| Author | Conceição Neto, Orlando C. | |
| Author | Costa, Bianca Santos da | |
| Author | Pontes, Leilane da Silva | |
| Author | Silveira, Melise Chaves | |
| Author | Silva, Lívia Helena Justo da | |
| Author | Santos, Ivson Cassiano de Oliveira | |
| Author | Teixeira, Camila Bastos Tavares | |
| Author | Oliveira, Thamirys Rachel Tavares e | |
| Author | Hermes, Fernanda Stephens | |
| Author | Galvão, Teca Calcagno | |
| Author | Antunes, L. Caetano M. | |
| Author | Souza, Cláudio Marcos Rocha de | |
| Author | Carvalho-Assef, Ana P. D. | |
| Access date | 2022-08-11T11:36:56Z | |
| Available date | 2022-08-11T11:36:56Z | |
| Document date | 2022 | |
| Citation | CONCEIÇÃO NETO, Orlando C. et al. Polymyxin Resistance in Clinical Isolates of K. pneumoniae in Brazil: Update on Molecular Mechanisms, Clonal Dissemination and Relationship With KPCProducing Strains. Frontiers in Cellular and Infection Microbiology, v. 12, Article 898125, p. 1 - 13, July 2022. | pt_BR |
| ISSN | 2235-2988 | pt_BR |
| URI | https://www.arca.fiocruz.br/handle/icict/54584 | |
| Language | eng | pt_BR |
| Publisher | Frontiers Media | pt_BR |
| Rights | open access | |
| Subject in Portuguese | Resistência à polimixina | pt_BR |
| Subject in Portuguese | Klebsiella pneumoniae | pt_BR |
| Subject in Portuguese | Resistência a antibióticos | pt_BR |
| Subject in Portuguese | gene Mcr | pt_BR |
| Subject in Portuguese | PhoPQ and PmrAB | pt_BR |
| Title | Polymyxin Resistance in Clinical Isolates of K. pneumoniae in Brazil: Update on Molecular Mechanisms, Clonal Dissemination and Relationship With KPCProducing Strains | pt_BR |
| Type | Article | |
| DOI | 10.3389/fcimb.2022.898125 | |
| Abstract | In Brazil, the production of KPC-type carbapenemases in Enterobacteriales is endemic,
leading to widespread use of polymyxins. In the present study, 502 Klebsiella pneumoniae
isolates were evaluated for resistance to polymyxins, their genetic determinants and
clonality, in addition to the presence of carbapenem resistance genes and evaluation of
antimicrobial resistance. Resistance to colistin (polymyxin E) was evaluated through initial
selection on EMB agar containing 4% colistin sulfate, followed by Minimal Inhibitory
Concentration (MIC) determination by broth microdilution. The susceptibility to 17
antimicrobials was assessed by disk diffusion. The presence of blaKPC, blaNDM and
blaOXA-48-like carbapenemases was investigated by phenotypic methods and
conventional PCR. Molecular typing was performed by PFGE and MLST. Allelic variants
of the mcr gene were screened by PCR and chromosomal mutations in the pmrA, pmrB,
phoP, phoQ and mgrB genes were investigated by sequencing. Our work showed a
colistin resistance frequency of 29.5% (n = 148/502) in K. pneumoniae isolates. Colistin
MICs from 4 to >128 μg/mL were identified (MIC50 = 64 μg/mL; MIC90 >128 μg/mL). All
isolates were considered MDR, with the lowest resistance rates observed for amikacin
(34.4%), and 19.6% of the isolates were resistant to all tested antimicrobials. The blaKPC
gene was identified in 77% of the isolates, in consonance with the high rate of resistance
to polymyxins related to its use as a therapeutic alternative. Through XbaI-PFGE, 51
pulsotypes were identified. MLST showed 21 STs, with ST437, ST258 and ST11 (CC11)
being the most prevalent, and two new STs were determined: ST4868 and ST4869. The
mcr-1 gene was identified in 3 K. pneumoniae isolates. Missense mutations in
chromosomal genes were identified, as well as insertion sequences in mgrB. Furthermore, the identification of chromosomal mutations in K. pneumoniae isolates
belonging from CC11 ensures its success as a high-risk epidemic clone in Brazil
and worldwide. | pt_BR |
| Affilliation | Fundação Oswaldo Cruz. Instituto Oswaldo Cruz. Laboratório de Pesquisa em Infecção Hospitalar. Rio de Janeiro, RJ, Brasil / Universidade Estácio de Sá. Faculdade de Medicina. Rio de Janeiro, RJ, Brasil. | pt_BR |
| Affilliation | Fundação Oswaldo Cruz. Instituto Oswaldo Cruz. Laboratório de Pesquisa em Infecção Hospitalar. Rio de Janeiro, RJ, Brasil. | pt_BR |
| Affilliation | Fundação Oswaldo Cruz. Instituto Oswaldo Cruz. Laboratório de Pesquisa em Infecção Hospitalar. Rio de Janeiro, RJ, Brasil. | pt_BR |
| Affilliation | Fundação Oswaldo Cruz. Instituto Oswaldo Cruz. Laboratório de Pesquisa em Infecção Hospitalar. Rio de Janeiro, RJ, Brasil. | pt_BR |
| Affilliation | Universidade Estácio de Sá. Faculdade de Medicina. Rio de Janeiro, RJ, Brasil. | pt_BR |
| Affilliation | Fundação Oswaldo Cruz. Instituto Oswaldo Cruz. Laboratório de Pesquisa em Infecção Hospitalar. Rio de Janeiro, RJ, Brasil. | pt_BR |
| Affilliation | Fundação Oswaldo Cruz. Instituto Oswaldo Cruz. Laboratório de Pesquisa em Infecção Hospitalar. Rio de Janeiro, RJ, Brasil. | pt_BR |
| Affilliation | Fundação Oswaldo Cruz. Instituto Oswaldo Cruz. Laboratório de Pesquisa em Infecção Hospitalar. Rio de Janeiro, RJ, Brasil. | pt_BR |
| Affilliation | Fundação Oswaldo Cruz. Instituto Oswaldo Cruz. Laboratório de Genômica Funcional e Bioinformática. Rio de Janeiro, RJ, Brasil. | pt_BR |
| Affilliation | Fundação Oswaldo Cruz. Instituto Oswaldo Cruz. Laboratório de Genômica Funcional e Bioinformática. Rio de Janeiro, RJ, Brasil. | pt_BR |
| Affilliation | Fundação Oswaldo Cruz. Instituto Oswaldo Cruz. Laboratório de Pesquisa em Infecção Hospitalar. Rio de Janeiro, RJ, Brasil. | pt_BR |
| Affilliation | Fundação Oswaldo Cruz. Instituto Oswaldo Cruz. Laboratório de Pesquisa em Infecção Hospitalar. Rio de Janeiro, RJ, Brasil. | pt_BR |
| Affilliation | Fundação Oswaldo Cruz. Instituto Oswaldo Cruz. Laboratório de Pesquisa em Infecção Hospitalar. Rio de Janeiro, RJ, Brasil. | pt_BR |
| Subject | Polymyxin resistance | pt_BR |
| Subject | Klebsiella pneumoniae | pt_BR |
| Subject | Antibiotic resistance | pt_BR |
| Subject | Mcr gene | pt_BR |
| Subject | PhoPQ and PmrAB | pt_BR |
