Diversity of genotypes in CTX-M-producing Klebsiella pneumoniae isolated in different hospitals in Brazil

Abstract

Objective: The present study was undertaken to characterize CTX-M ESBL-producing Klebsiella pneumoniae collected from hospitals in different cities of Brazil. Material and Methods: Eighty-five K. pneumoniae strains isolated from hospitalized patients in six different hospitals of three cities of Brazil were analyzed. ESBL production was confirmed by the standard double-disk synergy test and the Etest®. The MIC 50 and MIC 90 for ESBL-producing isolates were determined by the Etest® method. The antimicrobial susceptibilities of bacterial isolates were determined using the agar diffusion method according to the CLSI. Screening for bla TEM, bla SHV, bla CTX-M genes and class 1 integron was performed by PCR amplification. To determine the genomic diversity of CTX-M-producers, isolates were analyzed by macrorestriction profile analysis following PFGE. Results and Discussion: Seventy-one K. pneumoniae isolates were ESBL-producing. PCR and sequencing experiments detected 38 CTX-M-producing K. pneumoniae belonged to groups CTX-M 1, CTX-M 2, CTX-M 8 and CTX-M 9. The association of different types ESBL (CTX-M, SHV and TEM) was frequent. All K. pneumoniae isolates carried class 1 integron. PFGE analysis revealed thirty-one clonal types among CTX-M-producing isolates. The data presented herein illustrate the diversity of genotypes of CTX-M producing K. pneumoniae among Brazilians hospitals.

Investigation of class 1 integrons in Klebsiella pneumoniae clinical and microbiota isolates belonging to different phylogenetic groups in Recife, State of Pernambuco

“…Few studies have evaluated the presence of class 1 integrons in K. pneumoniae isolates from the Brazilian northeast 27 . Chagas et al 20 showed that all K. pneumoniae ESBL-producing isolates from Rio de Janeiro and São Paulo, Brazil carried class 1 integrons. Ahangarzadeh Rezaee et al 13 found that integrons were widely prevalent in clinical isolates of K. pneumoniae from northwestern Iran and were associated with multidrug resistance.…”

“…Classes 1, 2, and 3 are the most commonly detected 19 . Class 1 integrons are the most widespread and have been frequently found in extended-spectrum β-lactamase (ESBL)-producing clinical isolates of Enterobacteriaceae, including K. pneumoniae 6,13,16,20,21 . Class 2 integrons occur less frequently in ESBL-producing Escherichia coli and K. pneumoniae, and class 3 integrons are rarely found in ESBL-producing K. pneumoniae 21,22 .…”

Diversity Determination of CTX-M1 Producing Klebsiella pneumoniae Using Multilocus Variable-Number Tandem Repeat Analysis, Semnan, Iran

“…Production of extendedspectrum β-lactamase (ESBL) is the basic reason for the multidrug resistance in Gram negative bacteria throughout the world. Since 1983 when the first ESBL enzymes were described in Europe (Germany), there is an alarming increase in the incidence of ESBL-producing bacteria (4)(5)(6). ESBL-producing K. pneumoniae strains are one of the most important problems associated with nosocomial outbreak.…”

Pharmacokinetic/pharmacodynamic target attainment of intravenous β-lactam regimens against Gram-negative bacteria isolated in a Brazilian teaching hospital

“…This factor might also explain the increased rates of susceptibility to ceftazidime among Gram-negative rod-shaped organisms observed in our facility. However, another possible explanation is that there is a higher prevalence of cefotaximase (CTX-M)-producing Enterobacteriaceae strains in Brazil than in other countries (24) . The present study aimed at providing assessment data that might infl uence pharmacodynamic clinical guidelines for the selection of appropriate empirical antibiotic therapies for bacteremia.…”