title: Occurrence of a multidrug-resistant Pseudomonas aeruginosa clone in different hospitals in Rio de Janeiro, Brazil.
abstract: Multidrug-resistant Pseudomonas aeruginosa nosocomial infections are increasingly recognized worldwide. The existence of metallo-beta-lactamase- and extended-spectrum beta-lactamase-producing isolates exhibiting resistance to most beta-lactam antimicrobial agents greatly complicates the clinical management of patients infected with such isolates. Since 1998, P. aeruginosa isolates resistant to all commercially available antimicrobial agents have been detected at a university-affiliated public hospital in Rio de Janeiro, Brazil. The present study was designed to characterize the antimicrobial resistance profiles and the genetic diversity of the P. aeruginosa strains isolated at this hospital and four private hospitals in Rio de Janeiro. Between April 1999 and March 2000, 200 consecutive isolates were obtained and analyzed for antimicrobial resistance. The genetic diversity of a selected number of them was evaluated by pulsed-field gel electrophoresis and PCR with the ERIC-2 primer. A predominant genotype, designated genotype A, was identified among isolates from four of the five hospitals evaluated. Eighty-four ceftazidime-resistant isolates were evaluated for metallo-beta-lactamase production, which was detected in 20 (91%) of 22 genotype A isolates and 11 (18%) of 62 isolates belonging to other genotypes (P < 0.05). Two metallo-beta-lactamase-producing genotype A isolates also produced an extended-spectrum beta-lactamase. The occurrence of multidrug-resistant P. aeruginosa strains belonging to a unique genotype in different hospitals in Rio de Janeiro underscores the importance of the contribution of a single clone to the increase in the incidence of multidrug-resistant P. aeruginosa nosocomial infections.
authors.affiliation: Instituto de Microbiologia, Universidade Federal do Rio de Janeiro, Brazil.
authors.forename: Flávia Lúcia Piffano Costa
authors.initials: FL
authors.lastname: Pellegrino
authors.forename: Lúcia Martins
authors.initials: LM
authors.lastname: Teixeira
authors.forename: Maria da Glória Siqueira
authors.initials: Mda G
authors.lastname: Carvalho Md
authors.forename: Simone
authors.initials: S
authors.lastname: Aranha Nouér
authors.forename: Márcia
authors.initials: M
authors.lastname: Pinto De Oliveira
authors.forename: Jorge Luiz
authors.initials: JL
authors.lastname: Mello Sampaio
authors.forename: Andrea
authors.initials: A
authors.lastname: D'Avila Freitas
authors.forename: Adriana Lucia Pires
authors.initials: AL
authors.lastname: Ferreira
authors.forename: Efigenia de Lourdes Teixeira
authors.initials: Ede L
authors.lastname: Amorim Ed
authors.forename: Lee W
authors.initials: LW
authors.lastname: Riley
authors.forename: Beatriz Meurer
authors.initials: BM
authors.lastname: Moreira
mesh_terms: D001938:Brazil; D003428:Cross Infection / Q000382:microbiology; D004269:DNA, Bacterial / Q000235:genetics / Q000302:isolation & purification; D024881:Drug Resistance, Bacterial; D018432:Drug Resistance, Multiple; D016521:Electrophoresis, Gel, Pulsed-Field; D005838:Genotype; D006801:Humans; D011552:Pseudomonas Infections / Q000382:microbiology; D011550:Pseudomonas aeruginosa / Q000187:drug effects* / Q000201:enzymology / Q000235:genetics / Q000302:isolation & purification*; D001618:beta-Lactamases / Q000096:biosynthesis
chemical_list: D004269:DNA, Bacterial; D001618:beta-Lactamases