Clinical and microbiological characterization of KPC-producing Klebsiella pneumoniae infections in Brazil

Abstract

In 2008 isolates of KPC-producing Klebsiella pneumoniae (KPC-KPN) were detected for the fi rst time at Hospital Heliópolis, São Paulo, Brazil. The aim of this study was to characterize the clinical and microbiological outcomes of infections caused by KPC-KPN. A historical cohort of patients from whom KPC-KPN strains were isolated was performed. Isolates were identifi ed as resistant to ertapenem by automated broth microdilution system and screened as carbapenemase producers by the modifi ed Hodge test. The beta-lactamase resistance gene blaKPC was detected by PCR. The genetic relatedness of isolates was determined by PFGE. The study provides early clinical experience in treating KPC-KPN infections in a Brazilian tertiary center.

The first report of infection with Klebsiella pneumoniae carrying the bla kpc gene in State of Mato Grosso do Sul, Brazil

“…However, there is also evidence that the carpabenem-resistant genotype was described in 2005 in São Paulo 4 . Since then, this microorganism has been disseminate to several hospitals in different Brazilian states [5][6][7] .…”

Nosocomial meningitis caused by Klebsiella pneumoniae producing carbapenemase, with initial cerebrospinal fluid minimal inflammatory response

“…In the second CSF culture KP-KPC was identified, CSF biochemistry was normal, although minor increase of WBCs (6 cells/mm 3 ). CSF lactic acid and CSF/serum glucose rates fell within normal ranges; despite both are sensitive and specific biomarkers to differentiate bacterial from nonbacterial meningitis 4 .…”

“…Meningite nosocomial por Klebsiella pneumoniae produtora de carbapenemase, com resposta inflamatória inicial mínima no líquido cefalorraquidiano Meningitis caused by K. pneumoniae is a common problem following neurosurgery 1 ; however, reports of K. pneumoniae KPC producing (KP-KPC) strains isolated from cerebrospinal fluid (CSF) are infrequent 2,3 . A 47 year-old woman that suffered a series of subarachnoid hemorrhages underwent microembolization of an aneurysm in the anterior communication artery of the brain (April, 2010).…”

“…This was not reported before. To date, only two studies have been identified reporting the discovery of KP-KPC isolates from CSF 2,3 , and none of these presented CSF data.…”

Emergência de Klebsiella pneumoniae produtora de carbapenemase (KPC) em um hospital terciário

“…Hoje é endêmica nesse país e segue com crescente número de casos nos últimos anos em todo o mundo. No Brasil, já foram reportados isolados de Klebsiella pneumoniae, Escherichia coli e Serratia marcescens carreando o gene blaKPC, ficando evidente a emergência desse tipo de carbapenemase e sua disseminação entre espécies diferentes de enterobactérias em nosso país (2,5,8) .…”