Polymyxin B Resistance in Carbapenem-Resistant<i>Klebsiella pneumoniae</i>, São Paulo, Brazil

Bartolleti, Flávia; Seco, Bruna Mara Silva; Santos, Carla C.; Felipe, Carolina Bragança; Lemo, Mara Elisa Borsato; Alves, Tatiane da Silva; Passadore, Lilian Ferri; Mimica, Marcelo Jenne; Sampaio, Suely Carlos Ferreira; Zavascki, Alexandre Prehn; Sampaio, Julliane Messias Cordeiro

doi:10.3201/eid2210.160695

Cited by 52 publications

(35 citation statements)

References 8 publications

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“…Among the carbapenem-resistant K. pneumoniae STs identified in this study, the emergence of colistin resistance had been already reported in KPC-2-producing ST101 (14) and bla KPC-2 -and bla CTX-M -producing ST307 (15,16). Carbapenem-and colistin-resistant isolates of ST437 have been reported previously (17). The bla NDM gene was detected in ST340 (Table 1).…”

mentioning

confidence: 61%

Molecular Epidemiology of Colistin-Resistant, Carbapenemase-Producing Klebsiella pneumoniae in Serbia from 2013 to 2016

Novović

Trudić

Brkić

et al. 2017

Antimicrob Agents Chemother

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Twenty-seven colistin-resistant, carbapenemase-producing Klebsiella pneumoniae isolates were identified from hospitals in Serbia. All isolates were bla CTX-M-15 positive; ST101, ST888, ST437, ST336, and ST307 were bla OXA-48 positive; and ST340 was bla NDM-1 positive. ST307 had an insertion, and ST336 had a premature stop codon in the mgrB gene. Amino acid substitutions were detected in PmrAB of isolates ST101, ST888, ST336, and ST307. The mcr-1 and mcr-2 were not detected. An increase in phoP, phoQ, and pmrK gene transcription was detected for all sequence types.

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confidence: 61%

Molecular Epidemiology of Colistin-Resistant, Carbapenemase-Producing Klebsiella pneumoniae in Serbia from 2013 to 2016

Novović

Trudić

Brkić

et al. 2017

Antimicrob Agents Chemother

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“…The most recent evidence of the amazing polymyxin resistance problem in Brazil came from a report from São Paulo, the largest city in Latin America. The authors described a 35.5% carbapenem resistance rate due to KPC-2 production, among K. pneumoniae causing infections in 2015, and also found an increase in polymyxin B resistance among KPC-producing K. pneumoniae , from 0% in 2011 to 27.1% in 2015 80 . This increase coincided with the increased use of polymyxins as empiric therapy to treat severe infectious when Gram negatives are possible etiologic agents in intensive care units.…”

Section: Polymyxin Resistance In Carbapenem-resistant K Pneumoniae: mentioning

confidence: 95%

Antimicrobial resistance in Enterobacteriaceae in Brazil: focus on β-lactams and polymyxins

Sampaio

Gales

2016

Brazilian Journal of Microbiology

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111

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During the last 30 years there has been a dissemination of plasmid-mediated β-lactamases in Enterobacteriaceae in Brazil. Extended spectrum β-lactamases (ESBL) are widely disseminated in the hospital setting and are detected in a lower frequency in the community setting. Cefotaximases are the most frequently detected ESBL type and Klebsiella pneumoniae is the predominant species among ESBL producers. Klebsiella pneumoniae carbapenemase-producing Enterobacteriaceae became widely disseminated in Brazil during the last decade and KPC production is currently the most frequent resistance mechanism (96.2%) in carbapenem resistant K. pneumoniae. To date KPC-2 is the only variant reported in Brazil. Polymyxin B resistance in KPC-2-producing K. pneumoniae has come to an alarming rate of 27.1% in 2015 in São Paulo, the largest city in Brazil. New Delhi metallo-β-lactamase was detected in Brazil in 2013, has been reported in different Brazilian states but are not widely disseminated. Antimicrobial resistance in Enterobacteriaceae in Brazil is a very serious problem that needs urgent actions which includes both more strict adherence to infection control measures and more judicious use of antimicrobials.

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“…As carbapenemase-producing Enterobacteriaceae have become more prevalent, the use of polymyxin has gradually increased, and the resistance of these bacteria has subsequently also increased (107,108). Acquired resistance to polymyxins in Enterobacteriaceae is due mainly to modifications in the polymyxin target, the lipopolysaccharide.…”

Section: Detection Of Polymyxin Resistancementioning

confidence: 99%

Matrix-Assisted Laser Desorption Ionization–Time of Flight Mass Spectrometry for the Rapid Detection of Antimicrobial Resistance Mechanisms and Beyond

2018

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SUMMARY Matrix-assisted laser desorption ionization–time of flight mass spectrometry (MALDI-TOF MS) has been successfully applied in recent years for first-line identification of pathogens in clinical microbiology because it is simple to use, rapid, and accurate and has economic benefits in hospital management. The range of clinical applications of MALDI-TOF MS for bacterial isolates is increasing constantly, from species identification to the two most promising applications in the near future: detection of antimicrobial resistance and strain typing for epidemiological studies. The aim of this review is to outline the contribution of previous MALDI-TOF MS studies in relation to detection of antimicrobial resistance and to discuss potential future challenges in this field. Three main approaches are ready (or almost ready) for clinical use, including the detection of antibiotic modifications due to the enzymatic activity of bacteria, the detection of antimicrobial resistance by analysis of the peak patterns of bacteria or mass peak profiles, and the detection of resistance by semiquantification of bacterial growth in the presence of a given antibiotic. This review provides an expert guide for MALDI-TOF MS users to new approaches in the field of antimicrobial resistance detection, especially possible applications as a routine diagnostic tool in microbiology laboratories.

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Polymyxin B Resistance in Carbapenem-ResistantKlebsiella pneumoniae, São Paulo, Brazil

Cited by 52 publications

References 8 publications

Molecular Epidemiology of Colistin-Resistant, Carbapenemase-Producing Klebsiella pneumoniae in Serbia from 2013 to 2016

Molecular Epidemiology of Colistin-Resistant, Carbapenemase-Producing Klebsiella pneumoniae in Serbia from 2013 to 2016

Antimicrobial resistance in Enterobacteriaceae in Brazil: focus on β-lactams and polymyxins

Matrix-Assisted Laser Desorption Ionization–Time of Flight Mass Spectrometry for the Rapid Detection of Antimicrobial Resistance Mechanisms and Beyond

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