unit in a hospital in southern Brazil. Bacterial genomic DNA was extracted, followed by the genotypic detection of carbapenemases and enterobacterial repetitive intergenic consensus-polymerase chain reaction (ERIC-PCR). Fifty-six isolates (26 Klebsiella pneumoniae, five Escherichia coli, three Enterobacter aerogenes, nine P. aeruginosa, and 13 Acinetobacter spp.) were evaluated. The phenotypic extended spectrum β-lactamase (ESBL) test was positive in 53.8% of the K. pneumoniae isolates, 100.0% of the E. coli isolates, and 100.0% of the E. aerogenes isolates. Phenotypic and genotypic testing of K. pneumoniae carbapenemase (KPC) was positive in 50.0% of the K. pneumoniae isolates. Phenotypic and genotypic testing showed that none of the P. aeruginosa or Acinetobacter spp. isolates were positive for metallo- β-lactamase (MBL). The bla OXA gene was detected only in Acinetobacter spp. The lowest genetic diversity, determined by ERIC-PCR, was observed among the KPC-producing K. pneumoniae isolates and OXA-producing Acinetobacter spp. isolates, indicating the inadequate dissemination control of multidrug-resistant bacteria in this hospital environment.
Highlights
Healthcare-associated infections are among the leading causes of morbidity and mortality in patients and are associated with higher treatment costs (Sydnor, Perl, 2011)
The present study evaluated the antimicrobial susceptibility profile, b-lactamase production, and genetic diversity of Enterobacteriaceae, P. aeruginosa, and Acinetobacter spp. isolates that were obtained from patients in an intensive care unit (ICU) in a hospital in southern Brazil from March 2012 to August 2013
Enterobacteriaceae and non-glucose-fermenting Gram-negative (P. aeruginosa and Acinetobacter spp.) isolates were obtained from patients in an ICU in a hospital in southern Brazil, from March 2012 to August 2013
Summary
Healthcare-associated infections are among the leading causes of morbidity and mortality in patients and are associated with higher treatment costs (Sydnor, Perl, 2011). Pseudomonas aeruginosa, Acinetobacter spp., and some members of the Enterobacteriaceae family are often involved in nosocomial infections (Mendes et al, 2005). Extended-spectrum b-lactamase (ESBL)‐producing Gram-negative bacteria have been an important cause of therapy failure. Carbapenems are usually the only available treatment option (McGowan, 2006). Carbapenemase-producing Gramnegative pathogens, such as Klebsiella pneumoniae carbapenemase (KPC) and metallo-b-lactamase (MBL), are resistant to all available antimicrobial agents, including carbapenems, and have emerged in most hospitals worldwide (Zavascki et al, 2009; Nordmann, Naas, Poirel, 2011; Toledo et al, 2012; Maragakis, 2010; Cherkaoui et al, 2014)
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