title: The Spread of CTX-M-Type Extended-Spectrum β-Lactamases in Brazil: A Systematic Review.
abstract: The aim of this study was evaluate the spread of CTX-M-type extended-spectrum β-lactamase variants in microorganisms involved in both hospital- and community-acquired infections in different regions of Brazil to determine their epidemiology and identify areas for further research. Thirty-six studies were included and analyzed. Most of the studies were conducted in the southeastern (66.7%, 24/36), southern (22.2%, 8/36), and northeastern (8.3%, 3/36) regions of Brazil. No study was conducted in the northern or midwestern region. CTX-M-producing bacteria were isolated exclusively from humans in both hospital and community environments. The microorganisms that were most commonly associated with the presence of the blaCTX-M gene were Klebsiella pneumoniae and Escherichia coli. The β-lactamases of the CTX-M family that were most frequently identified in Brazil were CTX-M-2 and CTX-M-15, especially in the southeast where these variants are often detected. In this systematic review, the microorganisms that were most commonly associated with the presence of the blaCTX-M gene were K. pneumoniae and E. coli. CTX-M-2 and CTX-M-15 were the most dominant variants of the CTX-M family, followed by CTX-M-8, CTX-M-9, and CTX-M-59. A higher frequency of CTX-M variants was found in the southeastern region, especially in the states of São Paulo and Rio de Janeiro, where CTX-M-2 and CTX-M-15 are predominant.
authors.affiliation: Laboratory of Microbiology, Faculty of Medicine, Federal University of Ceará , Sobral, Brazil .
authors.forename: Francisco Ruliglésio
authors.initials: FR
authors.lastname: Rocha
authors.affiliation: Laboratory of Microbiology, Faculty of Medicine, Federal University of Ceará , Sobral, Brazil .
authors.forename: Vicente Paulo Teixeira
authors.initials: VP
authors.lastname: Pinto
authors.affiliation: Laboratory of Microbiology, Faculty of Medicine, Federal University of Ceará , Sobral, Brazil .
authors.forename: Francisco Cesar Barroso
authors.initials: FC
authors.lastname: Barbosa
mesh_terms: D000900:Anti-Bacterial Agents / Q000494:pharmacology; D001938:Brazil / Q000453:epidemiology; D017714:Community-Acquired Infections; D004926:Escherichia coli / Q000145:classification / Q000187:drug effects / Q000235:genetics* / Q000302:isolation & purification; D004927:Escherichia coli Infections / Q000188:drug therapy / Q000453:epidemiology* / Q000382:microbiology; D029968:Escherichia coli Proteins / Q000145:classification / Q000235:genetics*; D015870:Gene Expression; D022761:Gene Transfer, Horizontal; D006761:Hospitals; D006801:Humans; D015994:Incidence; D007710:Klebsiella Infections / Q000188:drug therapy / Q000453:epidemiology* / Q000382:microbiology; D007711:Klebsiella pneumoniae / Q000145:classification / Q000187:drug effects / Q000235:genetics* / Q000302:isolation & purification; D017720:Molecular Epidemiology; D018440:beta-Lactam Resistance / Q000235:genetics*; D001618:beta-Lactamases / Q000145:classification / Q000235:genetics*; D047090:beta-Lactams / Q000494:pharmacology
chemical_list: D000900:Anti-Bacterial Agents; D029968:Escherichia coli Proteins; D047090:beta-Lactams; D001618:beta-Lactamases; C000602253:beta-lactamase CTX-M, E coli