Secular trends in Klebsiella pneumoniae isolated in a tertiary-care hospital: increasing prevalence and accelerated decline in antimicrobial susceptibility

Santana, Rodrigo de Carvalho; Gaspar, Gilberto Gambero; Vilar, Fernando Crivelenti; Bellissimo-Rodrigues, Fernando; Martínez, Roberto

doi:10.1590/0037-8682-0072-2016

Cited by 6 publications

(5 citation statements)

References 25 publications

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“…However, the percentage of tigecycline-intermediate phenotype strains may predict a shift towards the tigecycline resistance phenotype. The results of percentage resistance in our study were significantly lower than those reported by several authors around the world concerning tigecycline (32,11). Overexpression of the AcrAB efflux pump is the most important mechanism for the resistance of K. pneumoniae strains to tigecycline (41).…”

Section: Discussioncontrasting

confidence: 94%

Multidrug resistance of the extended-spectrum beta-lactamase-producing Klebsiella pneumoniae isolated in Tizi-Ouzou (Algeria)

Bariz

Mendonça

Denis

et al. 2019

Cell Mol Biol (Noisy-le-grand)

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The emergence and spread of multidrug-resistant bacteria is a major public health concern. This study sought to investigate the phenotypic and genotypic characteristics of clinical isolates of ESBL-producing Klebsiella pneumoniae, at University Hospital of Tizi-Ouzou. Antibiotic susceptibility testing of the strains was carried out by the disc diffusion method, the ESBL production was screening by the Double Disc Synergy Test and confirmed by the Phenotypic Confirmatory Disc Diffusion Test. Genomic DNA was extracted using the Qiagen DNeasy Blood & Tissue Kit mini kit (Qiagen) according to the manufacturer's instructions.PCR targeting the genes blaCTX-M, blaTEM, blaSHV, blaVEB, blaGES, blaPER, blaBEL, blaVIM, blaIMP, blaKPC, blaNDM and blaOXA48 was performed. A CTX-M PCR-based grouping method was carried out using primers specific to the groups 1, 2 and 9. Conjugative transfer of plasmids was carried out using sodium azide-resistant recipient strain Escherichia coli K12. The phylogenetic relationship was determined by ERIC-PCR. All strains of K. pneumoniae tested shared ESBL producer's genes belonging to the CTX-M group 1. These strains showed a high level of resistance to ß-lactams, aminoglycosides, fluoroquinolones and trimethoprim/ sulfamethoxazole. Resistance to fosfomycin was also detected in one strain of K. pneumoniae. Only one carbapenem-resistant strain was isolated. Phylogenetic analysis showed 49 different genetic profiles of K. pneumoniae strains, showing the absence of clonality. This study revealed a high prevalence of ESBL belonging to the CTX-M group 1 in K. pneumoniae tested. The emergence of resistance to carbapenem and fosfomycin, could seriously limits the therapeutic choices options.

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Section: Discussioncontrasting

confidence: 94%

Multidrug resistance of the extended-spectrum beta-lactamase-producing Klebsiella pneumoniae isolated in Tizi-Ouzou (Algeria)

Bariz

Mendonça

Denis

et al. 2019

Cell Mol Biol (Noisy-le-grand)

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“…7 , 16 , 17 In contrast, K. pneumoniae has demonstrated reduction of colistin susceptibility rates. 18 Although resistance to colistin among Acinetobacter spp. in our Institution turned out to be not as high as compared to K. pneumoniae , it still represents a serious problem in our hospital, since carbapenem resistance among this species is elevated, and colistin is the only available antibiotic for treating these infections.…”

mentioning

confidence: 99%

Emergence of colistin resistance in the largest university hospital complex of São Paulo, Brazil, over five years

Rossi

Girardello

Cury

et al. 2017

The Brazilian Journal of Infectious Diseases

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Colistin resistance involving Gram-negative bacilli infections is a challenge for health institutions around of the world. Carbapenem-resistance among these isolates makes colistin the last therapeutic option for this treatment. Colistin resistance among Enterobacteriaceae, Acinetobacter spp., and Pseudomonas spp. was evaluated between 2010 and 2014 years, at Hospital das Clínicas, São Paulo, Brazil. Over five years 1346 (4.0%) colistin resistant Gram-negative bacilli were evaluated. Enterobacteriaceae was the most frequent (86.1%) pathogen isolated, followed by Acinetobacter spp. (7.6%), and Pseudomonas spp. (6.3%). By temporal analysis there was a trend for an increase of colistin resistance among Enterobacteriaceae, but not among non-fermentative isolates. Among 1346 colistin resistant isolates, carbapenem susceptibility was observed in 21.5%. Colistin resistance in our hospital has been alarmingly increased among Klebsiella pneumoniae isolates in both KPC positive and negative, thus becoming a therapeutic problem.

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“…8 A associação de resistência ao ciprofloxacino em isolados de K. pneumoniae é comum, estando entre 25% na Etiópia 7 , 69% na China 8 , e no Brasil um estudo vem demonstrando elevação da prevalência de resistência ao longo da última década com observação de valores próximos a 53% após 10 anos. 4 Entretanto, nos dados encontrados ao longo dos dois anos do nosso estudo não foi observada uma elevação significativa na prevalência da resistência de 18% no ano de 2014 para 44% no …”

Section: Resumen Justificación Y Objetivosunclassified

Emergência de resistência antimicrobiana em Klebsiella spp. em município do interior do Estado do Rio Grande do Sul, Brasil

Tessmann¹,

Caballero²,

Martins³

et al. 2017

Rev Epidemiol Control Infect

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Secular trends in Klebsiella pneumoniae isolated in a tertiary-care hospital: increasing prevalence and accelerated decline in antimicrobial susceptibility

Cited by 6 publications

References 25 publications

Multidrug resistance of the extended-spectrum beta-lactamase-producing Klebsiella pneumoniae isolated in Tizi-Ouzou (Algeria)

Multidrug resistance of the extended-spectrum beta-lactamase-producing Klebsiella pneumoniae isolated in Tizi-Ouzou (Algeria)

Emergence of colistin resistance in the largest university hospital complex of São Paulo, Brazil, over five years

Emergência de resistência antimicrobiana em Klebsiella spp. em município do interior do Estado do Rio Grande do Sul, Brasil

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