Author | Rocha, Verônica França Diniz | |
Author | Barbosa, Matheus Sales | |
Author | Leal, Helena Ferreira | |
Author | Silva, Giulyana Evelyn Oliveira | |
Author | Sales, Nabila Monalisa Mendes Dantas | |
Author | Monteiro, Adriano de Souza Santos | |
Author | Azevedo, Jailton | |
Author | Malheiros, Allan Roberto Xavier | |
Author | Ataide, Ledilce Almeida | |
Author | Moreira, Beatriz Meurer | |
Author | Reis, Mitermayer Galvão | |
Author | Bahia, Fabianna Márcia Maranhão | |
Author | Reis, Joice Neves | |
Access date | 2023-03-08T14:26:33Z | |
Available date | 2023-03-08T14:26:33Z | |
Document date | 2022 | |
Citation | ROCHA, Verônica França Diniz et al. Prolonged outbreak of carbapenem and colistin-resistant klebsiella pneumoniae at a large tertiary hospital in Brazil. Frontiers in Microbiology, v. 13, p. 1-12, 2022. | en_US |
ISSN | 1664-302X | en_US |
URI | https://www.arca.fiocruz.br/handle/icict/57275 | |
Sponsorship | Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES).
Fundação de Amparo à Pesquisa do Estado da Bahia (FAPESB).
Instituto Nacional de Pesquisa em Resistência Antimicrobiana (Brasil).
Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq).
FUNDAÇÃO DE AMPARO À PESQUISA DO ESTADO DO RS (FAPERGS). | en_US |
Language | eng | en_US |
Publisher | Frontiers Media | en_US |
Rights | open access | en_US |
Subject in Portuguese | Klebsiella pneumoniae | en_US |
Subject in Portuguese | Resistente à colistina | en_US |
Subject in Portuguese | Resistente a carbapenem | en_US |
Subject in Portuguese | Bactérias gram-negativas multirresistentes | en_US |
Subject in Portuguese | Surto | en_US |
Subject in Portuguese | Infecção por enterobactérias | en_US |
Title | Prolonged outbreak of carbapenem and colistin-resistant klebsiella pneumoniae at a large tertiary hospital in Brazil | en_US |
Type | Article | en_US |
DOI | 10.3389/fmicb.2022.831770 | |
Abstract | Multidrug-resistant gram-negative bacteria, such as carbapenem and colistin-resistant Klebsiella pneumoniae (ColR-CRKP), represent a major problem for health systems worldwide and have high lethality. This study investigated the genetic relationship, antimicrobial susceptibility profile, and resistance mechanisms to ColR-CRKP isolates from patients infected/colonized in a tertiary hospital in Salvador, Bahia/Brazil. From September 2016 to January 2018, 46 patients (56 ColR-CRKP positive cultures) were enrolled in the investigation but clinical and demographic data were obtained from 31 patients. Most of them were men (67.7%) and elderly (median age of 62 years old), and the median Charlson score was 3. The main comorbidities were systemic arterial hypertension (38.7%), diabetes (32.2%), and cerebrovascular disease (25.8%). The average hospitalization stay until ColR-CRKP identification in days were 35.12. A total of 90.6% used mechanical ventilation and 93.7% used a central venous catheter. Of the 31 patients who had the data evaluated, 12 had ColR-CRKP infection, and seven died (58.4%). Previous use of polymyxins was identified in 32.2% of the cases, and carbapenems were identified in 70.9%. The minimum inhibitory concentration (MIC) for colistin was > 16 μg/mL, with more than half of the isolates (55%) having a MIC of 256 μg/mL. The bla KPC gene was detected in 94.7% of the isolates, bla NDM in 16.0%, and bla GES in 1.7%. The bla OXA-48, bla VIM, and bla IMP genes were not detected. The mcr-1 test was negative in all 56 isolates. Alteration of the mgrB gene was detected in 87.5% (n = 49/56) of the isolates, and of these, 49.0% (24/49) had alteration in size probably due to IS903B, 22.4% (11/49) did not have the mgrB gene detected, 20.4% (10/49) presented the IS903B, 6.1% (3/49) had a premature stop codon (Q30*), and 2.1% (1/49) presented a thymine deletion at position 104 - 104delT (F35fs). The PFGE profile showed a monoclonal profile in 84.7% of the isolates in different hospital sectors, with ST11 (CC-258) being the most frequent sequence type. This study presents a prolonged outbreak of ColR-CRKP in which 83.9% of the isolates belonged to the same cluster, and 67.6% of the patients evaluated had not used polymyxin, suggesting the possibility of cross-transmission of ColR-CRKP isolates. | en_US |
Affilliation | Fundação Oswaldo Cruz. Instituto de Pesquisas Gonçalo Moniz Laboratório de Patologia e Biologia Molecular. Salvador, BA, Brasil. | en_US |
Affilliation | Universidade Federal da Bahia. Faculdade de Farmácia. Salvador, BA, Brasil. | en_US |
Affilliation | Fundação Oswaldo Cruz. Instituto de Pesquisas Gonçalo Moniz Laboratório de Patologia e Biologia Molecular. Salvador, BA, Brasil. | en_US |
Affilliation | Universidade Federal da Bahia. Faculdade de Farmácia. Salvador, BA, Brasil. | en_US |
Affilliation | Fundação Oswaldo Cruz. Instituto de Pesquisas Gonçalo Moniz Laboratório de Patologia e Biologia Molecular. Salvador, BA, Brasil. | en_US |
Affilliation | Fundação Oswaldo Cruz. Instituto de Pesquisas Gonçalo Moniz Laboratório de Patologia e Biologia Molecular. Salvador, BA, Brasil. | en_US |
Affilliation | Fundação Oswaldo Cruz. Instituto de Pesquisas Gonçalo Moniz Laboratório de Patologia e Biologia Molecular. Salvador, BA, Brasil. | en_US |
Affilliation | Secretaria da Saúde do Estado da Bahia. Salvador, BA, Brasil. | en_US |
Affilliation | Secretaria da Saúde do Estado da Bahia. Salvador, BA, Brasil. | en_US |
Affilliation | Universidade Federal do Rio de Janeiro. Instituto de Microbiologia Paulo de Góes. Rio de Janeiro, RJ, Brasil. | en_US |
Affilliation | Fundação Oswaldo Cruz. Instituto de Pesquisas Gonçalo Moniz Laboratório de Patologia e Biologia Molecular. Salvador, BA, Brasil / Universidade Federal da Bahia. Faculdade de Medicina da Bahia. Salvador, BA, Brasil / Yale School of Public Health. Yale University. New Haven, CT, United States. | en_US |
Affilliation | Universidade Federal da Bahia. Faculdade de Medicina da Bahia. Salvador, BA, Brasil. | en_US |
Affilliation | Fundação Oswaldo Cruz. Instituto de Pesquisas Gonçalo Moniz Laboratório de Patologia e Biologia Molecular. Salvador, BA, Brasil / Universidade Federal da Bahia. Faculdade de Farmácia. Salvador, BA, Brasil. | en_US |
Subject | Klebsiella pneumoniae | en_US |
Subject | Colistin-resistant | en_US |
Subject | Carbapenem-resistant | en_US |
Subject | Multidrug resistant gram-negative bacteria | en_US |
Subject | Outbreak | en_US |
Subject | Enterobacterales infection | en_US |
DeCS | Klebsiella pneumoniae | en_US |
DeCS | Resistência a medicamentos | en_US |
DeCS | Colistina | en_US |
DeCS | Bactérias gram-negativas | en_US |
DeCS | Surtos de doenças | en_US |
DeCS | Infecções | en_US |