Extended-spectrum beta-lactamases among Enterobacteriaceae isolated in a public hospital in Brazil.
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.
Dropa
Milena
M
Public Health Laboratory, School of Public Health, University of São Paulo, São Paulo, SP, Brazil. milenadropa@usp.br
Balsalobre
Livia C
LC
Lincopan
Nilton
N
Mamizuka
Elsa M
EM
Murakami
Thays
T
Cassettari
Valéria C
VC
Franco
Fábio
F
Guida
Stella M
SM
Balabakis
Angelica J
AJ
Passadore
Lilian F
LF
Santos
Silvia R
SR
Matté
Glavur R
GR
Matté
Maria H
MH
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
D001618:beta-Lactamases