title: High prevalence of bla(CTX-M) extended spectrum beta-lactamase genes in Klebsiella pneumoniae isolates from a tertiary care hospital: first report of bla(SHV-12), bla(SHV-31), bla(SHV-38), and bla(CTX-M-15) in Brazil.
abstract: The aim of this study was to investigate the presence and prevalence of bla(TEM), bla(SHV), and bla(CTX-M) and bla(GES)-like genes, responsible for extended spectrum beta-lactamases (ESBLs) production in clinical isolates of Klebsiella pneumoniae collected from a Brazilian tertiary care hospital. Sixty-five ESBL producing K. pneumoniae isolates, collected between 2005 and 2007, were screened by polymerase chain reaction (PCR). Identification of bla genes was achieved by sequencing. Genotyping of ESBL producing K. pneumoniae was performed by the enterobacterial repetitive intergenic consensus-PCR with cluster analysis by the Dice coefficient. The presence of genes encoding ESBLs was confirmed in 59/65 (90.8%) isolates, comprising 20 bla(CTX-M-2), 14 bla(CTX-M-59), 12 bla(CTX-M-15), 9 bla(SHV-12), 1 bla(SHV-2), 1 bla(SHV-2a), 1 bla(SHV-5), and 1 bla(SHV-31) genes. The ESBL genes bla(SHV-12), bla(SHV-31), and bla(CTX-M-15), and the chromosome-encoded SHV-type beta-lactamase capable of hydrolyzing imipenem were detected in Brazil for the first time. The analysis of the enterobacterial repetitive intergenic consensus-PCR band patterns revealed a high rate of multiclonal bla(CTX-M) carrying K. pneumoniae isolates (70.8%), suggesting that dissemination of encoding plasmids is likely to be the major cause of the high prevalence of these genes among the K. pneumoniae isolates considered in this study.
authors.affiliation: Laboratório de Microbiologia, Departamento de Doenças Dermatológicas, Infecciosas e Parasitárias, Faculdade de Medicina de São José do Rio Preto, São José do Rio Preto, Brazil.
authors.forename: Fernanda M
authors.initials: FM
authors.lastname: Tollentino
authors.forename: Milena
authors.initials: M
authors.lastname: Polotto
authors.forename: Mauricio L
authors.initials: ML
authors.lastname: Nogueira
authors.forename: Nilton
authors.initials: N
authors.lastname: Lincopan
authors.forename: Patrícia
authors.initials: P
authors.lastname: Neves
authors.forename: Elsa M
authors.initials: EM
authors.lastname: Mamizuka
authors.forename: Gisele A
authors.initials: GA
authors.lastname: Remeli
authors.forename: Margarete T G
authors.initials: MT
authors.lastname: De Almeida
authors.forename: Fernando G
authors.initials: FG
authors.lastname: Rúbio
authors.forename: Mara C L
authors.initials: MC
authors.lastname: Nogueira
mesh_terms: D000900:Anti-Bacterial Agents / Q000494:pharmacology; D001938:Brazil; D024881:Drug Resistance, Bacterial; D005838:Genotype; D006801:Humans; D007710:Klebsiella Infections / Q000188:drug therapy / Q000382:microbiology*; D007711:Klebsiella pneumoniae / Q000187:drug effects / Q000235:genetics* / Q000302:isolation & purification; D008826:Microbial Sensitivity Tests; D016133:Polymerase Chain Reaction; D015995:Prevalence; D001618:beta-Lactamases / Q000235:genetics*
chemical_list: D000900:Anti-Bacterial Agents; D001618:beta-Lactamases