RESUMO
We characterized NDM-1-producing Klebsiella isolates from Rio de Janeiro, Brazil. PCR was applied for resistance and virulence determinants. The genetic context of blaNDM was determined by S1 nuclease pulsed-field gel electrophoresis (PFGE) and hybridization. Genotyping was performed by PFGE and multilocus sequence typing (MLST). Most isolates carried multiple resistance genes and remained susceptible to amikacin, fosfomycin-trometamol, polymyxin B, and tigecycline. The spread of NDM-1-producing Klebsiella pneumoniae was not associated with clonal expansion and appears to be associated with Tn3000.
Assuntos
Antibacterianos/farmacologia , Elementos de DNA Transponíveis , Farmacorresistência Bacteriana Múltipla/genética , Klebsiella pneumoniae/genética , beta-Lactamases/genética , Amicacina/farmacologia , Técnicas de Tipagem Bacteriana , Brasil/epidemiologia , Células Clonais , Eletroforese em Gel de Campo Pulsado , Fosfomicina/farmacologia , Expressão Gênica , Genótipo , Humanos , Infecções por Klebsiella/epidemiologia , Infecções por Klebsiella/microbiologia , Infecções por Klebsiella/transmissão , Klebsiella pneumoniae/classificação , Klebsiella pneumoniae/efeitos dos fármacos , Klebsiella pneumoniae/isolamento & purificação , Minociclina/análogos & derivados , Minociclina/farmacologia , Tipagem de Sequências Multilocus , Filogenia , Plasmídeos/química , Plasmídeos/metabolismo , Polimixina B/farmacologia , Tigeciclina , beta-Lactamases/metabolismoRESUMO
Enzymes of the OXA-48 family have become some of the most important beta-lactamases in the world. A new OXA-48 variant (OXA-370) was first described for an Enterobacter hormaechei strain isolated in Rio Grande do Sul (southern region of Brazil) in 2013. Here we report detection of the blaOXA-370 gene in 24 isolates belonging to three Enterobacteriaceae species (22 Klebsiella pneumoniae isolates, 1 Enterobacter cloacae isolate, and 1 Enterobacter aerogenes isolate) collected from five hospitals in Rio de Janeiro, Brazil, in 2013 and 2014. The isolates showed a multidrug resistance profile, and 12.5% were resistant to polymyxin B. Besides blaOXA-370, no other carbapenemase genes were observed by PCR, whereas blaOXA-1 was found in all isolates and 22 isolates (91.6%) possessed blaCTX-M-15. Molecular typing of the K. pneumoniae isolates by pulsed-field gel electrophoresis (PFGE) showed the presence of two clonal groups, i.e., KpA (21 isolates) and KpB (1 isolate). KpA was characterized as sequence type 16 (ST16) and KpB as ST1041 by multilocus sequence typing (MLST). ST16 has been observed for KPC-producing K. pneumoniae in Rio de Janeiro. Plasmid analysis performed with six representative OXA-370-producing isolates showed plasmids harboring the blaOXA-370 gene in all strains, ranging from 25 kb to 150 kb. This study suggests that there is an urgent need to investigate the presence of OXA-370 and dissemination of the K. pneumoniae ST16 clone carrying this gene in Brazil.
Assuntos
Infecções por Klebsiella/microbiologia , Klebsiella pneumoniae/genética , Klebsiella pneumoniae/isolamento & purificação , beta-Lactamases/genética , Proteínas de Bactérias/genética , Técnicas de Tipagem Bacteriana/métodos , Brasil , Farmacorresistência Bacteriana Múltipla/genética , Plasmídeos/genéticaRESUMO
The most important resistance mechanism against ß-lactam drugs is the production of carbapenemases. In this study, we report the first identification of Klebsiella pneumoniae carbapenemase (KPC)-2 and New Delhi metallo-ß-lactamase (NDM)-1 in Enterobacter hormaechei subps. oharae from Brazil. The detection of carbapenemases was done by phenotypic assays, PCR, and DNA sequencing, whereas the identification was performed by conventional techniques, sequencing of the 16S rDNA gene, and hsp60-genotyping. Molecular typing was performed using pulsed-field gel electrophoresis, and antimicrobial susceptibility was surrogated by the Etest methodology. Using the whole genome sequencing approach, we searched for resistance genes, plasmid incompatibility group genes, and the genetic environment of blaNDM and blaKPC. The plasmid identification was done by restriction digests with the S1 nuclease followed by hybridization using digoxigenin labeled specific probes. The isolate was considered multiresistant, being susceptible to amikacin and polymyxin B. We observed the following resistance genes: blaCTX-M-15, blaACT-7, blaTEM-1, blaOXA-1, aadA1, aadA2, strA, strB, aac(3)-II, qnrB1, and aac(6')-Ib-cr and incompatibility group plasmid genes IncA/C, IncHI2, and IncN. The blaKPC gene was found associated to the transposon Tn4401 isoform b in plasmid with 50 kb (IncN) and blaNDM-1 was flanked by a truncated ISAba125 and bleMBL in plasmid with 160 kb (IncA/C). This study showed the coproduction of two important carbapenemases (KPC-2 and NDM-1) associated with mobile genetic elements of worldwide epidemiological importance (Tn4401 and ISAba125, respectively), reinforcing the idea that urgent measures are necessary to reduce and prevent the spreading of these carbapenemases primarily in the hospital settings.