title: Carbapenem-hydrolysing beta-lactamase KPC-2 in Klebsiella pneumoniae isolated in Rio de Janeiro, Brazil.
abstract: OBJECTIVE
  The aim of this study was to characterize the KPC-type carbapenem-hydrolysing beta-lactamase, extended-spectrum beta-lactamases (ESBLs) and class 1 integrons among nosocomial Klebsiella pneumoniae isolated in Rio de Janeiro, Brazil.
  
  
  METHODS
  MICs were determined and isolates were screened for ESBLs, metallo-beta-lactamases (MBLs) and class A carbapenemase-producing phenotypes. The main beta-lactamases resistance genes (bla(TEM), bla(SHV), bla(CTX-M), bla(KPC), bla(IMP) and bla(VIM)) and class 1 integrons were detected by PCR followed by DNA sequencing. The genetic relatedness of isolates was determined by PFGE.
  
  
  RESULTS
  All K. pneumoniae isolates were positive for ESBL and class A carbapenemase production and negative for MBL production. All isolates were resistant to all beta-lactam antibiotics, ciprofloxacin and gentamicin, being susceptible only to tigecycline and polymyxin B. The bla(KPC-2), bla(CTX-M-1), bla(CTX-M-2), bla(CTX-M-8) and bla(SHV-11) genes were detected. PFGE analysis revealed two clonal types among KPC-producing isolates, both identified in the same hospital.
  
  
  CONCLUSIONS
  Our findings should alert medical authorities to implement stringent methods for the detection and spread control of emerging KPC-2 carbapenemases in the hospital setting in Brazil.
authors.affiliation: Oswaldo Cruz Institute, Avenida Brasil 4365, 21040-360 Rio de Janeiro, Brazil. peirano@ioc.fiocruz.br
authors.forename: Gisele
authors.initials: G
authors.lastname: Peirano
authors.forename: Liliane M
authors.initials: LM
authors.lastname: Seki
authors.forename: Vera Lúcia
authors.initials: VL
authors.lastname: Val Passos
authors.forename: Maria Cristina F G
authors.initials: MC
authors.lastname: Pinto
authors.forename: Lília R
authors.initials: LR
authors.lastname: Guerra
authors.forename: Marise D
authors.initials: MD
authors.lastname: Asensi
mesh_terms: D000900:Anti-Bacterial Agents / Q000037:antagonists & inhibitors* / Q000378:metabolism; D015373:Bacterial Typing Techniques; D001938:Brazil; D003428:Cross Infection / Q000382:microbiology; D004269:DNA, Bacterial / Q000235:genetics; D016521:Electrophoresis, Gel, Pulsed-Field; D005838:Genotype; D006801:Humans; D032023:Integrons; D007710:Klebsiella Infections / Q000382:microbiology*; D007711:Klebsiella pneumoniae / Q000145:classification / Q000201:enzymology* / Q000235:genetics / Q000302:isolation & purification*; D008826:Microbial Sensitivity Tests; D016133:Polymerase Chain Reaction; D017422:Sequence Analysis, DNA; D018440:beta-Lactam Resistance; D001618:beta-Lactamases / Q000235:genetics* / Q000378:metabolism*; D047090:beta-Lactams / Q000037:antagonists & inhibitors* / Q000378:metabolism
chemical_list: D000900:Anti-Bacterial Agents; D004269:DNA, Bacterial; D047090:beta-Lactams; C491478:beta-lactamase KPC-2; D001618:beta-Lactamases