Costa Jandira S Tomás da, Lima Celia A, Vera-Leiva Alejandra, San Martin Magdalena Iván, Bello-Toledo Helia, Domínguez Yévenes Mariana, Opazo-Capurro Andrés, Mella Montecinos Sergio, Quezada-Aguiluz Mario, González-Rocha Gerardo
Departamento de Microbiología, Facultad de Ciencias Biológicas, Universidad de Concepción, Chile.
Departamento de Medicina Interna, Facultad de Medicina, Universidad de Concepción, Chile.
Rev Chilena Infectol. 2021 Feb;38(1):81-87. doi: 10.4067/S0716-10182021000100081.
Carbapenem resistance mediated by carbapenemases in Pseudomonas aeruginosa is an important mechanism; however, loss of porin OprD remains as the most frequent.
To determine the proportion of P. aeruginosa isolates, resistant to imipenem and/or meropenem, producing carbapenemases, the type of enzyme produced and the genetic relationship between the isolates.
One hundred and thirteen resistant to at least one carbapenem isolates, obtained in 12 hospitals and 9 cities in Chile were studied. Additionally, susceptibility to ceftazidime, amikacin, gentamicin, piperacillin/tazobactam, ciprofloxacin and colistin was determined. Carba NP was performed and in the positive isolates carbapenemase genes were detected by PCR. The isolates were typified by restriction with SpeI and PFGE.
Not all isolates produce carbapenemases, and only in 61/113 of them (54%) the blaKPC (32) or blaVIM (29) was amplified. In none of the isolates was found the coharboring of both genes. The pulsotypes indicated no clonal dissemination of the isolates, evidencing an important genetic diversity.
P. aeruginosa isolates producing carbapenemases, obtained in Chilean hospitals carry blaKPC and blaVIM genes and, mostly, are polyclonal. These results emphasize the importance of carrying out epidemiological studies with a greater number of isolates to allow a better understanding of the epidemiology of carbapenemase-producing P. aeruginosa in Chile.
铜绿假单胞菌中由碳青霉烯酶介导的碳青霉烯耐药是一种重要机制；然而，孔蛋白OprD缺失仍然是最常见的。
确定对亚胺培南和/或美罗培南耐药的铜绿假单胞菌分离株产生碳青霉烯酶的比例、所产生酶的类型以及分离株之间的遗传关系。
对在智利12家医院和9个城市获得的113株至少对一种碳青霉烯耐药的分离株进行研究。此外，还测定了对头孢他啶、阿米卡星、庆大霉素、哌拉西林/他唑巴坦、环丙沙星和黏菌素的敏感性。进行了Carba NP试验，对阳性分离株通过PCR检测碳青霉烯酶基因。通过SpeI酶切和PFGE对分离株进行分型。
并非所有分离株都产生碳青霉烯酶，仅在其中61/113株（54%）中扩增出blaKPC（32株）或blaVIM（29株）。未在任何分离株中发现这两种基因的共同存在。脉冲型表明分离株无克隆传播，证明存在重要的遗传多样性。
在智利医院获得的产生碳青霉烯酶的铜绿假单胞菌分离株携带blaKPC和blaVIM基因，且大多为多克隆的。这些结果强调了对更多分离株进行流行病学研究的重要性，以便更好地了解智利产碳青霉烯酶铜绿假单胞菌的流行病学情况。
