دورية أكاديمية
أعرض في EDS

KPC-producing Klebsiella pneumoniae bloodstream isolates from Brazilian hospitals: What (still) remains active?

التفاصيل البيبلوغرافية
العنوان: KPC-producing Klebsiella pneumoniae bloodstream isolates from Brazilian hospitals: What (still) remains active?
المؤلفون: Antochevis LC; Laboratório de Pesquisa em Resistência Bacteriana (LABRESIS), Centro de Pesquisa Experimental, Hospital de Clínicas de Porto Alegre, Porto Alegre, Brazil; Laboratório Weinmann-Grupo Fleury, Porto Alegre, Brazil., Magagnin CM; Laboratório de Pesquisa em Resistência Bacteriana (LABRESIS), Centro de Pesquisa Experimental, Hospital de Clínicas de Porto Alegre, Porto Alegre, Brazil; Laboratório Weinmann-Grupo Fleury, Porto Alegre, Brazil., Nunes AG; Laboratório de Pesquisa em Resistência Bacteriana (LABRESIS), Centro de Pesquisa Experimental, Hospital de Clínicas de Porto Alegre, Porto Alegre, Brazil., Goulart TM; Laboratório de Pesquisa em Resistência Bacteriana (LABRESIS), Centro de Pesquisa Experimental, Hospital de Clínicas de Porto Alegre, Porto Alegre, Brazil., Martins AS; Laboratório de Pesquisa em Resistência Bacteriana (LABRESIS), Centro de Pesquisa Experimental, Hospital de Clínicas de Porto Alegre, Porto Alegre, Brazil., Cayô R; Laboratório Alerta, Division of Infectious Diseases, Department of Internal Medicine, Escola Paulista de Medicina/Universidade Federal de São Paulo, São Paulo, Brazil., Gales AC; Laboratório Alerta, Division of Infectious Diseases, Department of Internal Medicine, Escola Paulista de Medicina/Universidade Federal de São Paulo, São Paulo, Brazil., Barth AL; Laboratório de Pesquisa em Resistência Bacteriana (LABRESIS), Centro de Pesquisa Experimental, Hospital de Clínicas de Porto Alegre, Porto Alegre, Brazil., Zavascki AP; Department of Internal Medicine, Medical School, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil; Infectious Diseases Service, Hospital de Clínicas de Porto Alegre, Porto Alegre, Brazil; Infectious Diseases Service, Hospital Moinhos de Vento, Porto Alegre, Brazil. Electronic address: azavascki@hcpa.edu.br.
المصدر: Journal of global antimicrobial resistance [J Glob Antimicrob Resist] 2018 Dec; Vol. 15, pp. 173-177. Date of Electronic Publication: 2018 Jul 30.
نوع المنشور: Journal Article; Research Support, Non-U.S. Gov't
اللغة: English
بيانات الدورية: Publisher: Published by Elsevier Ltd. on behalf of International Society of Chemotherapy for Infection and Cancer Country of Publication: Netherlands NLM ID: 101622459 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 2213-7173 (Electronic) Linking ISSN: 22137165 NLM ISO Abbreviation: J Glob Antimicrob Resist Subsets: MEDLINE
أسماء مطبوعة: Original Publication: Amsterdam : Published by Elsevier Ltd. on behalf of International Society of Chemotherapy for Infection and Cancer
مواضيع طبية MeSH: Drug Resistance, Bacterial*, Klebsiella Infections/*blood , Klebsiella pneumoniae/*enzymology , beta-Lactamases/*biosynthesis, Anti-Bacterial Agents/pharmacology ; Brazil ; Humans ; Klebsiella pneumoniae/drug effects ; Klebsiella pneumoniae/isolation & purification ; Microbial Sensitivity Tests ; Polymyxins/pharmacology
مستخلص: Objectives: This study assessed susceptibility to polymyxin B (PMB) and alternative antimicrobials, with focus on aminoglycosides and tigecycline, according to different breakpoints in KPC-producing Klebsiella pneumoniae (KPC-Kp) bloodstream isolates from Brazilian hospitals.
Methods: Bloodstream K. pneumoniae isolates non-susceptible to any of the three carbapenems (meropenem, imipenem or ertapenem) from four Brazilian tertiary-care hospitals were selected. Antimicrobial susceptibility was determined and interpreted according to distinct breakpoints. Twenty-nine PMB-resistant KPC-Kp isolates were selected for molecular typing.
Results: A total of 158 KPC-Kp were analysed. MIC 50/90 values for PMB were 0.25/16mg/L; 40 isolates (25.3%) were resistant to PMB. MIC 50/90 values for meropenem were 32/≥256mg/L; no isolates were susceptible to meropenem according to CLSI, but 10 isolates were intermediate using EUCAST breakpoints (1, MIC=4mg/L; 9, MIC=8mg/L). MIC 50/90 values for tigecycline were 2/8mg/L; 53 (33.5%) and 94 (59.5%) isolates were susceptible according to EUCAST and FDA breakpoints, respectively. MIC 50/90 values were 32/≥64mg/L for amikacin and ≥16/≥16mg/L for gentamicin; 48 (30.4%), 28 (17.7%) and 16 (10.1%) were susceptible to amikacin according to CLSI, EUCAST and USCAST, respectively, but susceptibility rates to gentamicin were <7.0%. Eighteen distinct clonal profiles were identified among 29 PMB-resistant isolates by DNA macrorestriction. Most clones belonged to CC11.
Conclusion: Elevated rates of PMB-resistant KPC-Kp bloodstream infections were found in four Brazilian hospitals, mostly of polyclonal origin. Alternative antimicrobials with the highest in vitro activity were tigecycline and amikacin, although susceptibility rates significantly decreased using criteria with stricter breakpoints (e.g. EUCAST, USCAST).
(Copyright © 2018 International Society for Chemotherapy of Infection and Cancer. Published by Elsevier Ltd. All rights reserved.)
فهرسة مساهمة: Keywords: Aminoglycosides; Colistin; Klebsiella pneumoniae carbapenemase; Polymyxins; Resistance; Tigecycline
المشرفين على المادة: 0 (Anti-Bacterial Agents)
0 (Polymyxins)
EC 3.5.2.6 (beta-Lactamases)
تواريخ الأحداث: Date Created: 20180803 Date Completed: 20190925 Latest Revision: 20190925
رمز التحديث: 20240628
DOI: 10.1016/j.jgar.2018.07.011
PMID: 30071353
قاعدة البيانات: MEDLINE
الوصف
تدمد:2213-7173
DOI:10.1016/j.jgar.2018.07.011