First Insights into Clinical and Resistance Features of Infections by Klebsiella pneumoniae among Oncological Patients from a Referral Center in Amazon Region, Brazil

Abstract

Klebsiella pneumoniae appears as one of the most prevalent pathogens among cancer patients. The present study investigates the clinical, epidemiological and microbiological aspects related to infections caused by K. pneumoniae in cancer patients treated at an oncology referral center in the state of Pará, Amazon region, Brazil. Between July 2017 to July 2019, an epidemiological, observational, cross-sectional study, with a descriptive and analytical approach was conducted, including patients with confirmed diagnosis of cancer who acquired infection by K. pneumoniae 72 h after hospital admission. K. pneumoniae isolates included in the study were obtained from different clinical materials (blood, urine, catheter tip and bladder catheter, orotracheal secretions, oncological and surgical wounds). Antimicrobial susceptibility testing and molecular detection of the carbapenemase-encoding genes were performed. A high prevalence of MDR K. pneumoniae isolates was observed, including two colistin-resistant isolates and seven isolates harboring blaKPC-1 gene. To conclude, our findings provide the firsts insights into the epidemiology and infection by K. pneumoniae in the state of Pará, Brazil, and may be useful on treatment guidance and establishment of strategies to control the spread of resistance strains of K. pneumoniae in the region.

The Spread of NDM-1 and NDM-7-Producing Klebsiella pneumoniae Is Driven by Multiclonal Expansion of High-Risk Clones in Healthcare Institutions in the State of Pará, Brazilian Amazon Region

“…Indeed, on recently reported data of national surveillance on antimicrobial resistance, K. pneumoniae isolated in adult and pediatric Brazilian ICUs presented resistance rates ranging 49.3% to 68.1% and 19.3% to 51.8% to 3rd/4th generation cephalosporins and carbapenems, respectively [ 19 ]. Previous reports suggest the increasing prevalence of MDR CR-Kp isolates in the Brazilian Amazon region [ 20 , 21 , 22 ]. As in line with the discussed data, the antimicrobial susceptibility features of K. pneumoniae isolates in our study demonstrated that all tested isolates were MDR (possible XDR), predominantly exhibiting combined resistance to 3rd/4th generation cephalosporins, carbapenems, and fluoroquinolones.…”

“…CR-Kp has been typically related to transmissible genetic elements added to carbapenemases genes, such as bla NDM and bla KPC , which have been increasingly detected in different countries, emphasizing their worldwide dissemination [ 7 , 8 , 25 , 26 ]. In Brazil, KPC has become endemic and widely disseminated among K. pneumoniae from hospitals in all Brazilian regions [ 5 , 14 , 17 , 20 , 21 , 27 , 28 , 29 , 30 ]. Since 2013, NDM-producing isolates have been reported in different Brazilian regions and associated with a wide variety of bacterial species, including Escherichia coli , Acinetobacter baumannii , A. nosocomialis , A. pittii, Enterobacter cloacae, Enterobacter hormaechei, and K. pneumoniae [ 12 , 15 , 16 , 31 , 32 , 33 , 34 , 35 ].…”

Caracterização molecular e fenotípica de >i<Klebsiella>/i< spp. produtoras de NDM

“…O gênero Klebsiella é composto por bacilos Gram-negativos, que podem expressar cápsula, medem cerca de 0,5 a 5,0 µm e são anaeróbios facultativos. SANTOS et al, 2020;WYRES et al, 2020).…”