Multi-drug-resistant Gram-negative bacteria

Abstract

ative bacteria is a serious concern not only for humans but also companion animals [1][2][3] . Recent clinical attention has focused on the increasing frequency of Gram-negative pathogens responsible for hospital-acquired infections. In this group, extended-spectrum b-lactamase (ESBL) and carbapenemase producing Enterobacteriaceae, in particular E. coli and K. pneumoniae, as well as carbapenemase producing A. baumannii, have caused major challenges in the past decade. These three groups of organisms will be the focus of this article. ESBL and CMY-2-like producing EnterobacteriaceaeTwo types of cephalosporinases commonly described in human and animal pathogens are ESBLs and CMY-2 like. CMY-2 type of resistance was commonly described in Salmonella and E. coli isolated from food-producing animals 5,6 . CMY-2 producing E. coli is also relatively common in humans and nearly as common as ESBL. In addition, the pandemic clone E. coli ST131 also belonged to the phylogenetic group B2, the highly virulent group of ExPEC. The combination of virulence and antimicrobial resistance may give E. coli ST131 a fitness advantage over other E. coli strains,

Incidência de infecções por Enterobactérias resistentes a carbapenêmicos em pacientes previamente colonizados

“…As carbapenemases são enzimas pertencentes à grande família das β-lactamases 5 , que tem a capacidade de inativar os carbapenêmicos através da hidrólise do antibiótico 10 . Essas enzimas são classificadas de acordo com suas propriedades funcionais e moleculares: enzimas de Classe A, B e D, segundo Ambler, sendo as mais prevalentes entre as enterobactérias a Klebsiella pneumoniae carbapenemase (KPC) (Classe A); a New Delhi metallo-beta-lactamase (NDM) (Classe B) e a oxacilinase (OXA)-48 (Classe D) 3,11 .…”