Abstract
The prevalence of cephalosporins and carbapenem-resistant Klebsiella pneumoniae strains is rising in Brazil, with potential serious consequences in terms of patients' outcomes and general care. This study characterized 24 clinical isolates of K. pneumoniae from two hospitals in Recife, Brazil, through the antimicrobial susceptibility profile, analyses of β-lactamase genes (bla(TEM), bla(SHV),bla(CTX-M), bla(KPC), bla(VIM), bla(IMP), and bla(SPM), plasmidial profile and ERIC-PCR (Enterobacterial repetitive intergenic consensus-polymerase chain reaction). ERIC-PCR and plasmidial analysis grouped the isolates in 17 and 19 patterns, respectively. Six isolates from one hospital presented the same pattern by ERIC-PCR, indicating clonal dissemination. All isolates presented bla(SHV), 62.5% presented bla(CTX)-M-2, 29% bla(TEM), and 41.7% bla(KPC). Metallo-β-lactamase genes bla(VIM), bla(IMP), and bla(SPM) not detected. Eleven isolates were identified carrying at least 3 β-lactamase studied genes, and 2 isolates carried bla(SHV), bla(TEM), bla (CTX-M-2) and bla(KPC) simultaneously. The accumulation of resistance genes in some strains, observed in this study, imposes limitations in the therapeutic options available for the treatment of infections caused by K. pneumoniae in Recife, Brazil. These results should alert the Brazilian medical authorities to establish rigorous methods for more efficiently control the dissemination of antimicrobial resistance genes in the hospital environment.
Highlights
The prevalence of cephalosporins and carbapenem-resistant Klebsiella pneumoniae strains is rising in Brazil, with potential serious consequences in terms of patients’ outcomes and general care
Nosocomial infections are caused by multidrug resistant K. pneumoniae strains, mainly extended-spectrum β-lactamases (ESBLs) producers
Most of ESBLs are derived from the TEM (Temoniera) and SHV groups, since around 2008 CTX-M ESBLs have become dominant in many countries, including Brazil, mainly in K. pneumoniae nosocomial isolates[3,4,5]
Summary
The prevalence of cephalosporins and carbapenem-resistant Klebsiella pneumoniae strains is rising in Brazil, with potential serious consequences in terms of patients’ outcomes and general care. Methods: This study characterized 24 clinical isolates of K. pneumoniae from two hospitals in Recife, Brazil, through the antimicrobial susceptibility profile, analyses of β-lactamase genes Nosocomial infections are caused by multidrug resistant K. pneumoniae strains, mainly extended-spectrum β-lactamases (ESBLs) producers. The carbapenems are often used for the treatment of infections caused by K. pneumoniae ESBLs producers This species has presented an efficient mechanism of resistance to carbapenems, known as Klebsiella pneumoniae carbapenemase (KPC), which was initially detected in the United States and Israel and later in other countries[6]. The objective of this study was to genetically characterize clinical isolates of K. pneumoniae from patients in two hospitals, in the City of Recife, Brazil, through the investigation of bla bla bla , bla bla , bla and bla TEM, ,SHV, CTX-M
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