Navegando por Palavras-chave "carbapenem resistance"

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    Carbapenem-resistant Pseudomonas aeruginosa - clonal spread in Southern Brazil and in the State of Goias
    (Contexto, 2010-09-01) Scheffer, Mara Cristina; Gales, Ana Cristina [UNIFESP]; Barth, Afonso Luis; Carmo Filho, Jose Rodrigues do; Dalla-Costa, Libera Maria; Univ Fed Parana; Universidade Federal de Santa Catarina (UFSC); Universidade Federal de São Paulo (UNIFESP); Hosp Clin Porto Alegre; Univ Catolica Goias; Fac Pequeno Principe
    This study evaluated the clonal spread of carbapenem-resistant P. aeruginosa producing SPM-1 type metallo-beta-lactamase (MBL), at the university hospital of Florianopolis, Santa Catarina, Brazil, compared to an epidemic clone previously reported, as well as strains collected in other three Brazilian states. Among the isolates, 17 (62%) were clonal and highly related to strains from other regions of Brazil. Six clonal strains harbored the bla(SPM-1) gene. the finding of a unique SPM-1 producer clone suggests that its dissemination has contributed to the high resistance to carbapenems in Brazilian hospitals.
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    Cloverleaf test (modified Hodge test) for detecting carbapenemase production in Klebsiella pneumoniae: be aware of false positive results
    (Oxford Univ Press, 2010-02-01) Carvalhaes, Cecilia G. [UNIFESP]; Picão, Renata C. [UNIFESP]; Nicoletti, Adriana G. [UNIFESP]; Xavier, Danilo E. [UNIFESP]; Gales, Ana C. [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)
    The aim of this study was to evaluate the presence of carbapenemases in a Klebsiella pneumoniae collection and the performance of the modified Hodge test (MHT) to correctly identify this phenotype.Twenty-eight K. pneumoniae clinical isolates with reduced susceptibility to carbapenems were evaluated. Antimicrobial susceptibility and molecular typing were performed by agar dilution and PFGE, respectively. the MHT was performed using both standard and high inoculum of test organisms. Imipenem hydrolysis was investigated by spectrophotometric assays and carbapenemase-encoding genes were identified by PCR and amplicon sequencing. Porin loss was investigated by both PCR and SDS-PAGE.Susceptibility rates for imipenem, meropenem and ertapenem were 93%, 57% and 11%, respectively. the PFGE analysis showed seven unrelated genotypes. By testing standard inoculum and ertapenem or meropenem discs, 25% (n = 7) and 21% (n = 6) of the isolates were classified as carbapenemase producers, respectively. When a higher inoculum was employed, these rates increased to 54% (n = 15) and 43% (n = 12), respectively. No imipenem hydrolysis was detected. PCRs identified bla(CTX-M) in 27 (96%) isolates, of which 2 isolates also carried bla(GES-1.) SDS-PAGE and PCR assays revealed that all isolates had lost at least one outer membrane protein, except for a single isolate that was found to express both OmpK35 and OmpK36.False detection of carbapenemase production was observed by the MHT possibly as a result of extended-spectrum beta-lactamase (ESBL) production coupled with porin loss as reported before. Clinical laboratories must be aware of this fact, especially in geographical areas where ESBL-producing isolates are highly prevalent.
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    Dissemination in distinct Brazilian regions of an epidemic carbapenem-resistant Pseudomonas aeruginosa producing SPM metallo-beta-lactamase
    (Oxford Univ Press, 2003-10-01) Gales, Ana C. [UNIFESP]; Menezes, Liana C. [UNIFESP]; Silbert, Suzane [UNIFESP]; Sader, Helio S. [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)
    Background: in Brazil, carbapenem use has been limited by high carbapenem-resistance rates among Pseudomonas aeruginosa isolates.Objective: the main objective of this study was to evaluate the presence of an epidemic P. aeruginosa strain in unrelated Brazilian hospitals. We also aimed to search for the gene bla(SPM), which encodes production of SPM, a novel metallo-beta-lactamase (MBL).Methods: A reference broth microdilution method was used for antimicrobial susceptibility testing. the isolates were typed by ribotyping and pulsed-field gel electrophoresis (PFGE). A disc-approximation test using MBL inhibitors was employed to screen isolates for MBL production. PCR was used to search for the gene bla(SPM).Results: A total of 43 clinical isolates of carbapenem-resistant P. aeruginosa were collected from 12 hospitals. Colistin retained greatest activity in vitro. A single ribogroup included 17 P. aeruginosa isolates (39.5%) collected from seven unrelated hospitals located in five Brazilian states. Sixteen of these isolates showed an identical PFGE pattern, and 15 produced an SPM-1-like MBL. the remaining 26 isolates were grouped into 25 diverse ribogroups; none were MBL producers.Conclusions: the emergence and dissemination of an epidemic clone has contributed to the high carbapenem resistance rates among P. aeruginosa isolates in Brazil. in addition, the production of SPM MBL has an important role in carbapenem resistance in this region. This is the first report of dissemination of an SPM-1-like-MBL-producing strain of P. aeruginosa among unrelated Brazilian hospitals.
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    IMPs, VIMs and SPMs: the diversity of metallo-beta-lactamases produced by carbapenem-resistant Pseudomonas aeruginosa in a Brazilian hospital
    (Blackwell Publishing Ltd, 2005-01-01) Sader, Helio Silva [UNIFESP]; Reis, A. O. [UNIFESP]; Silbert, Suzane [UNIFESP]; Gales, Ana Cristina [UNIFESP]; Jones Grp; Universidade Federal de São Paulo (UNIFESP)
    Pseudomonas aeruginosa isolates (n = 183), collected from bacteraemic patients hospitalised in São Paulo Hospital (Brazil) during 2000-2001, were screened for susceptibility to antimicrobial agents. the polymyxins were the most active compounds (100% susceptibility), followed by amikacin and cefepime (59.0%), meropenem (57.4%), and imipenem and gentamicin (55.2%). Imipenem-resistant isolates were ribotyped and screened for production of metallo-beta-lactamases (MBLs) by PCR with primers for bla(IMP), bla(VIM) and bla(SPM). MBL production was detected in 36 isolates (19.7% of the entire collection; 43.9% of the imipenem-resistant isolates) and the MBLs included SPM-1-like (55.6%), VIM-2-like (30.6%) and IMP-1-like (8.3%) enzymes.
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    Increasing prevalence of antimicrobial resistance among Pseudomonas aeruginosa isolates in Latin American medical centres: 5 year report of the SENTRY Antimicrobial Surveillance Program (1997-2001)
    (Oxford Univ Press, 2003-07-01) Andrade, Soraya S. [UNIFESP]; Jones, R. N.; Gales, Ana C. [UNIFESP]; Sader, Helio S. [UNIFESP]; Universidade Federal de São Paulo (UNIFESP); JMI Labs
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    Occurrence of IMP-1 in non-baumannii Acinetobacter clinical isolates from Brazil
    (Microbiology Soc, 2018) Cayô, Rodrigo [UNIFESP]; Streling, Ana Paula [UNIFESP]; Nodari, Carolina Silva [UNIFESP]; Matos, Adriana Pereira [UNIFESP]; Luz, Adryella de Paula [UNIFESP]; Dijkshoorn, Lenie; Pignatari, Antonio Carlos Campos [UNIFESP]; Gales, Ana Cristina [UNIFESP]
    The aim of this study was to characterize the presence of carbapenemase-encoding genes in distinct species of Acinetobacter spp. isolated from Brazilian hospitals. Five carbapenem-resistant Acinetobacter spp. isolates (two Acinetobacter pittii, two Acinetobacter bereziniae and one Acinetobacter junii) recovered from two distinct hospitals between 2000 and 2016 were included in this study. All of the isolates harboured bla(IMP-1), which was inserted into In86, a class 1 integron. Pulsed field gel eletrophoresis analysis showed that both A. pittii were identical, while the two A. berezinae isolates were considered to be clonally related. In this study, we demonstrated that mobile elements carrying carbapenemase-encoding genes such as In86 may persist for a long period, allowing their mobilization from A. baumannii to other Acinetobacter spp. that are usually susceptible to multiple antimicrobials.
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    Resistance trends of Acinetobacter spp. in Latin America and characterization of international dissemination of multi-drug resistant strains: five-year report of the SENTRY Antimicrobial Surveillance Program
    (Elsevier B.V., 2004-09-01) Tognim, Maria Cristina Bronharo [UNIFESP]; Andrade, Soraya Sgambatti [UNIFESP]; Silbert, Suzane [UNIFESP]; Gales, Ana Cristina [UNIFESP]; Jones, Ronald N.; Sader, Helio Silva [UNIFESP]; Universidade Federal de São Paulo (UNIFESP); Universidade Estadual de Maringá (UEM); Jones Grp
    Objectives: To analyze the antimicrobial susceptibility of Acinetobacter spp. isolates collected from Latin American medical centers as part of the SENTRY Antimicrobial Surveillance Program and also to evaluate the dissemination of mutti-drug resistant Acinetobacter spp. strains in the region.Methods: A total of 826 isolates of Acinetobacter spp. from multiple infection sites were collected from January 1997 to December 2001 in ten medical centers and susceptibility tested to >25 selected agents by broth microdilution. Multi-drug resistant Acinetobacter spp. isolates were molecular typed.Results: Resistance rates to carbapenems varied significantly among countries. A continued annual increase occurred in the Argentinean medical centers. in contrast, carbapenem resistance was rare in Chilean centers, and decreased significantly in the Brazilian institutions. Acinetobacter spp. isolates recovered from lower respiratory tract and bloodstream infections were associated with lower antimicrobial susceptibility rates. Resistance rates to imipenem were higher among isolates collected from intensive care units (13.5%) than among isolates from other units. A major ribogroup pattern (521-1) was detected among eight Acinetobocter spp. strains isolated from three distinct Latin American countries.Conclusions: This study found that antimicrobial resistance is still a major issue among Acinetobacter spp. isolates collected from some Latin American countries. the dissemination of a major bacterial cluster in different regions reinforces the importance of longitudinal surveillance programs, such as SENTRY, as valuable tools for monitoring antimicrobial susceptibility rates and guiding local interventions. (C) 2004 International Society for Infectious Diseases. Published by Elsevier B.V. All rights reserved.
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    Temporal evolution of carbapenem-resistant Acinetobacter baumannii in Curitiba, southern Brazil
    (Elsevier B.V., 2010-05-01) Schimith, Karina Eugenia; Luiz, Simone Oliveira; Scheffer, Mara Cristina; Gales, Ana Cristina [UNIFESP]; Paganini, Maria Cristina; Nascimento, Agnaldo Jose do; Carignano, Evelyn; Dalla Costa, Libera Maria; Universidade Federal do Paraná (UFPR); Universidade Federal de Santa Catarina (UFSC); Universidade Federal de São Paulo (UNIFESP); Univ Tuiuti Parana; Pequeno Principe Coll Pele Pequeno Res Inst FPP I
    Background: in the last few years, carbapenem-resistant Acinetobacter baumannii isolates (CR-AB) have been identified worldwide. the first description of OXA-23-producing A baumannii in Brazil was from the city of Curitiba in 2003. the aim of the present study was to evaluate the persistence and dissemination of the first OXA-23-producing A baumannii clone isolated from patients in Hospital de Clinicas, Curitiba, Brazil.Methods: An antimicrobial susceptibility profile of the isolates was determined by the standard agar dilution method. Molecular detection of beta-lactamase genes was done by polymerase chain reaction. the clonal relationship of the isolates was analyzed by pulsed-field gel electrophoresis (PFGE). Epidemiologic and clinical features were evaluated as well.Results: Genotypic analysis of 172 CR-AB isolates by PFGE identified 3 distinct major PFGE clusters (A, B, and C, accounting for 36, 69, and 65 isolates, respectively). All isolates carried the bla(OXA-23)-like gene and were multidrug-resistant, but were susceptible to tigecycline and polymixin B. the mortality rate related to CR-AB infection was 45.4%, and ventilator-associated pneumonia and bloodstream infections were the most frequent clinical manifestations.Conclusions: the presence of 3 clones among the CR-AB isolates suggests that cross-transmission was the main mechanism responsible for dissemination of OXA-23 producers. PFGE pattern A was genotypically similar to that of the first OXA-23-producing A baumannii clone identified in Curitiba in 1999. This clone persisted in the same hospital until April 2004. the presence of the bla(OXA-23)-like gene was the main mechanism associated with carbapenem resistance among the isolates studied.