Journal Information
Vol. 15. Issue 5.
Pages 420-425 (September - October 2011)
Share
Share
Download PDF
More article options
Vol. 15. Issue 5.
Pages 420-425 (September - October 2011)
Original article
Open Access
Diversity of genotypes in CTX-M-producing Klebsiella pneumoniae isolated in different hospitals in Brazil
Visits
2817
Thiago Pavoni Gomes Chagas1, Ronaldo Mendes Alves2, Deyse Christina Vallim3, Liliane Miyuki Seki4, Leila Carvalho Campos5, Marise Dutra Asensi6,
Corresponding author
marise@ioc.fiocruz.br

Correspondence to: Av. Brasil, 4365, Manguinhos Rio de Janeiro - RJ - Brazil CEP: 21040-360
1 Graduated in Biological Sciences, Universidade do Estado do Rio de Janeiro (UERJ); MSc Student in Tropical Medicine, Instituto Oswaldo Cruz (IOC)/Fiocruz, Rio de Janeiro, RJ, Brazil
2 Graduated in Biological Sciences; Technologist, IOC/FIOCRUZ, Rio de Janeiro, RJ, Brazil
3 Microbiology, Universidade Federal do Rio de Janeiro (UFRJ); Technologist, IOC/Fiocruz, Rio de Janeiro, RJ, Brazil
4 Microbiology, Universidade Federal Rural do Rio de Janeiro (UFRRJ); Technician, IOC/Fiocruz, Rio de Janeiro, RJ, Brazil
5 Microbiology, Researcher, CPqGM/Fiocruz, Rio de Janeiro, RJ, Brazil
6 Microbiology; Chief, Hospital Infection Research Laboratory, IOC/Fiocruz, Rio de Janeiro, RJ, Brazil
This item has received

Under a Creative Commons license
Article information
Abstract
Bibliography
Download PDF
Statistics
Abstract
Objective

The present study was undertaken to characterize CTX-M ESBL-producing Klebsiella pneumoniae collected from hospitals in different cities of Brazil.

Material and Methods

Eighty-five K. pneumoniae strains isolated from hospitalized patients in six different hospitals of three cities of Brazil were analyzed. ESBL production was confirmed by the standard double-disk synergy test and the Etest®. The MIC50 and MIC90 for ESBL-producing isolates were determined by the Etest® method. The antimicrobial susceptibilities of bacterial isolates were determined using the agar diffusion method according to the CLSI. Screening for blaTEM, blaSHV, blaCTX-M genes and class 1 integron was performed by PCR amplification. To determine the genomic diversity of CTX-M-producers, isolates were analyzed by macrorestriction profile analysis following PFGE.

Results and Discussion

Seventy-one K. pneumoniae isolates were ESBL-producing. PCR and sequencing experiments detected 38 CTX-M-producing K. pneumoniae belonged to groups CTX-M 1, CTX-M 2, CTX-M 8 and CTX-M 9. The association of different types ESBL (CTX-M, SHV and TEM) was frequent. All K. pneumoniae isolates carried class 1 integron. PFGE analysis revealed thirty-one clonal types among CTX-M-producing isolates. The data presented herein illustrate the diversity of genotypes of CTX-M producing K. pneumoniae among Brazilians hospitals.

Keywords:
Klebsiella pneumoniae
β-lactamases
genotype
Full text is only aviable in PDF
References
[1.]
R. Podschun, U. Ullmann.
Klebsiella spp. as nosocomial pathogens: epidemiology, taxonomy, typing methods, and pathogenicity factors.
Clin Microbiol Rev, 11 (1998), pp. 589-603
[2.]
D.L. Paterson, R.A. Bonomo.
Extended-spectrum β-lactamases: a clinical update.
Clin Microbiol Rev, 18 (2005), pp. 657-686
[3.]
P.A. Bradford.
Extended-spectrum β-lactamases in the 21st century: characterization, epidemiology, and detection of this important resistance threat.
Clin Microbiol Rev, 14 (2001), pp. 933-951
[4.]
R. Cantón, T.M. Coque.
The CTX-M β-lactamase pandemic.
Curr Opinion in Microbiol, 9 (2006), pp. 466-475
[5.]
R. Bonnet.
Growing group of extended-spectrum β-lactamase: the CTX-M enzymes.
Antimicrob Agents Chemother, 48 (2004), pp. 1-14
[6.]
M. Quinteros, M. Radice, N. Gardella, et al.
Extended-Spectrum β-Lactamases in Enterobacteriaceae in Buenos Aires, Argentina.
Public Hospitals. Antimicrob Agents Chemother, 47 (2003), pp. 2864-2867
[7.]
J.J. Yan, P.R. Hsueh, J.J. Lu, et al.
Extended-Spectrum β-Lactamases and Plasmid-Mediated AmpC Enzymes among Clinical Isolates of Escherichia coli and Klebsiella pneumoniae from Seven Medical Centers in Taiwan.
Antimicrob Agents Chemother, 50 (2006), pp. 1861-1864
[8.]
D.M. Livermore, P.M. Hawkey.
CTX-M: changing the face of ESBLs in the UK.
J Antimicrob Chemother, 56 (2005), pp. 451-454
[9.]
M.V. Villegas, J.N. Kattan, M.G. Quinteros, et al.
Prevalence of extended-spectrum β-lactamases in South America.
Clin Microbiol Infect, 14 (2008), pp. 154-158
[10.]
G.M. Rossolini, M.M. D’Andrea, C. Mugnaioli.
The spread of CTX-M-type extended-spectrum β-lactamases.
Clin Microbiol Infect, 14 (2008), pp. 33-41
[11.]
CLSI. Clinical and Laboratory Standards Institute.
Performance standards for antimicrobial susceptibility testing. CLSI/NCCLS M100-S19.
CLSI, (2009),
[12.]
H. Hasman, D. Mevius, K. Veldman, et al.
β-lactamases among extended-spectrum β-lactamase (ESBL)-resistant Salmonella from poultry, poultry products and human patients in The Netherlands.
J Antimicrob Chemother, 56 (2005), pp. 115-121
[13.]
M.R. Mulvey, G. Soule, D. Boyd, The Multi-Provincial Salmonella Typhimurium Case Control Study Group, et al.
Characterization of the first extended-spectrum β-lactamase-producing Salmonella isolate identified in Canada.
J Clin Microbiol, 41 (2003), pp. 460-462
[14.]
D. Sandvang, F.M. Aarestrup, L.B. Jensen.
Characterization of integrons and antibiotic resistance genes in Danish multiresistant Salmonella enterica Typhmurium DT104.
FEMS Microbiol Lett, 157 (1997), pp. 177-181
[15.]
H. Seifert, P. Gerner-Smidt.
Comparison of ribotyping and pulsed-field gel electrophoresis for molecular typing of Acinetobacter isolates.
J Clin Microbiol, 33 (1995), pp. 1402-1407
[16.]
F.C. Tenover, R.D. Arbeit, R.V. Goering, et al.
Interpreting chromosomal DNA restriction patterns produced by pulsed-field gel electrophoresis: criteria for bacterial strain typing.
J Clin Microbiol, 33 (1995), pp. 2233-2239
[17.]
E.P. Hyle, A.D. Lipworth, T.E. Zaoutis, et al.
Risk Factors for Increasing Multidrug Resistance among Extended-Spectrum β-Lactamase-Producing Escherichia coli and Klebsiella Species.
Clin Infect Dis, 40 (2005), pp. 1317-1324
[18.]
C. Mendes, C. Kiffer, A. Segura, et al.
Klebsiella pneumoniae with multiple antimicrobial resistance.
Braz J Infect Dis, 8 (2004), pp. 109-111
[19.]
N. Lincopan, J.A. Mcculloch, C. Reinert, et al.
First isolation of metallo-β-lactamase-producing multiresistant Klebsiella pneumoniae from a patient in Brazil.
J Clin Microbiol, 43 (2005), pp. 516-519
[20.]
A. Valverde, T.M. Coque, M.P. Sanchez-Moreno, et al.
Dramatic increase in prevalence of fecal carriage of extended-spectrum β-lactamase-producing Enterobacteriaceae during nonoutbreak situations in Spain.
J Clin Microbiol, 42 (2004), pp. 4769-4775
[21.]
R. Bonnet, J.L.M. Sampaio, R. Labia, et al.
A novel CTX-M β-lactamase (CTX-M-8) in cefotaxime-resistant Enterobacteriaceae isolated in Brazil.
Antimicrob Agents Chemother, 44 (2000), pp. 1936-1942
[22.]
S.R. Partridge, R.M. Hall.
In34, a complex In5 family class 1 integron containing orf513 and dfrA10.
Antimicrob Agents Chemother, 47 (2003), pp. 342-349
[23.]
A. Bauernfeind, J.M. Casellas, M. Goldberg, et al.
A new plasmidic cefotaximase from patients infected with Salmonella typhimurium.
Infection, 20 (1992), pp. 158-163
[24.]
F.J.R. Do Carmo, R.M. Silva, M. Castanheira, et al.
Prevalence and genetic characterization of blaCTX-M among Klebsiella pneumoniae isolates collected in an intesive care unit in Brazil.
J Chemother, 20 (2008), pp. 600-603
[25.]
D.O. Garcia, Y. Doi, D. Szabo, et al.
Multiclonal outbreak of Klebsiella pneumoniae producing extended-spectrum β-lactamase CTX-M-2 and novel variant CTX-M-59 in a neonatal intensive care unit in Brazil.
Antimicrob Agents Chemother, 52 (2008), pp. 1790-1793
[26.]
E.C. Clímaco, L.A. Minarini, A.L. Da Costa Darini.
CTX-M-producing Klebsiella spp. in a Brazilian hospital: what has changed in 6 years?.
Diagn Microbiol Infect Dis, 68 (2010), pp. 186-189
[27.]
L.A. Minarini, L. Poirel, N.A. Trevisani, et al.
Predominance of CTX-M-type extended-spectrum β-lactamase genes among enterobacterial isolates from outpatients in Brazil.
Diagn Microbiol Infect Dis, 65 (2009), pp. 202-206
[28.]
P. Kiratisin, A. Apisarnthanarak, C. Laesripa, et al.
Molecular characterization and epidemiology of extended spectrum-β-lactamase-producing Escherichia coli and Klebsiella pneumoniae isolates causing health care-associated infection in Thailand, where the CTX-M family is endemic.
Antimicrob Agents Chemother, 52 (2008), pp. 2818-2824
[29.]
K. Tullus, B. Berglund, B. Fryklund, et al.
Epidemiology of fecal strains of the family Enterobacteriaceae in 22 neonatal wards and influence of antibiotic policy.
J Clin Microbiol, 26 (1998), pp. 1166-1170
[30.]
T.M. Weller, F.M. MacKenzie, K.J. Forbes.
Molecular epidemiology of a large outbreak of multiresistant Klebsiella pneumoniae.
J Med Microbiol, 46 (1997), pp. 921-926
[31.]
G. Cuzon, T. Naas, H. Truong, et al.
Worldwide diversity of Klebsiella pneumoniae that produce β-lactamase blaKPC-2 gene.
Emerg Infect Dis, 16 (2010), pp. 1349-1356
[32.]
P.S. Pereira, L.M. Seki, Figueira, et al.
Epidemiologia molecular de cepas de K. pneumoniae produtoras de KPC-2 do Rio de Janeiro: disseminação do ST 437 (abstract MH-003).
Abstracts: II Simpósio Internacional de Microbiologia Clínica (Florianópolis) Florianópolis, SBM, (2010),
Copyright © 2011. Elsevier Editora Ltda.. All rights reserved
Download PDF
The Brazilian Journal of Infectious Diseases
Article options
Tools