Phenotypic and molecular detection of the blaKPC gene in clinical isolates from inpatients at hospitals in São Luis, MA, Brazil

BMC Infectious Diseases

Research Article

Rosimary de Jesus Gomes Turri¹  Sirlei Garcia Marques²  Simone Gonçalves Santos³  Patricia Cristina Saldanha Ribeiro⁴  Andrea Souza Monteiro⁴  Maria Rosa Quaresma Bomfim⁴  Martina Márcia Melo Coqueiro⁴  Sílvio Gomes Monteiro⁴  Valério Monteiro-Neto⁴  Ana Cláudia Garcia Marques⁵ 

[1] Departamento de Farmácia, Universidade Federal do Maranhão, Av. dos Portugueses, 1966 - Bacanga, São Luis, Maranhão, Brazil;Hospital Universitário da Universidade Federal do Maranhão, Rua Barão de Itapari, 227, Centro, São Luís, Maranhão, Brazil;Instituto de Ciências Biológicas, Universidade Federal de Minas Gerais, Av. Antonio Carlos, 6627, Pampulha, Belo Horizonte, MG, Brazil;Programa de Pós-Graduação em Biologia Parasitária, Universidade CEUMA, Rua Josué Montello, No. 1, Renascença II, CEP 65075-120, São Luís, Maranhão, Brazil;Programa de Pós-Graduação em Saúde do Adulto e da Criança-UFMA, Universidade Federal do Maranhão, Av. dos Portugueses, 1966 - Bacanga, São Luis, Maranhão, Brazil;

关键词: Klebsiella pneumoniae;    bla;    Multidrug-resistance (MDR);    Enterobacterial repetitive intergenic consensus PCR (ERIC-PCR);   

DOI  :  10.1186/s12879-016-2072-3

 received in 2016-02-25, accepted in 2016-11-28,  发布年份 2016

来源: Springer

【 摘 要 】

BackgroundBacteria that produce Klebsiella pneumoniae carbapenemases (KPCs) are resistant to broad-spectrum β-lactam antibiotics. The objective of this study was to phenotypically and genotypically characterize the antibiotic susceptibility to carbapenems of 297 isolates recovered from clinical samples obtained from inpatients at 16 hospitals in São Luis (Maranhão, Brazil).MethodsThe study was conducted using phenotypic tests and molecular methods, including polymerase chain reaction (PCR), sequencing and enterobacterial repetitive intergenic consensus (ERIC)-PCR. The nonparametric chi-square test of independence was used to evaluate the associations between the bacterial blaKPC gene and the modified Hodge test, and the chi-square adherence test was used to assess the frequency of carbapenemases and their association with the blaKPC gene.ResultsThe most frequently isolated species were Acinetobacter baumannii (n = 128; 43.0%), K. pneumoniae (n = 75; 25.2%), and Pseudomonas aeruginosa (n = 42; 14.1%). Susceptibility assays showed that polymixin B was active against 89.3% of the bacterial isolates. The Acinetobacter spp. and K. pneumoniae strains were susceptible to amikacin and tigecycline, and Pseudomonas spp. were sensitive to gentamicin and amikacin. Among the 297 isolates, 100 (33.7%) were positive for the blaKPC gene, including non-fermentative bacteria (A. baumannii) and Enterobacteriaceae species. Among the isolates positive for the blaKPC gene, K. pneumoniae isolates had the highest positivity rate of 60.0%. The blaKPC gene variants detected included KPC-2, which was found in all isolates belonging to species of the Enterobacteriaceae family. KPC-2 and KPC-3 were observed in A. baumannii isolates. Importantly, the blaKPC gene was also detected in three Raoultella isolates and one isolate of the Pantoea genus. ERIC-PCR patterns showed a high level of genetic diversity among the bacterial isolates; it was capable of distinguishing 34 clones among 100 strains that were positive for blaKPC and were circulating in 11 of the surveyed hospitals.ConclusionsThe high frequency of the blaKPC gene and the high degree of clonal diversity among microorganisms isolated from patients from different hospitals in São Luis suggest the need to improve the quality of health care to reduce the incidence of infections and the emergence of carbapenem resistance in these bacteria as well as other Gram-negative pathogens.

【 授权许可】

CC BY   
© The Author(s). 2016