Antimicrobial resistance among Enterobacteriaceae in South America: History, current dissemination status and associated socioeconomic factors

Bonelli, Raquel Regina; Moreira, Beatriz Meurer; Picão, Renata C.

doi:10.1016/j.drup.2014.02.001

Cited by 64 publications

(68 citation statements)

References 149 publications

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“…In Enterobacteriaceae, ESBL production is a decisive mechanism that determines resistance to broad-spectrum cephalosporins. Recent studies by Jones et al (2013), Bonelli, Moreira, and Picão, (2014), and Nogueira et al (2014) corroborate our findings, indicating that this mechanism of resistance is especially common in K. pneumoniae, E. coli, and Enterobacter spp. in Brazil, with important implications for decisions regarding adequate antimicrobial therapy.…”

Section: Discussionsupporting

confidence: 91%

“…This finding raises concerns about inadequate control in the studied hospital environment and the dissemination of multidrug-resistant bacteria. KPC-producing Enterobacteriaceae was first reported in Brazil in 2005 and has spread, becoming endemic in many hospitals (Bonelli, Moreira, Picão, 2014). A previous study in southern Brazil was based on a surveillance program for multidrug-resistant bacteria and found that KPC-producing Enterobacteriaceae increased from 17% in 2010 to over 80% in 2011 (Toledo et al, 2012).…”

Section: Discussionmentioning

confidence: 99%

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β-lactamase-producing Gram-negative bacteria in an intensive care unit in southern Brazil

Leite

Oizumi

Caleffi-Ferracioli

et al. 2017

Braz. J. Pharm. Sci.

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The present study evaluated the antimicrobial susceptibility profile, b-lactamase production, and genetic diversity of Enterobacteriaceae, Pseudomonas aeruginosa, and Acinetobacter spp. using phenotypic identification, antimicrobial susceptibility testing, and b-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 b-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-b-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.

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Section: Discussionsupporting

confidence: 91%

Section: Discussionmentioning

confidence: 99%

β-lactamase-producing Gram-negative bacteria in an intensive care unit in southern Brazil

Leite

Oizumi

Caleffi-Ferracioli

et al. 2017

Braz. J. Pharm. Sci.

View full text Add to dashboard Cite

show abstract

“…From clinical and epidemiological perspectives, antimicrobial resistance observed in this study is extremely relevant, especially considering the Gram‐negative bacteria which may be related to production of modifying enzymes, as ESBL, AmpC and metallo‐β‐lactamases (Hawkey ). These enzymes may be chromosomally encoded in several Gram‐negative bacteria, however, it is also documented that in enterobacteria and some NFR they may be plasmid‐mediated (Wellington, Boxall, Cross, Feil, Gaze, Hawkey, Johnson‐Rollings, Jones, Lee, Otten, Thomas & Williams ; Bonelli, Moreira & Picão ).…”

Section: Resultsmentioning

confidence: 99%

Antibiotic resistance in potentially bacteriocinogenic probiotic bacteria in aquaculture environments

et al. 2016

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Bacteriocin‐producing bacteria in aquaculture may prevent spreading of potentially pathogenic microorganisms, and could be used as an alternative to the empirical use of antimicrobial drugs, especially for prophylaxis. Bacteriocinogenic bacteria inoculated as probiotics should not carry undesirable traits, such as antibiotic resistance. This study aimed to find potentially bacteriocinogenic bacteria in an aquaculture system and evaluate their antimicrobial susceptibility patterns. Selective cultures for enterobacteria, non‐fermenting Gram‐negative rods and Gram‐positive cocci were obtained from water samples before bacterial isolation and biochemical identification. Overall, 160 representative strains were recovered and for 57 antagonism was observed against selected strains such as Staphylococcus aureus, with antagonism being expressed better on Brain Heart Infusion medium. After exclusion of interfering factors, bacteriocin or bacteriocin‐like substances were suggested to be related to the antagonism observed. Higher drug‐resistant rates were observed among potentially bacteriocinogenic bacteria for different antimicrobials of clinical relevance. Although antibiotic resistance is a global health problem and bacteriocins are attractive alternatives to classical antibiotic even to multiresistant bacteria, the data obtained suggest that bacteriocin‐producing bacteria may harbour resistance genes available for transference in different environments. From the ecological and biotechnological perspective, antimicrobial susceptibility tests must be always performed when prospecting potentially bacteriocinogenic bacteria as probiotic candidates in the environment.

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“…Low socioeconomic status has been described previously as a risk factor for antimicrobial resistance of Enterobacteriaceae, Mycobacterium tuberculosis, and other pathogens [19][20][21]. To our knowledge, low socioeconomic status has not been previously described as a risk factor for CRAB.…”

Section: Discussionmentioning

confidence: 69%

“…Antibiotic exposure is one of the most frequently reported risk factors for MDR A. baumannii colonization or infection. Some studies found carbapenems to be a risk factor, but reported ORs varied across the studies [9,12,14,19]. In other studies, the use of fluoroquinolones was associated with MDR A. baumannii infection, whereas several studies did not find an association between antibiotic use and MDR A. baumannii isolation [11].…”

Section: Discussionmentioning

confidence: 94%

Risk factors for and impact of carbapenem-resistant Acinetobacter baumannii colonization and infection: matched case–control study

Henig

Weber

Hoshen

et al. 2015

Eur J Clin Microbiol Infect Dis

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The objective of this investigation was to identify risk factors for carbapenem-resistant Acinetobacter baumannii (CRAB) and its association with mortality. A population-based matched case-control study using the computerized database of Clalit Health Services (CHS) in the period between 2007 and 2012 was conducted. Hospitalized patients with CRAB colonization or infection were compared to hospitalized patients without evidence of A. baumannii, matched by age, ward of hospitalization, season, Charlson score, and length of hospitalization. Risk factors for CRAB isolation were searched for using multivariate analysis. Association of CRAB and other risk factors with mortality were assessed in the cohort. A total of 1190 patients with CRAB were matched to 1190 patients without CRAB. Low socioeconomic status was independently associated with CRAB isolation and CRAB bacteremia [odds ratio 2.18, 95% confidence interval (CI) 1.02-5]. Other risk factors were invasive procedures and bacteremia with other pathogens prior to CRAB isolation, and various comorbidities. Among all patients, CRAB isolation was independently associated with increased mortality (hazard ratio 2.33, 95% CI 2.08-2.6). Socioeconomic status is associated with health outcomes. Our population-based study revealed an almost doubled risk for CRAB in patients at lower socioeconomic status and an association with healthcare exposure. CRAB was associated with mortality and might become a risk indicator for complex morbidity and mortality.

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Antimicrobial resistance among Enterobacteriaceae in South America: History, current dissemination status and associated socioeconomic factors

Cited by 64 publications

References 149 publications

β-lactamase-producing Gram-negative bacteria in an intensive care unit in southern Brazil

β-lactamase-producing Gram-negative bacteria in an intensive care unit in southern Brazil

Antibiotic resistance in potentially bacteriocinogenic probiotic bacteria in aquaculture environments

Risk factors for and impact of carbapenem-resistant Acinetobacter baumannii colonization and infection: matched case–control study

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