Emergence of colistin resistance in the largest university hospital complex of São Paulo, Brazil, over five years.
Colistin resistance involving Gram-negative bacilli infections is a challenge for health institutions around of the world. Carbapenem-resistance among these isolates makes colistin the last therapeutic option for this treatment. Colistin resistance among Enterobacteriaceae, Acinetobacter spp., and Pseudomonas spp. was evaluated between 2010 and 2014 years, at Hospital das Clínicas, São Paulo, Brazil. Over five years 1346 (4.0%) colistin resistant Gram-negative bacilli were evaluated. Enterobacteriaceae was the most frequent (86.1%) pathogen isolated, followed by Acinetobacter spp. (7.6%), and Pseudomonas spp. (6.3%). By temporal analysis there was a trend for an increase of colistin resistance among Enterobacteriaceae, but not among non-fermentative isolates. Among 1346 colistin resistant isolates, carbapenem susceptibility was observed in 21.5%. Colistin resistance in our hospital has been alarmingly increased among Klebsiella pneumoniae isolates in both KPC positive and negative, thus becoming a therapeutic problem.
Universidade de São Paulo, Hospital das Clínicas da Faculdade de Medicina, Divisão Laboratório Central, São Paulo, SP, Brazil; Universidade de São Paulo, Faculdade de Medicina, Medicina Laboratorial - LIM-03, São Paulo, SP, Brazil. Electronic address: flaviarossi61@gmail.com.
Flávia
F
Rossi
Universidade de São Paulo, Hospital das Clínicas da Faculdade de Medicina, Divisão Laboratório Central, São Paulo, SP, Brazil; Universidade de São Paulo, Faculdade de Medicina, Medicina Laboratorial - LIM-03, São Paulo, SP, Brazil.
Raquel
R
Girardello
Universidade de São Paulo, Hospital das Clínicas da Faculdade de Medicina, Divisão Laboratório Central, São Paulo, SP, Brazil; Universidade de São Paulo, Faculdade de Medicina, Medicina Laboratorial - LIM-03, São Paulo, SP, Brazil.
Ana Paula
AP
Cury
Universidade de São Paulo, Hospital das Clínicas da Faculdade de Medicina, Divisão Laboratório Central, São Paulo, SP, Brazil; Universidade de São Paulo, Faculdade de Medicina, Medicina Laboratorial - LIM-03, São Paulo, SP, Brazil.
Thais Sabato Romano
TS
Di Gioia
Universidade de São Paulo, Hospital das Clínicas da Faculdade de Medicina, Divisão Laboratório Central, São Paulo, SP, Brazil; Universidade de São Paulo, Faculdade de Medicina, Medicina Laboratorial - LIM-03, São Paulo, SP, Brazil.
João Nóbrega de
JN
Almeida
Universidade de São Paulo, Faculdade de Medicina, Medicina Laboratorial - LIM-03, São Paulo, SP, Brazil.
Alberto José da Silva
AJ
Duarte
D000150:Acinetobacter / Q000187:drug effects* / Q000302:isolation & purification; D000900:Anti-Bacterial Agents / Q000494:pharmacology*; D001938:Brazil; D003091:Colistin / Q000494:pharmacology*; D024881:Drug Resistance, Bacterial / Q000187:drug effects*; D004755:Enterobacteriaceae / Q000187:drug effects* / Q000302:isolation & purification; D006785:Hospitals, University; D006801:Humans; D008826:Microbial Sensitivity Tests; D011549:Pseudomonas / Q000187:drug effects* / Q000302:isolation & purification; D012189:Retrospective Studies; D013997:Time Factors
D000900:Anti-Bacterial Agents; D003091:Colistin
Brazil; Colistin-resistant; Enterobacteriaceae; Polymyxin B-resistant