Temporal evolution of polymyxin B-resistant Klebsiella pneumoniae clones recovered from blood cultures in a teaching hospital during a 7-year period

Autor(es)

Braun, Graziela ^{[1, 2]} ; Cayo, Rodrigo ^[1] ; Matos, Adriana Pereira ^[1] ; Fonseca, Juliane de Mello ^[3] ; Gales, Ana Cristina ^{[1, 3]}

Afiliação do(s) autor(es)

^[1] Univ Fed Sao Paulo UNIFESP, Escola Paulista Med, Dept Internal Med, Lab Alerta, Div Infect Dis, Sao Paulo, SP - Brazil

^[2] Univ Estadual Oeste Parana Unioeste, Ctr Ciencias Med & Farmaceut, Cascavel, PR - Brazil

^[3] Univ Fed Sao Paulo UNIFESP, Dept Med, Disciplina Infectol, LEMC, Sao Paulo, SP - Brazil

• Tipo de documento: Artigo Científico
• Fonte: INTERNATIONAL JOURNAL OF ANTIMICROBIAL AGENTS; v. 51, n. 3, p. 522-527, MAR 2018.
• Citações Web of Science: 7

Resumo

The polymyxins have become one of the last resorts to treat serious infections caused by KPC-2-producing Klebsiella pneumoniae worldwide. However, the increase of polymyxin consumption has favored the emergence of resistance to these compounds. In this study, we observed an increase in polymyxin B resistance rates from 0 to 30.6% among 224 K. pneumoniae isolates recovered from blood cultures between 2009 and 2015. Only gentamicin, tigecycline and fosfomycin remained active against the polymyxin B-resistant K. pneumoniae (PMB-R-KPN) isolates, which were classified as extensively drug-resistant (XDR; 83.3%), multidrug-resistant (MDR; 13.9%), or pan-drug resistant (2.8%). Most PMB-R-KPN clones belonged to CC258 (ST11, ST258, ST340, and ST437). A C7/ST258 XDR clone carrying distinct resistance determinants (bla(SHV-11), bla(TEM-1), bla(CTX-M-15), bla(CTX-M-14), bla(KPC-2), and rmtB-1) was introduced in 2014. Twelve of 36 PMB-R-KPN isolates showed disruption of mgrB. No mcr-1-positive isolate was found. The rapid detection of PMB-R-KPN isolates allied to implementation of effective infection control measures are of crucial importance to avoid the dissemination of high-risk PMB-R-KPN clones. (C) 2017 Elsevier B.V. and International Society of Chemotherapy. All rights reserved. (AU)

• Processo FAPESP: 10/12891-9 - Estudo dos transcriptomas de Pseudomonas aeruginosa, Acinetobacter baumannii e Klebsiella pneumoniae na elucidação dos seus mecanismos de resistência às polimixinas
• Beneficiário: Ana Cristina Gales
• Modalidade de apoio: Auxílio à Pesquisa - Regular