KPC: an important mechanism of resistance in K. pneumoniae isolates from intensive care units in the Midwest region of Brazil.

Autor: Conci Campos C; Federal University of Mato Grosso do Sul, Campo Grande, Brazil. caroline_conci@hotmail.com., Franco Roriz N; Federal University of Mato Grosso do Sul, Campo Grande, Brazil. nathaliaf.roriz@hotmail.com., Nogueira Espínola C; Federal University of Mato Grosso do Sul, Campo Grande, Brazil. miris_camila@hotmail.com., Aguilar Lopes F; Maria Aparecida Pedrossian University Hospital, Campo Grande, Brazil. fernando.lopes@ufms.br., Tieppo C; Regional Hospital of Mato Grosso do Sul, Campo Grande, Brazil. carol.tieppo@hotmail.com., Freitas Tetila A; Maria Aparecida Pedrossian University Hospital, Campo Grande, Brazil. andyanetetila@hotmail.com., Volpe Chaves CE; Regional Hospital of Mato Grosso do Sul, Campo Grande, Brazil. claudiavolpe70@hotmail.com., Alexandrino de Oliveira P; Beneficent Association of Campo Grande, Campo Grande, Brazil. priscilaalexandrino@hotmail.com., Rodrigues Chang M; Federal University of Mato Grosso do Sul, Campo Grande, Brazil. marirchang@yahoo.com.br.
Jazyk: angličtina
Zdroj: Journal of infection in developing countries [J Infect Dev Ctries] 2017 Sep 05; Vol. 11 (8), pp. 646-651. Date of Electronic Publication: 2017 Sep 05.
DOI: 10.3855/jidc.8920
Abstrakt: Introduction: Infections caused by multidrug-resistant Klebsiella pneumoniae are difficult to treat and pose a serious threat to public health worldwide. Here, we describe the presence of carbapenemase-producing K. pneumoniae in intensive care units (ICU) of three major Mato Grosso do Sul hospitals located in the Midwest region of Brazil.
Methodology: A total of 165 K. pneumoniae isolates with reduced susceptibility to carbapenems as identified by the VITEK-2 compact system were studied. Antimicrobial susceptibility testing was performed using the disk diffusion method, as recommended by the Clinical and Laboratory Standards Institute, and the E-test method. The detection of carbapenemase was performed using the modified Hodge test and polymerase chain reaction.
Results: The blaKPC gene was identified in 88.1% (n=89) of the selected K. pneumoniae isolates from Beneficent Association of Campo Grande, 94.9% (n=34) of the isolates from the Regional Hospital of Mato Grosso do Sul and 95.2% (n=26) of the isolates from Maria Aparecida Pedrossian University Hospital. Resistance greater than 80% was observed against cephalosporins, aztreonam, ciprofloxacin and piperacillin/tazobactam. Carbapenemase-producing K. pneumoniae (Kp-KPC) isolates were considered important causative agents of urinary tract infections, pneumonia and bloodstream infections in ICU patients. While rarely reported in the literature, we documented three cases of meningoencephalitis caused by Kp-KPC.
Conclusions: Our study documents the presence of Kp-KPC in three major Mato Grosso do Sul state hospitals, providing key national epidemiology data. This is an important mechanism of resistance in K. pneumoniae isolates from ICU patients and is associated with resistance to multiple classes of antimicrobial drugs.
Databáze: MEDLINE
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