title: Clinical and Molecular Epidemiology of Multidrug-Resistant P. aeruginosa Carrying aac(6')-Ib-cr, qnrS1 and blaSPM Genes in Brazil.
abstract: We described a comprehensive analysis of the molecular epidemiology of multidrug-resistant (MDR) P. aeruginosa. Molecular analysis included typing by Pulsed Field Gel Electrophoresis, identification of genes of interest through PCR-based assays and sequencing of target genes. Case-control study was conducted to better understand the prognostic of patients and the impact of inappropriate therapy in patients with bacteremia, as well as the risk factors of MDR infections. We observed a high rate of MDR isolates (40.7%), and 51.0% of them was independently associated with inappropriate antibiotic therapy. Bacteremia was detected in 66.9% of patients, and prolonged hospital stay was expressive in those resistant to fluoroquinolone. Plasmid-mediated quinolone resistance genes (PMQR), qnrS1 and aac(6')Ib-cr, were detected in two different nosocomial isolates (5.3%), and the aac(6')-Ib7 variant was detected at a high frequency (87.5%) in those negative to PMQR. The presence of mutations in gyrA and parC genes was observed in 100% and 85% of selected isolates, respectively. Isolates harboring PMQR genes or mutations in gyrA and parC were not closely related, except in those containing SPM (São Paulo metallo-β-lactamase) clone. In addition, there is no study published in Brazil to date reporting the presence of Pseudomonas aeruginosa isolates harboring both qnrS1 and aac(6')Ib-cr genes, with alarming frequency of patients with inappropriate therapy.
authors.affiliation: Instituto de Ciências Biomédicas (ICBIM), Laboratory of Molecular Microbiology, Universidade Federal de Uberlandia (UFU), Uberlandia, Minas Gerais, Brazil.
authors.forename: Bruna Fuga
authors.initials: BF
authors.lastname: Araujo
authors.affiliation: Instituto de Ciências Biomédicas (ICBIM), Laboratory of Molecular Microbiology, Universidade Federal de Uberlandia (UFU), Uberlandia, Minas Gerais, Brazil.
authors.forename: Melina Lorraine
authors.initials: ML
authors.lastname: Ferreira
authors.affiliation: Instituto de Ciências Biomédicas (ICBIM), Laboratory of Molecular Microbiology, Universidade Federal de Uberlandia (UFU), Uberlandia, Minas Gerais, Brazil.
authors.forename: Paola Amaral de
authors.initials: PA
authors.lastname: Campos
authors.affiliation: Instituto de Ciências Biomédicas (ICBIM), Laboratory of Molecular Microbiology, Universidade Federal de Uberlandia (UFU), Uberlandia, Minas Gerais, Brazil.
authors.forename: Sabrina
authors.initials: S
authors.lastname: Royer
authors.affiliation: Instituto de Ciências Biomédicas (ICBIM), Laboratory of Molecular Microbiology, Universidade Federal de Uberlandia (UFU), Uberlandia, Minas Gerais, Brazil.
authors.forename: Deivid William da Fonseca
authors.initials: DW
authors.lastname: Batistão
authors.affiliation: Instituto de Ciências Biomédicas (ICBIM), Laboratory of Molecular Microbiology, Universidade Federal de Uberlandia (UFU), Uberlandia, Minas Gerais, Brazil.
authors.forename: Raquel Cristina Cavalcanti
authors.initials: RC
authors.lastname: Dantas
authors.affiliation: Instituto de Ciências Biomédicas (ICBIM), Laboratory of Molecular Microbiology, Universidade Federal de Uberlandia (UFU), Uberlandia, Minas Gerais, Brazil.
authors.forename: Iara Rossi
authors.initials: IR
authors.lastname: Gonçalves
authors.affiliation: Instituto de Ciências Biomédicas (ICBIM), Laboratory of Molecular Microbiology, Universidade Federal de Uberlandia (UFU), Uberlandia, Minas Gerais, Brazil.
authors.forename: Ana Luiza Souza
authors.initials: AL
authors.lastname: Faria
authors.affiliation: Instituto de Ciências Biomédicas (ICBIM), Laboratory of Molecular Microbiology, Universidade Federal de Uberlandia (UFU), Uberlandia, Minas Gerais, Brazil.
authors.forename: Cristiane Silveira de
authors.initials: CS
authors.lastname: Brito
authors.affiliation: Instituto de Ciências Biomédicas (ICBIM), Laboratory of Virology, Universidade Federal de Uberlandia (UFU), Uberlandia, Minas Gerais, Brazil.
authors.forename: Jonny
authors.initials: J
authors.lastname: Yokosawa
authors.affiliation: Instituto de Ciências Biomédicas (ICBIM), Laboratory of Molecular Microbiology, Universidade Federal de Uberlandia (UFU), Uberlandia, Minas Gerais, Brazil.
authors.forename: Paulo Pinto
authors.initials: PP
authors.lastname: Gontijo-Filho
authors.affiliation: Instituto de Ciências Biomédicas (ICBIM), Laboratory of Molecular Microbiology, Universidade Federal de Uberlandia (UFU), Uberlandia, Minas Gerais, Brazil.
authors.forename: Rosineide Marques
authors.initials: RM
authors.lastname: Ribas
mesh_terms: D000328:Adult; D000368:Aged; D016470:Bacteremia / Q000188:drug therapy / Q000453:epidemiology*; D001426:Bacterial Proteins / Q000235:genetics*; D015373:Bacterial Typing Techniques; D001938:Brazil / Q000453:epidemiology; D016022:Case-Control Studies; D024901:Drug Resistance, Multiple, Bacterial; D005260:Female; D024841:Fluoroquinolones / Q000494:pharmacology / Q000627:therapeutic use; D006760:Hospitalization / Q000706:statistics & numerical data; D006801:Humans; D008297:Male; D008875:Middle Aged; D058889:Molecular Typing; D011379:Prognosis; D011552:Pseudomonas Infections / Q000188:drug therapy / Q000453:epidemiology* / Q000382:microbiology; D011550:Pseudomonas aeruginosa / Q000145:classification* / Q000187:drug effects / Q000235:genetics
chemical_list: D001426:Bacterial Proteins; D024841:Fluoroquinolones