Molecular epidemiology of extended-spectrum beta-lactamase-producing Klebsiella pneumoniae isolated from neonatal intensive care unit patients involved in hospital infection cases in Rio de Janeiro, Brazil.
During a two years period, in this study was analyzed the demographic and bacteriologic data of 42 hospitalized newborns attempted by extended-spectrum beta-lactamase-producing Klebsiella pneumoniae sepsis in a neonatal intensive care unit of a public maternity hospital in Rio de Janeiro, Brazil. The newborns mean age was 10.4 days, with a major prevalence of hospital infection in males (55.0%) than females (45.0%), and a major frequency in vaginal delivery (65.0%) than cesarean delivery (35.0%). 31 patients (77.5%) received a mean of 3 antimicrobials during a 7.9 days before positive blood cultures. The most important underlying risk conditions were prematurely (87.5%), very low birth weight (55.0%) and asphyxia (40.0%). Among the isolated strains were detected high resistance proportion to beta-lactams, aminoglycosides, chloramphenicol and trimethoprim-sulfamethoxazole. 6 distinct clones in a cluster of 42 epidemiologically related strains were detected through PFGE profiles. The isolated strains presented 9 different antimicrobial resistance profiles (ARPs), where the most frequent clones (A, B and D) were distributed in 5, 3 and 5 ARPs, respectively. Based in the PFGE profiles and isolation periods, apparently the clones A plus A1, B and D caused 3 distinct outbreaks during the study period.
Martins-Loureiro
M
M
Laboratório de Enterobactérias, Departamento de Bacteriologia, Instituto Oswaldo Cruz, Fundação Oswaldo Cruz, Rio de Janeiro, Brasil.
de Moraes
B A
BA
de Mendonça
V L
VL
Rocha-Quadra
M R
MR
dos Santos-Pinheiro
G
G
Dutra-Asensi
M
M
D001238:Asphyxia Neonatorum / Q000453:epidemiology; D001426:Bacterial Proteins / Q000145:classification / Q000302:isolation & purification*; D001938:Brazil / Q000453:epidemiology; D015897:Comorbidity; D003428:Cross Infection / Q000453:epidemiology / Q000382:microbiology*; D004196:Disease Outbreaks; D024901:Drug Resistance, Multiple, Bacterial; D016521:Electrophoresis, Gel, Pulsed-Field; D005260:Female; D006771:Hospitals, Maternity / Q000706:statistics & numerical data; D006779:Hospitals, Public / Q000706:statistics & numerical data; D006801:Humans; D006819:Hyaline Membrane Disease / Q000453:epidemiology; D007231:Infant, Newborn; D007234:Infant, Premature; D007235:Infant, Premature, Diseases / Q000453:epidemiology / Q000382:microbiology*; D019102:Infant, Very Low Birth Weight; D007363:Intensive Care Units, Neonatal / Q000706:statistics & numerical data; D007710:Klebsiella Infections / Q000453:epidemiology / Q000382:microbiology*; D007711:Klebsiella pneumoniae / Q000201:enzymology* / Q000302:isolation & purification; D008297:Male; D012189:Retrospective Studies; D012307:Risk Factors; D013379:Substrate Specificity; D018440:beta-Lactam Resistance; D001618:beta-Lactamases / Q000145:classification / Q000302:isolation & purification*
D001426:Bacterial Proteins; D001618:beta-Lactamases