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Vol. 15. Issue 5.
Pages 420-425 (September - October 2011)
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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
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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
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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
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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),
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