β-lactamase producing enterobacteria isolated from surveillance swabs of patients in a cardiac intensive care unit in Rio de Janeiro, Brazil

Abstract

There is a high incidence of infections caused by betalactamase-producing Gram-negative microorganisms in Brazil. These organisms are of clinical and epidemiological importance, since their mobile genetic elements facilitate cross-infection. The present study was conducted in sentinel rectal swabs from patients admitted to a cardiac surgery hospital in Rio de Janeiro, from January through December 2007, in a consecutive manner. The aim of the study was to characterize the genotype and phenotype of these isolates from colonized patients. Biochemical tests, antimicrobial susceptibility tests, a confirmatory test for the expression of extended spectrum betalactamase (ESBL) production and polymerase chain reaction for the blaTEM, blaSHV, CTX-M1, Toho-1 and AmpC genes were performed at the University Hospital of Universidade do Estado do Rio de Janeiro (UERJ). The most frequently isolated bacteria were Escherichia coli 9/41 (21.95%) and Klebsiella pneumoniae 14/41 (34.1%). In 24/41 (58%), the ESBL genotype was confirmed. The most prevalent genes in samples that expressed ESBL were blaTEM 13/24 (54%), AmpC 12/24 (50%), blaSHV 6/24 (25%), CTX-M1 7/24 (29%), and Toho-1 6/24 (25%). Of these, 14/24 (58%) presented more than one genotype for the tested primers. In nine (37%) samples other than E. coli, K. pneumoniae or Proteus spp., the phenotype for ESBL was found and confirmed by PCR. The most sensitive substrate in the approximation test in ESBL positive samples was ceftriaxone (83%). Fifty percent of the samples expressed AmpC were associated with other genes. Intermediate susceptibility to ertapenem was found in 2/41 (5%).

Epidemiologia das betalactamases de espectro estendido no Brasil: impacto clínico e implicações para o agronegócio

“…Desse modo, diferentes clones de Klebsiella spp. produtores de CTX-M têm sido relatados na literatura, especialmente em unidades de tratamento intensivo, assim como cepas de Escherichia coli extraintestinal (16,35,83,86) . Logo, altas taxas de mortalidade são associadas a infecções por K. pneumoniae produtora de ESBL (48,49,82) , tendo como evento favorável a colonização para o estabelecimento da infecção (16) .…”

A Visualized Mortality Prediction Score Model in Hematological Malignancies Patients with Carbapenem-Resistant Organisms Bloodstream Infection

“…Notably, an increasing number of novel potent molecules are being developed for CRO therapy, such as the novel β-lactam/β-lactamase inhibitor combinations, ceftazidime/avibactam, meropenem/vaborbactam, and imipenem/ cilastatin/relebactam. [71][72][73][74][75] Their role in the treatment of high-risk population should be furtherly studied.…”

“…The univariate analysis results indicated the variables associated with mortality as follows: age, pre-infection length of stay >14 days, primary disease status, Pitt score >4, mucositis, laboratory findings including CAR >8.8, PCT >11. 74 The statistically significant risk factors from the univariate analysis above were chosen for further multivariate analysis. Early definitive therapy (HR=0.52; 95% CI, 0.32-0.86), long-duration treatment (HR=0.37; 95% CI, 0.21-0.64) were independent favorable prognostic factors for 30-day mortality, while pre-infection length of stay >14 days (HR=1.80; 95% CI, 1.02-3.17), Pitt score >4 (HR=3.32; 95% CI, 1.02-3.17), mucositis (HR=2.11; 95% CI, 1.20-3.70) and CAR >8.8 (HR=1.80; 95% CI,1.02-3.17) were independent negative prognostic factors for 30-day mortality (Table 2).…”

Diversity and antibiotic resistance patterns of enterobacteria isolated from seafood in Thailand

“…The co-occurrence of three β-lactamase genes in single strains was also noticed in this study. The blaTEM, ampC, and shv genes were reported as the most prevalent genes at the frequencies of 54%, 50%, and 25%, respectively, among isolates of ESBL-producing enterobacteria from patients in Rio de Janeiro, Brazil (Vasques, Bello, Da Cruz Lamas, Correa, & Pereira, 2011). The blaTEM gene was also the most prevalent (89.2%) among E. coli isolates from animals presenting at a veterinary hospital in Dublin, Ireland.…”