Extended-spectrum beta-lactamases among Enterobacteriaceae isolated in a public hospital in Brazil

Abstract

SUMMARYExtended-spectrum β-lactamases (ESBL) in enterobacteria are recognized worldwide as a great hospital problem. In this study, 127 ESBL-producing Enterobacteriaceae isolated in one year from inpatients and outpatients at a public teaching hospital at São Paulo, Brazil, were submitted to analysis by PCR with specific primers for bla SHV , bla TEM and bla CTX-M genes. From the 127 isolates, 96 (75.6%) Klebsiella pneumoniae, 12 (9.3%) Escherichia coli, 8 (6.2%) Morganella morganii, 3 (2.3%) Proteus mirabilis, 2 (1.6%) Klebsiella oxytoca, 2 (1.6%) Providencia rettgeri, 2 (1.6%) Providencia stuartti, 1 (0.8%) Enterobacter aerogenes and 1 (0.8%) Enterobacter cloacae were identified as ESBL producers. Bla SHV , bla TEM and bla CTX-M were detected in 63%, 17.3% and 33.9% strains, respectively. Pulsed field gel eletrophoresis genotyping of K. pneumoniae revealed four main molecular patterns and 29 unrelated profiles. PCR results showed a high variety of ESBL groups among strains, in nine different species. The results suggest the spread of resistance genes among genetically different strains of ESBL-producing K. pneumoniae in some hospital wards, and also that some strongly related strains were identified in different hospital wards, suggesting clonal spread in the institutional environment.

High Prevalence and Significant Association of ESBL and QNR Genes in Pathogenic Klebsiella pneumoniae Isolates of Patients from Kolkata, India

“…During our one year study, most of the K. pneumoniae was isolated from patients with urinary tract infection at inpatient department. The prevalence of Klebsiella among hospitalized patients has been reported by other investigators from different countries including France, Turkey, Brazil and India [2,3,5,19]. Similar to our study (58.9 % ESBL), reports from other parts of India and other Asian countries have demonstrated comparable prevalence of ESBL K. pneumoniae (40-83.3 and 60 % respectively) whereas much lower prevalence is noted in western countries [5][6][7]20].…”

“…Resistance against beta-lactam and quinolone group of drugs, widely used for their treatment is mainly acquired by intra or inter species exchange of transferable plasmid encoded antibiotic resistant genes (viz bla TEM , bla SHV , bla CTX-M , QNR A, QNR B, and QNR S) [2]. Currently C150 TEM, C88 SHV, C69 CTX-M types variants has been described [3]. Six QNR A (QNR A1-QNR A6), 20 QNR B (QNR B1-QNR B20) and 3 QNR S variants (QNR S1-QNR S3) have been identified worldwide.…”

Complex class 1 integrons harboring CTX-M-2-encoding genes in clinical Enterobacteriaceae from a hospital in Brazil

“…Twenty-eight non-clonal ESBL-producing Enterobacteriaceae strains, previously isolated [17] in a hospital set and representing, according to the institution's infection control committee, hospital infections (n = 9), community-acquired infections (n = 4), and colonization strains (n=15), were selected based on their distinct PFGE profiles and the detection of bla CTX-M genes by polymerase chain reaction (PCR) [18]. These non-clonal strains were selected in order to demonstrate the mobility and spread potential of CTX-M-encoding genes even when there is no clonal dissemination.…”

Detection of bla KPC-2 in Proteus mirabilis in Brazil

“…expasy.org/tools/ translate) showed that the isolate harbored bla KPC-2 and bla TEM-1 (GenBank accession numbers KC736925 and KF811201). bla TEM has been described in P. mirabilis from Brazil by Dropa et al (10) and Abreu et al (11) , but they did not sequence the gene. The analysis of antimicrobial agents revealed susceptibility to meropenem, polymyxin, and tigecycline.…”