巴西累西腓市分离的肺炎克雷伯菌中存在多种耐药基因，包括 bla(KPC)和 bla(CTX)-M-2。
Multidrug resistance genes, including bla(KPC) and bla(CTX)-M-2, among Klebsiella pneumoniae isolated in Recife, Brazil.
机构信息
Departamento de Medicina Tropical, Universidade Federal de Pernambuco, Recife, PE.
出版信息
Rev Soc Bras Med Trop. 2012 Oct;45(5):572-8. doi: 10.1590/s0037-86822012000500007.
INTRODUCTION
The prevalence of cephalosporins and carbapenem-resistant Klebsiella pneumoniae strains is rising in Brazil, with potential serious consequences in terms of patients' outcomes and general care.
METHODS
This study characterized 24 clinical isolates of K. pneumoniae from two hospitals in Recife, Brazil, through the antimicrobial susceptibility profile, analyses of β-lactamase genes (bla(TEM), bla(SHV),bla(CTX-M), bla(KPC), bla(VIM), bla(IMP), and bla(SPM), plasmidial profile and ERIC-PCR (Enterobacterial repetitive intergenic consensus-polymerase chain reaction).
RESULTS
ERIC-PCR and plasmidial analysis grouped the isolates in 17 and 19 patterns, respectively. Six isolates from one hospital presented the same pattern by ERIC-PCR, indicating clonal dissemination. All isolates presented bla(SHV), 62.5% presented bla(CTX)-M-2, 29% bla(TEM), and 41.7% bla(KPC). Metallo-β-lactamase genes bla(VIM), bla(IMP), and bla(SPM) not detected. Eleven isolates were identified carrying at least 3 β-lactamase studied genes, and 2 isolates carried bla(SHV), bla(TEM), bla (CTX-M-2) and bla(KPC) simultaneously.
CONCLUSIONS
The accumulation of resistance genes in some strains, observed in this study, imposes limitations in the therapeutic options available for the treatment of infections caused by K. pneumoniae in Recife, Brazil. These results should alert the Brazilian medical authorities to establish rigorous methods for more efficiently control the dissemination of antimicrobial resistance genes in the hospital environment.
简介
巴西头孢菌素和碳青霉烯类耐药肺炎克雷伯菌的流行率正在上升，这可能对患者的预后和一般治疗产生严重后果。
方法
本研究通过抗菌药物敏感性分析、β-内酰胺酶基因（bla(TEM)、bla(SHV)、bla(CTX-M)、bla(KPC)、bla(VIM)、bla(IMP)和bla(SPM)）、质粒图谱和ERIC-PCR（肠杆菌重复基因间一致性-聚合酶链反应）对来自巴西累西腓的两家医院的 24 株肺炎克雷伯菌临床分离株进行了特征分析。
结果
ERIC-PCR 和质粒分析分别将分离株分为 17 种和 19 种模式。来自一家医院的 6 株分离株通过 ERIC-PCR 呈现相同的模式，表明存在克隆传播。所有分离株均携带 bla(SHV)，62.5%携带 bla(CTX)-M-2，29%携带 bla(TEM)，41.7%携带 bla(KPC)。未检测到金属β-内酰胺酶基因 bla(VIM)、bla(IMP)和 bla(SPM)。11 株分离株携带至少 3 种研究的β-内酰胺酶基因，2 株分离株同时携带 bla(SHV)、bla(TEM)、bla(CTX-M-2)和 bla(KPC)。
结论
本研究观察到一些菌株中耐药基因的积累，这对巴西累西腓地区治疗肺炎克雷伯菌感染的治疗选择造成了限制。这些结果应提醒巴西卫生当局建立严格的方法，以更有效地控制医院环境中抗菌药物耐药基因的传播。
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