Publication
Carbapenemase-producing Enterobacteriaceae isolates collected in Portuguese hospitals
| dc.contributor.author | Manageiro, Vera | |
| dc.contributor.author | Ferreira, Eugénia | |
| dc.contributor.author | Louro, Deolinda | |
| dc.contributor.author | Caniça, Manuela | |
| dc.contributor.author | Antibiotic Resistance Surveillance Program in Portugal (ARSIP) | |
| dc.date.accessioned | 2013-02-14T16:34:40Z | |
| dc.date.available | 2013-02-14T16:34:40Z | |
| dc.date.issued | 2012 | |
| dc.description.abstract | Objectives: In Portugal, little is known on carbapenemase (CARB)-producing Enterobacteriaceae. The aim of this study was to identify the resistance mechanisms of Enterobacteriaceae isolates, identified at hospital laboratories as carbapenem (CA) non-susceptible. Methods: This study included 61 Enterobacteriaceae isolates (26 Klebsiella spp, 15 Escherichia coli, 9 Enterobacter spp, 6 Morganella morgannii, 4 Proteus mirabilis, 1 Serratia marcescens), collected between 04/2006 and 09/2011 and sent to the NIH-Lisbon for CA susceptibility confirmation. Antimicrobial susceptibility of clinical isolates was performed by disk diffusion method (CA-SFM). Clinical isolates showing synergism between CA and boronic acid (BOR) (and/or clavulanic acid, CLAV) or with EDTA were considered presumptively CARB-producers from class A or Class B, respectively. PCR and sequencing were applied to detect and identify CARB-encoding genes; the respective genetic environment was revealed by sequencing using PCR mapping. Direct transfer of the CA resistance phenotype was attempted by mating-out assays. Antibiotics susceptibility (MIC) of transconjugants and respective isolates were tested by microdilution. Results: The majority of isolates were collected from the urine (57.4%) of elderly (≥65 years old) male patients (54.1%), admitted at the emergency room/ambulatory (24.6%) and at internal medicine (18.0%) wards. Among all isolates, 50.8% were nonsusceptible to at least one CA, being 67.2% multidrug-resistant; 16 isolates showed synergy between CA and BOR (and/or CLAV). Among those, 5 were KPC-3-producers (4 Klebsiella pneumoniae and 1 Enterobacter clocae), collected in 2010 (2) and 2011 (3). The blaKPC-3 genes were confirmed to be carried by plasmids. Genetic environment of blaKPC-3 gene revealed the presence of a Tn4401 transposon in all but one isolate (E. cloacae), suggesting that this last gene was included in other Tn4401-like isoform. We also detected a VIM-2-producing Klebsiella oxytoca, collected in 2009, among the 7 isolates that showed synergy between imipinem and EDTA. No blaGES, blaNDM or blaIMP were detected. Conclusion: In conclusion, this study provides new data regarding the molecular epidemiology of CARB-producing Enterobacteriaceae in Portugal. Overall, our results emphasize the need of a concerted action to manage CA use. This is supported by EARS-Net, which reported an increase in CA nonsusceptibility of K. pneumoniae isolates from 0.72% in 2008 to 1.58% in 2010. | por |
| dc.identifier.citation | Clinical Microbiology and Infection/ Abstracts accepted for publication only 2012;18:744 (R2492) | por |
| dc.identifier.issn | 1198-743X | |
| dc.identifier.issn | doi: 10.1111/j.1469-0691.2012.03803.x | |
| dc.identifier.uri | http://hdl.handle.net/10400.18/1370 | |
| dc.language.iso | eng | por |
| dc.publisher | European Society of Clinical Microbiology and Infectious Diseases | por |
| dc.subject | Carbapenem Resistance | por |
| dc.subject | Portugal | por |
| dc.subject | Enterobacteriaceae | por |
| dc.subject | Resistência aos Antimicrobianos | por |
| dc.title | Carbapenemase-producing Enterobacteriaceae isolates collected in Portuguese hospitals | por |
| dc.type | conference object | |
| dspace.entity.type | Publication | |
| oaire.citation.conferencePlace | Londres, Reino Unido | por |
| oaire.citation.endPage | 744 | por |
| oaire.citation.startPage | 744 | por |
| oaire.citation.title | 22nd European Congress of Clinical Microbiology and Infectious Diseases, 31st March-3rd April 2012 | por |
| oaire.citation.volume | 18 | por |
| rcaap.rights | openAccess | por |
| rcaap.type | conferenceObject | por |