Antimicrobial resistance in Enterobacteriaceae in Brazil: focus on β-lactams and polymyxins

Abstract

During the last 30 years there has been a dissemination of plasmid-mediated β-lactamases in Enterobacteriaceae in Brazil. Extended spectrum β-lactamases (ESBL) are widely disseminated in the hospital setting and are detected in a lower frequency in the community setting. Cefotaximases are the most frequently detected ESBL type and Klebsiella pneumoniae is the predominant species among ESBL producers. Klebsiella pneumoniae carbapenemase-producing Enterobacteriaceae became widely disseminated in Brazil during the last decade and KPC production is currently the most frequent resistance mechanism (96.2%) in carbapenem resistant K. pneumoniae. To date KPC-2 is the only variant reported in Brazil. Polymyxin B resistance in KPC-2-producing K. pneumoniae has come to an alarming rate of 27.1% in 2015 in São Paulo, the largest city in Brazil. New Delhi metallo-β-lactamase was detected in Brazil in 2013, has been reported in different Brazilian states but are not widely disseminated. Antimicrobial resistance in Enterobacteriaceae in Brazil is a very serious problem that needs urgent actions which includes both more strict adherence to infection control measures and more judicious use of antimicrobials.

Extended-spectrum beta-lactamase (ESBL)-producing Enterobacteriaceae in cattle production – a threat around the world

“…Originated from mastitis or with faecal origin in E. coli and K. pneumoniae. There are several reports in human clinical E-ESBL of CTX-M-2, CTX-M-15, CTX-M and SHV in Brazil (Sampaio and Gales, 2016).…”

Chemical Composition and Pharmacological Effects of Geopropolis Produced byMelipona quadrifasciata anthidioides

“…The identification of new compounds with antimicrobial action has aroused the interest of the pharmaceutical industry, especially because many strains of microorganisms have become resistant to currently available antimicrobial drugs, thereby resulting in high morbidity and mortality rates, especially among nosocomial infections [ 57 , 58 ]. Among the main mechanisms of resistance are the elimination of antibiotics by efflux pumps present in the cell wall of microorganisms [ 59 , 60 ] and the degradation of antibiotics by specific enzymes [ 61 ].…”

Microbiological investigation of ties and shirts in a Teaching Hospital, in São Paulo (SP), Brazil /Investigação microbiológica entre diferentes indumentárias em Hospital Escola em São Paulo (SP) Brasil

“…These bacteria are resistant to practically all antibiotics (17) and are able to transmit resistance to other bacteria they come into contact with. In the present study, only one K. pneumoniae colony was isolated, where this proved KPC positive.…”