Characterization of KPC-Producing Serratia marcescens in an Intensive Care Unit of a Brazilian Tertiary Hospital

Autor(es):Mostrar menos -

Ferreira, Roumayne L. ^[1] ; Rezende, Graziela S. ^[1] ; Folhas Damas, Marcelo Silva ^[1] ; Oliveira-Silva, Mariana ^{[2, 3]} ; Pitondo-Silva, Andre ^{[2, 3]} ; Brito, Marcia C. A. ^[4] ; Leonardecz, Eduardo ^[1] ; de Goes, Fabiana R. ^[5] ; Campanini, Emeline Boni ^[1] ; Malavazi, Iran ^[1] ; da Cunha, Anderson F. ; Pranchevicius, Maria-Cristina da Silva ^[1]

Afiliação do(s) autor(es)

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

^[2] Univ Ribeirao Preto, Programa Posgrad Odontol, Ribeirao Preto - Brazil

^[3] Univ Ribeirao Preto, Programa Posgrad Tecnol Ambiental, Ribeirao Preto - Brazil

^[4] Lab Cent Saude Publ Tocantins, Palmas - Brazil

^[5] Univ Sao Paulo, Inst Ciencias Matemat & Comp, Sao Carlos - Brazil

• Tipo de documento: Artigo Científico
• Fonte: FRONTIERS IN MICROBIOLOGY; v. 11, MAY 20 2020.
• Citações Web of Science: 0

Resumo

Serratia marcescens has emerged as an important opportunistic pathogen responsible for nosocomial and severe infections. Here, we determined phenotypic and molecular characteristics of 54 S. marcescens isolates obtained from patient samples from intensive-care-unit (ICU) and neonatal intensive-care-unit (NIUC) of a Brazilian tertiary hospital. All isolates were resistant to beta-lactam group antibiotics, and 92.6% (50/54) were not susceptible to tigecycline. Furthermore, 96.3% showed intrinsic resistance to polymyxin E (colistin), a last-resort antibiotic for the treatment of infections caused by MDR (multidrug-resistant) Gram-negative bacteria. In contrast, high susceptibility to other antibiotics such as fluoroquinolones (81.5%), and to aminoglycosides (as gentamicin 81.5%, and amikacin 85.2%) was found. Of all isolates, 24.1% were classified as MDR. The presence of resistance and virulence genes were examined by PCR and sequencing. All isolates carried KPC-carbapenemase (bla(KPC)) and extended spectrum beta-lactamase bla(TEM) genes, 14.8% carried bla(OXA-)(1), and 16.7% carried bla(CTX-M-)(1)(group) genes, suggesting that bacterial resistance to beta-lactam antibiotics found may be associated with these genes. The genes SdeB/HasF and SdeY/HasF that are associated with efflux pump mediated drug extrusion to fluoroquinolones and tigecycline, respectively, were found in 88.9%. The aac(6 `)-Ib-cr variant gene that can simultaneously induce resistance to aminoglycoside and fluoroquinolone was present in 24.1% of the isolates. Notably, the virulence genes to (i) pore-forming toxin (ShlA); (ii) phospholipase with hemolytic and cytolytic activities (PhlA); (iii) flagellar transcriptional regulator (FlhD); and (iv) positive regulator of prodigiosin and serratamolide production (PigP) were present in 98.2%. The genetic relationship among the isolates determined by ERIC-PCR demonstrated that the vast majority of isolates were grouped in a single cluster with 86.4% genetic similarity. In addition, many isolates showed 100% genetic similarity to each other, suggesting that the S. marcescens that circulate in this ICU are closely related. Our results suggest that the antimicrobial resistance to many drugs currently used to treat ICU and NIUC patients, associated with the high frequency of resistance and virulence genes is a worrisome phenomenon. Our findings emphasize the importance of active surveillance plans for infection control and to prevent dissemination of these strains. (AU)

• Processo FAPESP: 20/05699-6 - Caracterização de Serratia marcescens produtoras de KPC em uma unidade de terapia intensiva de um hospital terciário brasileiro
• Beneficiário: Maria Cristina da Silva Pranchevicius
• Modalidade de apoio: Auxílio à Pesquisa - Publicações científicas - Artigo
• Processo FAPESP: 18/24213-7 - Análise da presença de genes codificantes de resistência antimicrobiana e virulência em Serratia marcescens e identificação de candidatos a vacina contra Serratia marcescens, através de vacinação reversa
• Beneficiário: Marcelo Silva Folhas Damas
• Modalidade de apoio: Bolsas no Brasil - Iniciação Científica
• 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