Klebsiella pneumoniae strains can produce different virulence factors, such as fimbrial adhesins and siderophores, which are important in the colonization and development of the infection. The aims of this study were to determine the occurrence of fimH, mrkD, and irp2 virulence genes in 22 KPC-2-producing K. pneumoniae isolates as well as 22 not producing-KPC isolates, from patients from different hospitals in Recife-PE, Brazil, and also to analyze the clonal relationship of the isolates by enterobacterial repetitive intergenic consensus-polymerase chain reaction (ERIC-PCR). The genes were detected by PCR and DNA sequencing. The bla KPC-2 gene was identified in 22 KPC-positive isolates. On analyzing the antimicrobial susceptibility profile of the isolates, it was detected that polymyxin and amikacin were the antimicrobials of best activity against K. pneumoniae. On the other hand, five isolates exhibited resistance to polymyxin. In the KPC-positive group, was observed a high rate of resistance to cephalosporins, followed by carbapenems. Molecular typing by ERIC-PCR detected 38 genetic profiles, demonstrating a multiclonal spread of the isolates analyzed. It was observed that the virulence genes irp2, mrkD, and fimH were seen to have together a higher frequency in the KPC-positive group. The accumulation of virulence genes of KPC-positive K. pneumoniae isolates, observed in this study, along with the multi-resistance impose significant therapeutic limitations on the treatment of infections caused by K. pneumoniae.

Objetivo: O presente trabalho dá prosseguimento ao estudo da validade de equações para valores teóricos (VT) para cálculos espirométricos na população brasileira. Foi feita a comparação entre as equações propostas por Mallozzi (VT-M) para população brasileira e as de Polgar (VT-P), utilizadas especialmente na Europa e Estados Unidos. Métodos: Foram analisados os VT medidos em 185 pacientes de ambos os sexos, com idade entre 6 e 17 anos, sendo 89 meninos e 96 meninas. Para cada paciente foi feito o cálculo do VT para CVF, VEF 1 e FEF 25-75 segundo as equações de Mallozi VT-M e de Polgar VT-P. Em seguida foram comparados os laudos obtidos por um e por outro, segundo o Consenso de Espirometria da SBPT. Resultados: O VT-M para CVF é 0,38% maior para os meninos e 2,19% para as meninas que o calculado segundo Polgar. Os VT-P para o VEF 1 são 6,67% (p < 0,05) menores para as meninas e 7,26% para os meninos. Para o FEF 25-75 os valores diferem apenas em 0,35 e 0,43% para cada um dos sexos, sem significância estatística. Conclusão: Os VTs de CVF e VEF 1 para crianças brasileiras, avaliados segundo Mallozzi, diferem significativamente quanto aos VTs de Polgar. Como conseqüência, encontramos, utilizando as equações de Mallozzi, tendência maior em diagnosticar dificuldade obstrutiva e menor em achados de insuficiência ventilatória restritiva. (J Pneumol 2002;28(3):125-130) Comparison between the theoretical values for spirometric data in children determined by Mallozi's and Polgar's equations Objective: This paper is a continuation of the study on the validity of equations of predicted value (PV) for the Brazilian population. A comparison was made between the equations proposed by Mallozi and byPolgar for the Brazilian population, which are mainly used in the United States and Europe. Methods: PVs of 185 patients of both sexes (89 boys and 96 girls), ages between 6 and 17 years, were analyzed. For each subject, the PVs for forced vital capacity (FVC), forced expiratory volume at 1 sec. (FEV 1 ), and the medium expiratory flow (MEF) were calculated according to the equations proposed by Mallozi and Polgar. Results were compared. Diagnoses were made according to the Brazilian Consensus of Spirometry. Results: The PV-M for FVC is 0.38% higher for boys and 2.19% higher for girls than that determined by Polgar. The PV-P for FEV 1 is 6.67% (p < 0.05) lower for girls, suggesting an underassessment of the obstructive impairment. For boys, a mean lower value of 7.26% as compared to the VT-M is at the limit of significance (0.05 < p < 0.01). No significant difference between the two equations analyzed was found for MEF. Conclusions: The PVs for CVF and VEF 1 for Brazilian children, according to Mallozzi, are significantly different when compared to those published by authors like Polgar. As a result, the authors found that Mallozzi's equations are more likely to detect obstructive impairment and less likely to diagnose restrictive ventilatory insufficiency.ARTIGO ORIGINAL

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