Wide Dissemination of Pseudomonas aeruginosa Producing β-Lactamase bla _KPC-2 Gene in Colombia

Abstract

Ten bla KPC-2 -harboring Pseudomonas aeruginosa isolates from hospitals located in five different Colombian cities have been characterized. Isolates were multidrug resistant, belonged to five different pulsotypes, and possessed naturally chromosome-encoded bla AmpC and bla OXA-50 genes and the acquired bla KPC-2 gene. In most cases, the bla KPC-2 genes were carried by plasmids of different sizes and were associated with Tn4401b or a new structure containing only part of the Tn4401 sequence. This study revealed that several clones of P. aeruginosa producing bla KPC-2 are disseminating in Colombia.

Factores de riesgo para infección por Pseudomonas aeruginosa multi-resistente en un hospital de alta complejidad

“…Otro mecanismo de resistencia de esta bacteria es la alteración de los sitios blanco de los antimicrobianos como ocurre con las fluoroquinolonas, en los cuales se han observado mutaciones sobre el gen gyrA que codifica la subunidad A de la enzima ADN girasa, además de la alteración de las porinas, que impide la entrada del compuesto al microorganismo 11 ; por ejemplo, la pérdida de la porina OprD por mutación, a partir de la cual aparece resistencia a imipenem y una disminución de la sensibilidad a meropenem 10, 11,13 . En esta bacteria no fermentadora, mecanismos de panresistencia como la producción de metalo-carbapenemasas (VIM-2, VIM-8) y serin-carbapenemasas (KPC-2) ya han sido descritos en los hospitales de este país [14][15][16] , limitando el tratamiento de los pacientes a antibacterianos tóxicos y que muestran bajas tasas de curación como son las polimixinas 17 . Las medidas enfocadas a intervenir los factores de riesgo asociados a la presencia de multi-resistencia han demostrado ser las más costo efectivas [18][19][20] .…”

Klebsiella pneumoniae: Going on the Offense with a Strong Defense

“…This transposon has been found on a number of different types of plasmids in ST258 and closely related strains, and these plasmids can be transferred to other K. pneumoniae strains (14,27). To date, the spread of these plasmids and resistance cassettes to other types of bacteria has been much less frequent; however, there are several documented cases (28)(29)(30), and it is prudent to expect that more cases will be found or that the transposon may hop into a more promiscuous plasmid. In addition to KPCs, K. pneumoniae strains can carry other forms of carbapenemases, such as class B metallo-␤-lactamases (such as the New Delhi metallo-␤-lactamase NDM-1) and class D OXA enzymes (25).…”

Outbreak of pulmonary infection caused by Klebsiella pneumoniae isolates harbouring bla IMP-4 and bla DHA-1 in a neonatal intensive care unit in China

“…KPCs, especially KPC-2, have been found in members of the Enterobacteriaceae worldwide (Gupta et al, 2011;Nordmann et al, 2009). In addition to the family Enterobacteriaceae, KPCs have emerged in nonfermentative bacteria (Cuzon et al, 2011;Robledo et al, 2011;Villegas et al, 2007). In China, KPC-2 is a predominant carbapenemase and has been recognized in many members of the Enterobacteriaceae, such as K. pneumoniae, Serratia marcescens, Escherichia coli and Enterobacter cloacae (Cai et al, 2008;Wei et al, 2007;Wu et al, 2010).…”