title: Phenotypic and molecular characterization of antimicrobial resistance and virulence factors in Pseudomonas aeruginosa clinical isolates from Recife, State of Pernambuco, Brazil.
abstract: BACKGROUND
  The emergence of carbapenem resistance mechanisms in Pseudomonas aeruginosa has been outstanding due to the wide spectrum of antimicrobial degradation of these bacteria, reducing of therapeutic options.
  
  
  METHODS
  Sixty-one clinical strains of P. aeruginosa isolated from five public hospitals in Recife, Pernambuco, Brazil, were examined between 2006 and 2010, aiming of evaluating the profiles of virulence, resistance to antimicrobials, presence of metallo-β-lactamase (MBL) genes, and clonal relationship among isolates.
  
  
  RESULTS
  A high percentage of virulence factors (34.4% mucoid colonies; 70.5% pyocyanin; 93.4% gelatinase positives; and 72.1% hemolysin positive) and a high percentage of antimicrobial resistance rates (4.9% pan-resistant and 54.1% multi-drug resistant isolates) were observed. Among the 29 isolates resistant to imipenem and/or ceftazidime, 44.8% (13/29) were MBL producers by phenotypic evaluation, and of these, 46.2% (6/13) were positive for the blaSPM-1 gene. The blaIMP and blaVIM genes were not detected. The molecular typing revealed 21 molecular profiles of which seven were detected in distinct hospitals and periods. Among the six positive blaSPM-1 isolates, three presented the same clonal profile and were from the same hospital, whereas the other three presented different clonal profiles.
  
  
  CONCLUSIONS
  These results revealed that P. aeruginosa is able to accumulate different resistance and virulence factors, making the treatment of infections difficult. The identification of blaSPM-1 genes and the dissemination of clones in different hospitals, indicate the need for stricter application of infection control measures in hospitals in Recife, Brazil, aiming at reducing costs and damages caused by P. aeruginosa infections.
authors.affiliation: Departamento de Medicina Tropical, Programa de Pós-Graduação em Medicina Tropical, Universidade Federal de Pernambuco, Recife, PE. paulajacome@ibest.com.br
authors.forename: Paula Regina Luna de Araújo
authors.initials: PR
authors.lastname: Jácome
authors.forename: Lílian Rodrigues
authors.initials: LR
authors.lastname: Alves
authors.forename: Adriane Borges
authors.initials: AB
authors.lastname: Cabral
authors.forename: Ana Catarina Souza
authors.initials: AC
authors.lastname: Lopes
authors.forename: Maria Amélia Vieira
authors.initials: MA
authors.lastname: Maciel
mesh_terms: D000900:Anti-Bacterial Agents / Q000494:pharmacology; D001938:Brazil; D024901:Drug Resistance, Multiple, Bacterial; D016521:Electrophoresis, Gel, Pulsed-Field; D006801:Humans; D008826:Microbial Sensitivity Tests; D058889:Molecular Typing; D010641:Phenotype; D011550:Pseudomonas aeruginosa / Q000187:drug effects* / Q000201:enzymology / Q000302:isolation & purification; D037521:Virulence Factors / Q000032:analysis*; D001618:beta-Lactamases / Q000032:analysis / Q000096:biosynthesis*
chemical_list: D000900:Anti-Bacterial Agents; D037521:Virulence Factors; D001618:beta-Lactamases