title: High prevalence of metallo-beta-lactamase-mediated resistance challenging antimicrobial therapy against Pseudomonas aeruginosa in a Brazilian teaching hospital.
abstract: The prevalence of metallo-beta-lactamase (MBL) production among Pseudomonas aeruginosa nosocomial isolates from a Brazilian teaching hospital was determined. A total of 512 P. aeruginosa isolates were recovered from 245 patients during a 10-month period. Ninety-four (38.4%, 95% CI 32.2-44.8%) isolates were MBL producers. Most resistance to beta-lactams was mediated by MBL. Forty-one (16.7%) were resistant to all drugs except polymyxin B and 33 (80.5%) of these were MBL producers. Clonal dissemination, documented by DNA macrorestriction, played a major role for the spread of MBL isolates. The blaSPM-1 gene was demonstrated by PCR in 14 randomly selected MBL isolates. The extremely high prevalence of MBL production found challenges the choice of therapeutics for P. aeruginosa, and measures to control horizontal dissemination of MBL producers are urgently required.
authors.affiliation: Infectious Diseases Service, Hospital São Lucas da Pontifícia Universidade Católica do Rio Grande do Sul, Porto Alegre, Brazil. apzavascki@terra.com.br
authors.forename: A P
authors.initials: AP
authors.lastname: Zavascki
authors.forename: L Z
authors.initials: LZ
authors.lastname: Goldani
authors.forename: A L S
authors.initials: AL
authors.lastname: Gonçalves
authors.forename: A F
authors.initials: AF
authors.lastname: Martins
authors.forename: A L
authors.initials: AL
authors.lastname: Barth
mesh_terms: D001938:Brazil / Q000453:epidemiology; D016009:Chi-Square Distribution; D003428:Cross Infection / Q000188:drug therapy / Q000201:enzymology* / Q000453:epidemiology* / Q000382:microbiology; D024881:Drug Resistance, Bacterial; D006784:Hospitals, Teaching; D006801:Humans; D008826:Microbial Sensitivity Tests; D016133:Polymerase Chain Reaction; D011552:Pseudomonas Infections / Q000188:drug therapy / Q000453:epidemiology* / Q000382:microbiology; D011550:Pseudomonas aeruginosa / Q000187:drug effects / Q000201:enzymology* / Q000302:isolation & purification; D001618:beta-Lactamases / Q000096:biosynthesis*
chemical_list: D001618:beta-Lactamases