Isolation of NDM-producing Providencia rettgeri in Brazil

Carvalho-Assef, Ana Paula D’Alincourt; Pereira, Polyana Silva; Albano, Rodolpho Mattos; Berião, Gabriela Casemiro; Chagas, Thiago Pavoni Gomes; Timm, Loeci Natalina; Silva, Renato Cassol Ferreira da; Falci, Diego Rodrigues; Asensi, Marise Dutra

doi:10.1093/jac/dkt298

Cited by 94 publications

(74 citation statements)

References 7 publications

(7 reference statements)

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…En otros países de la región, como Brasil, Argentina y Colombia, la presencia de KPC es endémica 24 . Se suma a esta amenaza, la reciente aparición de NDM-1 (del inglés: New Dehli metallo b-lactamase-1) en Guatemala, Colombia, Argentina, Brasil y Paraguay [25][26][27][28][29] .…”

Section: Artículo Originalunclassified

Susceptibilidad antimicrobiana en Chile 2012

Cifuentes-D

Silva

García

et al. 2014

Rev. chil. infectol.

View full text Add to dashboard Cite

Section: Artículo Originalunclassified

Susceptibilidad antimicrobiana en Chile 2012

Cifuentes-D

Silva

García

et al. 2014

Rev. chil. infectol.

View full text Add to dashboard Cite

“…In South America, carbapenem-resistant Enterobacteriaceae (CRE) show relevant occurrence, and Klebsiella pneumoniae carbapenemase (KPC) producers seem to be the main problem (2). Recently, New Delhi metallo-betalactamase (NDM) producers have been detected in South America (3), including in Brazil (4), which worries the scientific and health communities. In Brazil, São Paulo metallo-beta-lactamase (SPM)-producing Pseudomonas aeruginosa strains are endemic carbapenem-resistant bacteria (5).…”

mentioning

confidence: 99%

Expansion and Evolution of a Virulent, Extensively Drug-Resistant (Polymyxin B-Resistant), QnrS1-, CTX-M-2-, and KPC-2-Producing Klebsiella pneumoniae ST11 International High-Risk Clone

et al. 2014

View full text Add to dashboard Cite

bIn this study, we report the early expansion, evolution, and characterization of a multiresistant Klebsiella pneumoniae clone that was isolated with increasing frequency from inpatients in a tertiary-care university hospital in Brazil. Seven carbapenem-and quinolone-resistant and polymyxin B-susceptible or -resistant K. pneumoniae isolates isolated between December 2012 and February 2013 were investigated. Beta-lactamase-and plasmid-mediated quinolone resistance (PMQR)-encoding genes and the genetic environment were investigated using PCR, sequencing, and restriction fragment length polymorphism (RFLP). Clonal relatedness was established using XbaI-pulsed-field gel electrophoresis (PFGE), multilocus sequence typing (MLST), and phylogenetic group characterization. Plasmid analyses included PCR-based replicon typing (PBRT) and hybridization of the S1-PFGE product, plasmid MLST, and conjugation experiments. Virulence potential was assessed by PCR by searching for 10 virulence factor-encoding genes (ureA, fimH, kfuBC, uge, wabG, magA, mrkD, allS, rmpA, and cf29a) and by phenotypic tests to analyze the hypermucoviscous phenotype. The genetic context of a multidrug-resistant and extensively drug-resistant K. pneumoniae ST11-KpI clone harboring IncFIIk-Tn4401a-bla KPC-2 , qnrS1, and bla CTX-M-2 was found. Moreover, three isolates displayed high resistance to polymyxin B (MICs ‫؍‬ 32, 32, and 128 mg/liter) as well as mucous and hypermucoviscous phenotypes. These bacteria also harbored ureA, fimH, uge, wabG, and mrkD, which code for virulence factors associated with binding, biofilm formation, and the ability to colonize and escape from phagocytosis. Our study describes the association of important coresistance and virulence factors in the K. pneumoniae ST11 international high-risk clone, which makes this pathogen successful at infections and points to the quick expansion and evolution of this multiresistant and virulent clone, leading to a pandrug-resistant phenotype and persistent bacteria in a Brazilian hospital.

show abstract

“…NDM-1 has now been detected in some South American countries, including Brazil. 1 The first Brazilian NDM-1-producing isolate was a Providencia rettgeri isolate that had an unexpected susceptibility profile, with susceptibility to ertapenem (minimum inhibitory concentration [MIC], 0.5 mg/L) and meropenem (MIC, 0.75 mg/L) and only a low-level resistance to imipenem (MIC, 4 mg/L) by epsilometer test (E-test); 1 the latter finding might be expected since higher imipenem MICs are common to wild-type Providencia spp.…”

Section: Heteroresistance To Carbapenems In New Delhi Metallo-b-lactamentioning

confidence: 99%