Molecular characterization of carbapenem-resistant Klebsiella pneumoniae isolates from a university hospital in Brazil

Introduction: The emergence of Klebsiella pneumoniae carbapenemase (KPC)-producing K. pneumoniae (KPC-Kpn) isolates is attracting significant attention in nosocomial infection settings. K. pneumoniae is the main pathogen that harbours blaKPC genes. Methodology: This study evaluated 54 K. pneumon...

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Main Authors: Ana Carolina Polano Vivan, Juliana Ferraz Rosa, Camila Fonseca Rizek, Marsileni Pelisson, Silvia Figueiredo Costa, Mariangela Hungria, Renata Kobayashi, Eliana Carolina Vespero
Format: Article
Language:English
Published: The Journal of Infection in Developing Countries 2017-06-01
Series:Journal of Infection in Developing Countries
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Online Access:https://jidc.org/index.php/journal/article/view/8614
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author Ana Carolina Polano Vivan
Juliana Ferraz Rosa
Camila Fonseca Rizek
Marsileni Pelisson
Silvia Figueiredo Costa
Mariangela Hungria
Renata Kobayashi
Eliana Carolina Vespero
author_facet Ana Carolina Polano Vivan
Juliana Ferraz Rosa
Camila Fonseca Rizek
Marsileni Pelisson
Silvia Figueiredo Costa
Mariangela Hungria
Renata Kobayashi
Eliana Carolina Vespero
author_sort Ana Carolina Polano Vivan
collection DOAJ
description Introduction: The emergence of Klebsiella pneumoniae carbapenemase (KPC)-producing K. pneumoniae (KPC-Kpn) isolates is attracting significant attention in nosocomial infection settings. K. pneumoniae is the main pathogen that harbours blaKPC genes. Methodology: This study evaluated 54 K. pneumoniae carbapenem-resistant isolates from patients hospitalized at the University Hospital of Londrina, between July 2009 and July 2010. The isolates were phenotypically screened for carbapenemase production and submitted for genotypic confirmation by polymerase chain reaction (PCR) for KPC, metallo-β-lactamases, OXA-48, and extended-spectrum beta-lactamase genes. The absence of outer membrane proteins (OMP) was investigated by SDS-PAGE. The susceptibility profile was determined by broth microdilution, according to Clinical and Laboratory Standards Institute protocol. Results: All isolates were phenotypically positive for class A carbapenemase production, but negative for metallo-β-lactamase activity. PCR analysis demonstrated that all isolates carried blaKPC genes and sequencing showed that all strains belonged to KPC-2 subtype. Four strains did not show porin expression, and all isolates were resistant to ertapenem, meropenem, and imipenem. Susceptibility rates reached 35.2% for gentamicin, 85.2% for polymixyn B, 87% for colistin, and 98.1% for both tigecycline and fosfomycin. Pulsed-field gel electrophoresis showed six clones, and three of them predominated among the isolates. Conclusions: KPC-2-producing K. pneumoniae is becoming predominant among carbapenem-resistant K. pneumoniae isolates at the hospital. The association of the enzyme KPC with other resistance determinants, such as loss of porins, may increase the severity of the situation of nosocomial infections. There is an urgent need to develop strategies for infection control and prevention.
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spelling doaj-art-8d717739be5742fbbd824ca9e609434f2025-08-20T02:57:01ZengThe Journal of Infection in Developing CountriesJournal of Infection in Developing Countries1972-26802017-06-01110510.3855/jidc.8614Molecular characterization of carbapenem-resistant Klebsiella pneumoniae isolates from a university hospital in BrazilAna Carolina Polano Vivan0Juliana Ferraz Rosa1Camila Fonseca Rizek2Marsileni Pelisson3Silvia Figueiredo Costa4Mariangela Hungria5Renata Kobayashi6Eliana Carolina Vespero7University of the Sacred Heart, Bauru, BrazilSão Paulo University, São Paulo, BrazilSão Paulo University, São Paulo, BrazilLondrina State University, Londrina, BrazilSão Paulo University, São Paulo, BrazilEmbrapa Soja, Londrina, PR, BrazilLondrina State University, Londrina, BrazilLondrina State University, Londrina, Brazil Introduction: The emergence of Klebsiella pneumoniae carbapenemase (KPC)-producing K. pneumoniae (KPC-Kpn) isolates is attracting significant attention in nosocomial infection settings. K. pneumoniae is the main pathogen that harbours blaKPC genes. Methodology: This study evaluated 54 K. pneumoniae carbapenem-resistant isolates from patients hospitalized at the University Hospital of Londrina, between July 2009 and July 2010. The isolates were phenotypically screened for carbapenemase production and submitted for genotypic confirmation by polymerase chain reaction (PCR) for KPC, metallo-β-lactamases, OXA-48, and extended-spectrum beta-lactamase genes. The absence of outer membrane proteins (OMP) was investigated by SDS-PAGE. The susceptibility profile was determined by broth microdilution, according to Clinical and Laboratory Standards Institute protocol. Results: All isolates were phenotypically positive for class A carbapenemase production, but negative for metallo-β-lactamase activity. PCR analysis demonstrated that all isolates carried blaKPC genes and sequencing showed that all strains belonged to KPC-2 subtype. Four strains did not show porin expression, and all isolates were resistant to ertapenem, meropenem, and imipenem. Susceptibility rates reached 35.2% for gentamicin, 85.2% for polymixyn B, 87% for colistin, and 98.1% for both tigecycline and fosfomycin. Pulsed-field gel electrophoresis showed six clones, and three of them predominated among the isolates. Conclusions: KPC-2-producing K. pneumoniae is becoming predominant among carbapenem-resistant K. pneumoniae isolates at the hospital. The association of the enzyme KPC with other resistance determinants, such as loss of porins, may increase the severity of the situation of nosocomial infections. There is an urgent need to develop strategies for infection control and prevention. https://jidc.org/index.php/journal/article/view/8614Klebsiella pneumoniaecarbapenemaseKPCcarbapenem resistance
spellingShingle Ana Carolina Polano Vivan
Juliana Ferraz Rosa
Camila Fonseca Rizek
Marsileni Pelisson
Silvia Figueiredo Costa
Mariangela Hungria
Renata Kobayashi
Eliana Carolina Vespero
Molecular characterization of carbapenem-resistant Klebsiella pneumoniae isolates from a university hospital in Brazil
Journal of Infection in Developing Countries
Klebsiella pneumoniae
carbapenemase
KPC
carbapenem resistance
title Molecular characterization of carbapenem-resistant Klebsiella pneumoniae isolates from a university hospital in Brazil
title_full Molecular characterization of carbapenem-resistant Klebsiella pneumoniae isolates from a university hospital in Brazil
title_fullStr Molecular characterization of carbapenem-resistant Klebsiella pneumoniae isolates from a university hospital in Brazil
title_full_unstemmed Molecular characterization of carbapenem-resistant Klebsiella pneumoniae isolates from a university hospital in Brazil
title_short Molecular characterization of carbapenem-resistant Klebsiella pneumoniae isolates from a university hospital in Brazil
title_sort molecular characterization of carbapenem resistant klebsiella pneumoniae isolates from a university hospital in brazil
topic Klebsiella pneumoniae
carbapenemase
KPC
carbapenem resistance
url https://jidc.org/index.php/journal/article/view/8614
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