Navegando por Palavras-chave "Klebsiella pneumoniae carbapenemase"

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    Antimicrobial resistance in Enterobacteriaceae in Brazil: focus on beta-lactams and polymyxins
    (Soc Brasileira Microbiologia, 2016) Mello Sampaio, Jorge Luiz; Gales, Ana Cristina [UNIFESP]
    uring the last 30 years there has been a dissemination of plasmid-mediated beta-lactamases in Enterobacteriaceae in Brazil. Extended spectrum beta-lactamases (ESBL) are widely disseminated in the hospital setting and are detected in a lower frequency in the community setting. Cefotaximases are the most frequently detected ESBL type and Klebsiella pneumoniae is the predominant species among ESBL producers. Klebsiella pneumoniae carbapenemase-producing Enterobacteriaceae became widely disseminated in Brazil during the last decade and KPC production is currently the most frequent resistance mechanism (96.2%) in carbapenem resistant K. pneumoniae. To date KPC-2 is the only variant reported in Brazil. Polymyxin B resistance in KPC-2-producing K. pneumoniae has come to an alarming rate of 27.1% in 2015 in Sao Paulo, the largest city in Brazil. New Delhi metallo-beta-lactamase was detected in Brazil in 2013, has been reported in different Brazilian states but are not widely disseminated. Antimicrobial resistance in Enterobacteriaceae in Brazil is a very serious problem that needs urgent actions which includes both more strict adherence to infection control measures and more judicious use of antimicrobials.(C) 2016 Sociedade Brasileira de Microbiologia. Published by Elsevier Editora Ltda.
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    Differentiation of Klebsiella pneumoniae carbapenemase (KPC) variants by pyrosequencing
    (Elsevier B.V., 2014-05-01) Monteiro, Jussimara [UNIFESP]; Widen, Raymond H.; Pignatari, Antonio C. C. [UNIFESP]; Kubasek, Carly; Silbert, Suzane; Tampa Gen Hosp; Universidade Federal de São Paulo (UNIFESP)
    A fast and reliable protocol using the pyrosequencing technique was developed to identify 11 different types of the KPC enzyme. A total of 65 b/alpha(Kpc) positive bacterial isolates were tested and characterized. in the end, the pyrosequencing proved to be a powerful tool for epidemiological studies of KPC producer isolates. (c) 2014 Elsevier B.V. All rights reserved.
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    Emergence of polymyxin B resistance in a polymyxin B-susceptible KPC-producing Klebsiella pneumoniae causing bloodstream infection in a neutropenic patient during polymyxin B therapy
    (Elsevier Science Inc, 2018) Zavascki, Alexandre P.; Girardello, Raquel [UNIFESP]; Magagnin, Cibele M.; Antochevis, Laura C.; Maciel, Rafael A.; Palmeiro, Jussara K. [UNIFESP]; Gales, Ana C. [UNIFESP]
    The emergence of resistance to polymyxins in KPC-producing Klebsiella pneumoniae isolates has been a major clinical problem. This study evaluated the molecular mechanisms associated with polymyxin B (PMB) resistance that emerged in a previously PMB-susceptible KPC-2-producing K. pneumoniae during PMB therapy for a bloodstream infection in a neutropenic patient. The first isolate (PMB-susceptible) was obtained while the patient was receiving meropenem and other isolates were recovered from 2 sets of blood cultures in different dates while the patient was receiving PMB therapy (4 of 6 blood cultures bottles yielded isolates with full PMB resistance). The population analysis profile of the first isolate revealed the growth of resistant subpopulations with PFGE profile distinct from the parental isolate but undistinguishable from those obtained in subsequent days under PMB exposure. Resistant subpopulations were obtained from all parental PMB-susceptible and in one PMB-resistant isolate recovered from the patient. The molecular mechanism observed in the hetero-resistant subpopulations (IS1-like in mgrB-promoter region, increased rstB transcription with no mutation and non-identified mechanism) differed from those found in the PMB-resistant isolates, in which no mutation or transcriptional alterations were detected. This study showed that the mechanism of resistance to PMB that emerged during PMB therapy was not related to those observed in subpopulations selected in vitro from PMB-susceptible isolates recovered from the patient. The absence of mutations in the former isolates may be due to adaptive resistance occurred because of sub-optimal PMB levels as well as amikacin and meropenem used in combination. (C) 2017 Elsevier Inc. All rights reserved.