Detection of antimicrobial resistance genes in beta-lactamase- and carbapenemase-producing Klebsiella pneumoniae by patient surveillance cultures at an intensive care unit in Rio de Janeiro, Brazil

ABSTRACT Introduction: The increasing incidence of multi-resistant microorganisms has been considered a public health problem. One of the routines included in hospital practice is the screening of colonized and/or infected patients. Objective: The aim of this study was to evaluate the genetic variab...

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Main Authors: Claudia Flores (Author), Célia Maria C. P. A. Romão (Author), Kayo Bianco (Author), Catia Chaia de Miranda (Author), Angela Breves (Author), Ana Paula S. Souza (Author), Rosana Maria R. Santos (Author), Bianca O. Fonseca (Author), Ivano de Filippis (Author), Maysa M. Clementino (Author)
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Published: Sociedade Brasileira de Patologia Clínica.
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042 |a dc 
100 1 0 |a Claudia Flores  |e author 
700 1 0 |a Célia Maria C. P. A. Romão  |e author 
700 1 0 |a Kayo Bianco  |e author 
700 1 0 |a Catia Chaia de Miranda  |e author 
700 1 0 |a Angela Breves  |e author 
700 1 0 |a Ana Paula S. Souza  |e author 
700 1 0 |a Rosana Maria R. Santos  |e author 
700 1 0 |a Bianca O. Fonseca  |e author 
700 1 0 |a Ivano de Filippis  |e author 
700 1 0 |a Maysa M. Clementino  |e author 
245 0 0 |a Detection of antimicrobial resistance genes in beta-lactamase- and carbapenemase-producing Klebsiella pneumoniae by patient surveillance cultures at an intensive care unit in Rio de Janeiro, Brazil 
260 |b Sociedade Brasileira de Patologia Clínica. 
500 |a 1676-2444 
500 |a 1678-4774 
500 |a 10.5935/1676-2444.20160049 
520 |a ABSTRACT Introduction: The increasing incidence of multi-resistant microorganisms has been considered a public health problem. One of the routines included in hospital practice is the screening of colonized and/or infected patients. Objective: The aim of this study was to evaluate the genetic variability and clonal relationships of extended-spectrum beta-lactamase (ESBL)-producing K. pneumoniae, from surveillance cultures, at an intensive care unit, in Rio de Janeiro, Brazil. Material and methods: Seventy K. pneumoniae isolates were obtained from rectal swabs (March 2013 to March 2014). Antimicrobial susceptibility was assessed by VITEK 2 System. Resistant genes blaSHV, blaTEM, blaOXA-1, blaKPC, blaOXA-48, blaCTX-M-15, blaVIM, blaIMP and blaNDM were investigated by polymerase chain reaction (PCR); genetic diversity, by Enterobacterial Repetitive Intergenic Consensus-PCR (ERIC-PCR). Results: Strains showed high resistance rates to cefepime (94%), ceftazidime (96%), ertapenem (61%), imipenem (54%) meropenem (43%) and ciprofloxacin (69%). The most prevalent genes were blaSHV (69%), blaTEM (63%), blaOXA-1 (60%), blaKPC (57%), blaCTX-M-15 (47%), blaOXA-48 (16%). Genes blaVIM, blaIMP and blaNDM were not detected. Twenty nine profiles of resistance genes were observed, with 23% carrying at least five genes. A great genetic diversity (68 ERIC profiles) was also observed among the strains. Conclusion: Although no clonal relationship was observed within the isolates, this study revealed alarming data on the antimicrobial resistance deficiently monitored for preventive purposes in Brazil. Our data allow us to conclude that the inclusion of surveillance cultures in health facilities is a recommended strategy aiming particularly at preventing the spread of resistance genes in the hospital environment and, consequently, reducing morbidity and mortality. 
546 |a EN 
690 |a infecção hospitalar 
690 |a monitoramento epidemiológico 
690 |a klebsiella pneumoniae 
690 |a betalactamases 
690 |a tipagem molecular 
690 |a Pathology 
690 |a RB1-214 
655 7 |a article  |2 local 
786 0 |n Jornal Brasileiro de Patologia e Medicina Laboratorial, Vol 52, Iss 5, Pp 284-292 
787 0 |n http://www.scielo.br/scielo.php?script=sci_arttext&pid=S1676-24442016000500284&lng=en&tlng=en 
787 0 |n https://doaj.org/toc/1676-2444 
787 0 |n https://doaj.org/toc/1678-4774 
856 4 1 |u https://doaj.org/article/2a6e150d50324c7d921ee2bc7bd70bb4  |z Connect to this object online.