High Prevalence of Multidrug-Resistant Klebsiella pneumoniae Harboring Several Virulence and beta-Lactamase Encoding Genes in a Brazilian Intensive Care Unit

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Ferreira, Roumayne L. ^{[1, 2]} ; da Silva, Brenda C. M. ^[1] ; Rezende, Graziela S. ^[1] ; Nakamura-Silva, Rafael ^[3] ; Pitondo-Silva, Andre ^[3] ; Campanini, Emeline Boni ^[1] ; Brito, Marcia C. A. ^[2] ; da Silva, Eulalia M. L. ^[4] ; de Melo Freire, Caio Cesar ^[1] ; da Cunha, Anderson F. ^[1] ; da Silva Pranchevicius, Maria-Cristina ^[1]

Afiliação do(s) autor(es)

^[1] Univ Fed Sao Carlos, Dept Genet & Evolucao, Sao Carlos, SP - Brazil

^[2] Lab Cent Saude Publ Tocantins, Palmas - Brazil

^[3] Univ Ribeirao Preto, Sch Dent, Ribeirao Preto - Brazil

^[4] Oklahoma Med Res Fdn, Dept Cell Cycle & Canc Biol, 825 NE 13th St, Oklahoma City, OK 73104 - USA

• Tipo de documento: Artigo Científico
• Fonte: FRONTIERS IN MICROBIOLOGY; v. 9, JAN 22 2019.
• Citações Web of Science: 7

Resumo

Klebsiella pneumoniae is an important opportunistic pathogen that commonly causes nosocomial infections and contributes to substantial morbidity and mortality. We sought to investigate the antibiotic resistance profile, pathogenic potential and the clonal relationships between K. pneumoniae (n = 25) isolated from patients and sources at a tertiary care hospital's intensive care units (ICUs) in the northern region of Brazil. Most of K. pneumoniae isolates (n = 21, 84%) were classified as multidrug resistant (MDR) with high-level resistance to beta-lactams, aminoglycosides, quinolones, tigecycline, and colistin. All the 25 isolates presented extended-spectrum beta-lactamase-producing (ESBL), including carbapenemase producers, and carried the bla(KPC) (100%), bla(TEM) (100%), bla(SHV) variants (n = 24, 96%), bia(OXA-1) group (n = 21, 84%) and bla(CTX\_M\_1) group (n = 18, 72%) genes. The K2 serotype was found in 4% (n = 1) of the isolates, and the K1 was not detected. The virulence-associated genes found among the 25 isolates were mrkD (n = 24, 96%), fimH-1 (n = 22, 88%), entB (100%), iutA (n = 10, 40%), ybtS (n = 15, 60%). The genes related with efflux pumps and outer membrane porins found were AcrAB (100%), to/C (n = 24, 96%), mdtK (n = 22, 88%), OmpK35 (n = 15, 60%), and OmpK36 (n = 7, 28%). ERIC-PCR was employed to determine the clonal relationship between the different isolated strains. The obtained ERIC-PCR patterns revealed that the similarity between isolates was above 70%. To determine the sequence types (STs) a multilocus sequence typing (MLST) assay was used. The results indicated the presence of high-risk international clones among the isolates. In our study, the wide variety of MDR K. pneumoniae harboring beta-lactams and virulence genes strongly suggest a necessity for the implementation of effective strategies to prevent and control the spread of antibiotic resistant infections. (AU)

• Processo FAPESP: 18/26100-5 - Alta Prevalência de Klebsiella Pneumoniae Multidroga Resistentes Carreando Vários Genes Codificantes de Beta Lactamases e de Virulência em uma Unidade de Terapia Intensiva Brasileira
• Beneficiário: Maria Cristina da Silva Pranchevicius
• Modalidade de apoio: Auxílio à Pesquisa - Publicações científicas - Artigo
• Processo FAPESP: 13/22581-5 - Estudo dos mecanismos de patogenicidade e correlação com resistência a antimicrobianos de Klebsiella pneumoniae isoladas no Brasil e em países dos cinco continentes
• Beneficiário: André Pitondo da Silva
• Modalidade de apoio: Auxílio à Pesquisa - Jovens Pesquisadores