title: Molecular Characterization of Extended-Spectrum β-Lactamase-Producer Klebsiella pneumoniae Isolates Causing Neonatal Sepsis in Peru.
abstract: Klebsiella pneumoniae (KP) is the most common cause of neonatal sepsis in the low- and middle-income countries. Our objective was to describe the phenotypic and molecular characteristics of extended-spectrum β-lactamase (ESBL)-producer KP in neonatal care centers from Peru. We collected 176 non-duplicate consecutive KP isolates from blood isolates of neonates from eight general public hospitals of Lima, Peru. The overall rate of ESBL production was 73.3% (N = 129). The resistance rates were higher among ESBL-producer isolates when compared with the nonproducers: 85.3% versus 12.8% for gentamicin (P < 0.01), 59.7% versus 8.5% for trimethoprim-sulfamethoxazole (P < 0.01), 45.0% versus 8.5% for ciprofloxacin (P < 0.01), and 36.4% versus 12.8% for amikacin (P < 0.01). A total of 359 β-lactamase-encoding genes were detected among 129 ESBL-producer isolates; 109 isolates (84.5%) carried two or more genes. Among 37 ESBL-producer isolates randomly selected, CTX-M-15 and CTX-M-2 were the most common ESBLs detected. Most of the isolates (92%) belonged to the group KpI. Pulsed-field gel electrophoresis showed that multiple KP clones were circulating among the eight neonatal units included.
authors.affiliation: Instituto de Medicina Tropical Alexander von Humboldt, Universidad Peruana Cayetano Heredia, Lima, Peru; Centro de Investigación Biomédica de La Rioja, Logroño, Spain; Institute of Tropical Medicine Antwerp, Antwerp, Belgium; Department of Microbiology and Immunology, University of Leuven, Leuven, Belgium coralith.garcia@upch.pe.
authors.forename: Coralith
authors.initials: C
authors.lastname: García
authors.affiliation: Instituto de Medicina Tropical Alexander von Humboldt, Universidad Peruana Cayetano Heredia, Lima, Peru; Centro de Investigación Biomédica de La Rioja, Logroño, Spain; Institute of Tropical Medicine Antwerp, Antwerp, Belgium; Department of Microbiology and Immunology, University of Leuven, Leuven, Belgium.
authors.forename: Lizeth
authors.initials: L
authors.lastname: Astocondor
authors.affiliation: Instituto de Medicina Tropical Alexander von Humboldt, Universidad Peruana Cayetano Heredia, Lima, Peru; Centro de Investigación Biomédica de La Rioja, Logroño, Spain; Institute of Tropical Medicine Antwerp, Antwerp, Belgium; Department of Microbiology and Immunology, University of Leuven, Leuven, Belgium.
authors.forename: Beatriz
authors.initials: B
authors.lastname: Rojo-Bezares
authors.affiliation: Instituto de Medicina Tropical Alexander von Humboldt, Universidad Peruana Cayetano Heredia, Lima, Peru; Centro de Investigación Biomédica de La Rioja, Logroño, Spain; Institute of Tropical Medicine Antwerp, Antwerp, Belgium; Department of Microbiology and Immunology, University of Leuven, Leuven, Belgium.
authors.forename: Jan
authors.initials: J
authors.lastname: Jacobs
authors.affiliation: Instituto de Medicina Tropical Alexander von Humboldt, Universidad Peruana Cayetano Heredia, Lima, Peru; Centro de Investigación Biomédica de La Rioja, Logroño, Spain; Institute of Tropical Medicine Antwerp, Antwerp, Belgium; Department of Microbiology and Immunology, University of Leuven, Leuven, Belgium.
authors.forename: Yolanda
authors.initials: Y
authors.lastname: Sáenz
mesh_terms: D000900:Anti-Bacterial Agents / Q000494:pharmacology; D024881:Drug Resistance, Bacterial; D015964:Gene Expression Regulation, Bacterial; D005949:Glucose Oxidase; D006801:Humans; D007231:Infant, Newborn; D007232:Infant, Newborn, Diseases / Q000453:epidemiology / Q000382:microbiology*; D007710:Klebsiella Infections / Q000453:epidemiology / Q000382:microbiology*; D007711:Klebsiella pneumoniae / Q000187:drug effects* / Q000201:enzymology / Q000302:isolation & purification; D007784:Lactoperoxidase; D010568:Peru / Q000453:epidemiology; D018805:Sepsis / Q000453:epidemiology / Q000382:microbiology*; D001618:beta-Lactamases / Q000235:genetics / Q000378:metabolism*
chemical_list: D000900:Anti-Bacterial Agents; C041744:enzymobeads; D005949:Glucose Oxidase; D007784:Lactoperoxidase; D001618:beta-Lactamases