title: Multidrug resistance genes, including bla(KPC) and bla(CTX)-M-2, among Klebsiella pneumoniae isolated in Recife, Brazil.
abstract: BACKGROUND
  The prevalence of cephalosporins and carbapenem-resistant Klebsiella pneumoniae strains is rising in Brazil, with potential serious consequences in terms of patients' outcomes and general care.
  
  
  METHODS
  This study characterized 24 clinical isolates of K. pneumoniae from two hospitals in Recife, Brazil, through the antimicrobial susceptibility profile, analyses of β-lactamase genes (bla(TEM), bla(SHV),bla(CTX-M), bla(KPC), bla(VIM), bla(IMP), and bla(SPM), plasmidial profile and ERIC-PCR (Enterobacterial repetitive intergenic consensus-polymerase chain reaction).
  
  
  RESULTS
  ERIC-PCR and plasmidial analysis grouped the isolates in 17 and 19 patterns, respectively. Six isolates from one hospital presented the same pattern by ERIC-PCR, indicating clonal dissemination. All isolates presented bla(SHV), 62.5% presented bla(CTX)-M-2, 29% bla(TEM), and 41.7% bla(KPC). Metallo-β-lactamase genes bla(VIM), bla(IMP), and bla(SPM) not detected. Eleven isolates were identified carrying at least 3 β-lactamase studied genes, and 2 isolates carried bla(SHV), bla(TEM), bla (CTX-M-2) and bla(KPC) simultaneously.
  
  
  CONCLUSIONS
  The accumulation of resistance genes in some strains, observed in this study, imposes limitations in the therapeutic options available for the treatment of infections caused by K. pneumoniae in Recife, Brazil. These results should alert the Brazilian medical authorities to establish rigorous methods for more efficiently control the dissemination of antimicrobial resistance genes in the hospital environment.
authors.affiliation: Departamento de Medicina Tropical, Universidade Federal de Pernambuco, Recife, PE.
authors.forename: Adriane Borges
authors.initials: AB
authors.lastname: Cabral
authors.forename: Rita de Cássia de Andrade
authors.initials: Rde C
authors.lastname: Melo
authors.forename: Maria Amélia Vieira
authors.initials: MA
authors.lastname: Maciel
authors.forename: Ana Catarina Souza
authors.initials: AC
authors.lastname: Lopes
mesh_terms: D001426:Bacterial Proteins / Q000235:genetics; D001938:Brazil; D015780:Carbapenems / Q000627:therapeutic use; D003428:Cross Infection / Q000188:drug therapy / Q000382:microbiology*; D024901:Drug Resistance, Multiple, Bacterial / Q000235:genetics*; D019450:Genes, MDR / Q000235:genetics*; D006801:Humans; D007710:Klebsiella Infections / Q000188:drug therapy* / Q000382:microbiology; D007711:Klebsiella pneumoniae / Q000235:genetics* / Q000302:isolation & purification; D008826:Microbial Sensitivity Tests; D010957:Plasmids / Q000032:analysis; D016133:Polymerase Chain Reaction / Q000379:methods; D001618:beta-Lactamases / Q000235:genetics
chemical_list: D001426:Bacterial Proteins; D015780:Carbapenems; C515384:beta-lactamase CTX-M-2, Klebsiella pneumoniae; D001618:beta-Lactamases; C547585:beta-lactamase KPC-2, Klebsiella pneumoniae; C063912:carbapenemase