Molecular epidemiology of KPC-2-producing Enterobacteriaceae (non-Klebsiella pneumoniae) isolated from Brazil.
In Brazil, since 2009, there has been an ever increasing widespread of the bla(KPC-2) gene, mainly in Klebsiella pneumoniae. This study aims to assess the molecular epidemiology and genetic background of this gene in Enterobacteriaceae (non-K. pneumoniae) species from 9 Brazilian states between 2009 and 2011. Three hundred eighty-seven isolates were analyzed exhibiting nonsusceptibility to carbapenems, in which the bla(KPC-2) gene was detected in 21.4%. By disk diffusion and E-test, these isolates exhibited high rates of resistance to most of the antimicrobials tested, including tigecycline (45.6% nonsusceptible) and polymyxin B (16.5%), the most resistant species being Enterobacter aerogenes and Enterobacter cloacae. We found great clonal diversity and a variety of bla(KPC-2)-carrying plasmids, all of them exhibiting a partial Tn4401 structure. Therefore, this study demonstrates the dissemination of KPC-2 in 9 Enterobacteriaceae species, including species that were not previously described such as Pantoea agglomerans and Providencia stuartii.
Laboratório de Pesquisa em Infecção Hospitalar, Oswaldo Cruz Institute, RJ, Brazil.
Carolina Padilha
CP
Tavares
Laboratório de Pesquisa em Infecção Hospitalar, Oswaldo Cruz Institute, RJ, Brazil.
Polyana Silva
PS
Pereira
Departamento de Microbiologia e Imunologia, Faculdade de Ciências Médicas, Universidade do Estado do Rio de Janeiro, RJ, Brazil.
Elizabeth de Andrade
Ede A
Marques
Laboratório Central de Saúde Pública do Distrito Federal, DF, Brazil.
Celio
C
Faria
Laboratório Central de Saúde Pública do Espírito Santo, ES, Brazil.
Maria da Penha Araújo Herkenhoff
Mda P
de Souza
Laboratório Central de Saúde Pública de Goiás, GO, Brazil.
Robmary
R
de Almeida
Laboratório Central de Saúde Pública de Minas Gerais, MG, Brazil.
Carlene de Fátima Morais
Cde F
Alves
Laboratório de Pesquisa em Infecção Hospitalar, Oswaldo Cruz Institute, RJ, Brazil.
Marise Dutra
MD
Asensi
Laboratório de Pesquisa em Infecção Hospitalar, Oswaldo Cruz Institute, RJ, Brazil. Electronic address: anapdca@ioc.fiocruz.br.
Ana Paula D'Alincourt
AP
Carvalho-Assef
D000900:Anti-Bacterial Agents / Q000494:pharmacology; D001938:Brazil / Q000453:epidemiology; D015780:Carbapenems / Q000494:pharmacology*; D052978:Disk Diffusion Antimicrobial Tests; D004755:Enterobacteriaceae / Q000187:drug effects / Q000201:enzymology* / Q000235:genetics* / Q000302:isolation & purification; D004756:Enterobacteriaceae Infections / Q000453:epidemiology* / Q000382:microbiology; D014644:Genetic Variation; D005838:Genotype; D006801:Humans; D017720:Molecular Epidemiology; D058889:Molecular Typing; D018440:beta-Lactam Resistance; D001618:beta-Lactamases / Q000235:genetics / Q000378:metabolism*
D000900:Anti-Bacterial Agents; D015780:Carbapenems; C491478:beta-lactamase KPC-2; D001618:beta-Lactamases
Carbapenem resistance; Enterobacteriaceae; KPC; Tn4401