title: Extended-spectrum beta-lactamases among Enterobacteriaceae isolated in a public hospital in Brazil.
abstract: Extended-spectrum beta-lactamases (ESBL) in enterobacteria are recognized worldwide as a great hospital problem. In this study, 127 ESBL-producing Enterobacteriaceae isolated in one year from inpatients and outpatients at a public teaching hospital at São Paulo, Brazil, were submitted to analysis by PCR with specific primers for bla SHV, bla TEM and bla CTX-M genes. From the 127 isolates, 96 (75.6%) Klebsiella pneumoniae, 12 (9.3%) Escherichia coli, 8 (6.2%) Morganella morganii, 3 (2.3%) Proteus mirabilis, 2 (1.6%) Klebsiella oxytoca, 2 (1.6%) Providencia rettgeri, 2 (1.6%) Providencia stuartti, 1 (0.8%) Enterobacter aerogenes and 1 (0.8%) Enterobacter cloacae were identified as ESBL producers. Bla SHV, bla TEM and bla CTX-M were detected in 63%, 17.3% and 33.9% strains, respectively. Pulsed field gel eletrophoresis genotyping of K. pneumoniae revealed four main molecular patterns and 29 unrelated profiles. PCR results showed a high variety of ESBL groups among strains, in nine different species. The results suggest the spread of resistance genes among genetically different strains of ESBL-producing K. pneumoniae in some hospital wards, and also that some strongly related strains were identified in different hospital wards, suggesting clonal spread in the institutional environment.
authors.affiliation: Public Health Laboratory, School of Public Health, University of São Paulo, São Paulo, SP, Brazil. milenadropa@usp.br
authors.forename: Milena
authors.initials: M
authors.lastname: Dropa
authors.forename: Livia C
authors.initials: LC
authors.lastname: Balsalobre
authors.forename: Nilton
authors.initials: N
authors.lastname: Lincopan
authors.forename: Elsa M
authors.initials: EM
authors.lastname: Mamizuka
authors.forename: Thays
authors.initials: T
authors.lastname: Murakami
authors.forename: Valéria C
authors.initials: VC
authors.lastname: Cassettari
authors.forename: Fábio
authors.initials: F
authors.lastname: Franco
authors.forename: Stella M
authors.initials: SM
authors.lastname: Guida
authors.forename: Angelica J
authors.initials: AJ
authors.lastname: Balabakis
authors.forename: Lilian F
authors.initials: LF
authors.lastname: Passadore
authors.forename: Silvia R
authors.initials: SR
authors.lastname: Santos
authors.forename: Glavur R
authors.initials: GR
authors.lastname: Matté
authors.forename: Maria H
authors.initials: MH
authors.lastname: Matté
mesh_terms: D001938:Brazil; D024901:Drug Resistance, Multiple, Bacterial / Q000235:genetics; D016521:Electrophoresis, Gel, Pulsed-Field; D004755:Enterobacteriaceae / Q000187:drug effects / Q000235:genetics*; D004756:Enterobacteriaceae Infections / Q000382:microbiology* / Q000517:prevention & control; D004926:Escherichia coli / Q000302:isolation & purification; D005838:Genotype; D006784:Hospitals, Teaching; D006801:Humans; D007711:Klebsiella pneumoniae / Q000235:genetics; D016133:Polymerase Chain Reaction; D001618:beta-Lactamases / Q000096:biosynthesis* / Q000235:genetics
chemical_list: D001618:beta-Lactamases