title: Epidemiological characteristics and antimicrobial susceptibility among carbapenem-resistant non-fermenting bacteria in Brazil.
abstract: BACKGROUND
  Non-fermenting Gram-negative bacteria such as Pseudomonas aeruginosa and Acinetobacter baumannii are widespread in the environment and are increasingly associated with nosocomial infections. Extensive and indiscriminate use of antibiotics in hospitals has contributed to an increased number of infections caused by these microorganisms, that are resistant to a wide variety of antimicrobials, including β-lactams. This study aimed to isolate and identify carbapenem-resistant Acinetobacter spp. and P. aeruginosa from hospitalized patients, to determine their antimicrobial susceptibility patterns and to screen for blaOXA-23, blaOXA-24, blaOXA-51, blaOXA-58, and blaOXA-143 genes among the isolated bacteria.
  
  
  METHODS
  Antimicrobial resistance patterns were performed using the disk-diffusion method. Genetic markers related to carbapenem resistance were screened by polymerase chain reaction.
  
  
  RESULTS
  Carbapenem-resistant Acinetobacter spp. (n = 44) and P. aeruginosa (n = 28) samples were isolated from patients admitted to a tertiary hospital. Polymyxin B was the only effective drug for all isolates. Considering the oxacillinase gene screening, genetic markers were observed only in Acinetobacter isolates. The most frequent genotype observed was blaOXA-23+/blaOXA-51+ (45.5%), followed by blaOXA-51+/blaOXA-143+ (41%). The oxacillinase genes blaOXA-24 and blaOXA-58 were not detected. High mortality rates (> 70%) were observed.
  
  
  CONCLUSIONS
  The data suggest the need for rational use of antimicrobials associated with early diagnosis of multidrug-resistant bacteria, especially considering non-fermenting Gram-negative rods, which are widespread in hospitals. The findings of blaoxa-51(-) strains suggest the occurrence and spread of non-A. baumannii species throughout our hospitals. Effective implementation of surveillance programs in hospitals is needed to reduce infectious and resistant intra- and inter-species bacteria.
authors.affiliation: Federal University of Juiz de Fora, Juiz de Fora, Minas Gerais, Brazil. vancdias@hotmail.com.
authors.forename: Vanessa Cordeiro
authors.initials: VC
authors.lastname: Dias
authors.forename: Claudio Galuppo
authors.initials: CG
authors.lastname: Diniz
authors.forename: Ana Claudia De Oliveira
authors.initials: AC
authors.lastname: Peter
authors.forename: Andre Netto
authors.initials: AN
authors.lastname: Bastos
authors.forename: Victor Quinnet de Andrade
authors.initials: VQ
authors.lastname: Bastos
authors.forename: Lucas Quinnet de Andrade
authors.initials: LQ
authors.lastname: Bastos
authors.forename: Vania Lucia
authors.initials: VL
authors.lastname: Da Silva
mesh_terms: D040981:Acinetobacter baumannii / Q000187:drug effects* / Q000302:isolation & purification; D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000900:Anti-Bacterial Agents / Q000494:pharmacology*; D001938:Brazil / Q000453:epidemiology; D015780:Carbapenems / Q000494:pharmacology*; D002648:Child; D002675:Child, Preschool; D003430:Cross-Sectional Studies; D052978:Disk Diffusion Antimicrobial Tests; D024901:Drug Resistance, Multiple, Bacterial; D005260:Female; D016905:Gram-Negative Bacterial Infections / Q000453:epidemiology* / Q000382:microbiology / Q000401:mortality; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D008875:Middle Aged; D016133:Polymerase Chain Reaction; D011550:Pseudomonas aeruginosa / Q000187:drug effects* / Q000302:isolation & purification; D016019:Survival Analysis; D055815:Young Adult; D001618:beta-Lactamases / Q000032:analysis / Q000235:genetics
chemical_list: D000900:Anti-Bacterial Agents; D015780:Carbapenems; D001618:beta-Lactamases