Intrahospital spread of carbapenem-resistant Pseudomonas aeruginosa in a University Hospital in Florianópolis, Santa Catarina, Brazil

Revista da Sociedade Brasileira de Medicina Tropical

Mara Cristina Scheffer²  Maria Luiza Bazzo¹  Mario Steindel¹  Ana Lucia Darini¹  Eduardo Clímaco¹  Libera Maria Dalla-costa¹ 

[1] ,Federal University of Santa Catarina University Hospital Florianópolis SC ,Brazil

关键词: Pseudomonas aeruginosa;    Carbapenem resistance;    Nosocomial infections;    Pseudomonas aeruginosa;    Resistência aos carbapenêmicos;    Infecção nosocomial;   

DOI  :  10.1590/S0037-86822010000400006

来源: SciELO

【 摘 要 】

INTRODUCTION: Carbapenem-resistant Pseudomonas aeruginosa (CRPA) has been isolated with increasing frequency in Brazilian hospitals. Since June 2003, its detection in a teaching hospital in the city of Florianópolis, Brazil, has increased. This study aimed to investigate the minimal inhibitory concentration (MIC), presence of Metallo-β-lactamase (MβL) and a possible clonal relationship among the isolates. METHODS: The study included 29 CRPA and seven isolates with reduced susceptibility. The MIC was determined by agar-dilution. Detection of MβL was performed by Double Disk Sinergism (DDS) and Combined Disk (CD). The MβL gene was verified by PCR and nucleotide sequence analysis. Epidemiological typing was performed by pulsed-field gel electrophoresis. RESULTS: Among the 29 carbapenem-resistant isolates, polymyxin B presented 100% susceptibility and piperacillin/tazobactam 96.7%. Seventeen (62%) strains were verified as clonal (A clone) and among these, six isolates indicated phenotypically positive tests for MβL and harbored the blaSPM-1 gene. The first CRPA isolates were unrelated to clone A, harbored blaIMP-16 and were phenotypically positive only by CD. CONCLUSIONS: The spread of a high-level of resistance clone suggests cross transmission as an important dissemination mechanism and has contributed to the increased rate of resistance to carbapenems. This study emphasizes the need for continuous surveillance and improved strategies.

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