KPC: an important mechanism of resistance in K. pneumoniae isolates from intensive care units in the Midwest region of Brazil

KPC-producing Klebsiella in Brazil Midwest region

  • Caroline Conci Campos Federal University of Mato Grosso do Sul, Campo Grande, Brazil
  • Náthalia Franco Roriz Federal University of Mato Grosso do Sul, Campo Grande, Brazil
  • Camila Nogueira Espínola Federal University of Mato Grosso do Sul, Campo Grande, Brazil
  • Fernando Aguilar Lopes Maria Aparecida Pedrossian University Hospital, Campo Grande, Brazil
  • Caroline Tieppo Regional Hospital of Mato Grosso do Sul, Campo Grande, Brazil
  • Andyane Freitas Tetila Maria Aparecida Pedrossian University Hospital, Campo Grande, Brazil
  • Claudia Elizabeth Volpe Chaves Regional Hospital of Mato Grosso do Sul, Campo Grande, Brazil
  • Priscilla Alexandrino de Oliveira Beneficent Association of Campo Grande, Campo Grande, Brazil
  • Marilene Rodrigues Chang Federal University of Mato Grosso do Sul, Campo Grande, Brazil

Abstract

Introduction: Infections caused by multidrug-resistant Klebsiella pneumoniae are difficult to treat and pose a serious threat to public health worldwide. Here, we describe the presence of carbapenemase-producing K. pneumoniae in intensive care units (ICU) of three major Mato Grosso do Sul hospitals located in the Midwest region of Brazil.


Methodology: A total of 165 K. pneumoniae isolates with reduced susceptibility to carbapenems as identified by the VITEK-2 compact system were studied. Antimicrobial susceptibility testing was performed using the disk diffusion method, as recommended by the Clinical and Laboratory Standards Institute, and the E-test method. The detection of carbapenemase was performed using the modified Hodge test and polymerase chain reaction.


Results: The blaKPC gene was identified in 88.1% (n=89) of the selected K. pneumoniae isolates from Beneficent Association of Campo Grande, 94.9% (n=34) of the isolates from the Regional Hospital of Mato Grosso do Sul and 95.2% (n=26) of the isolates from Maria Aparecida Pedrossian University Hospital. Resistance greater than 80% was observed against cephalosporins, aztreonam, ciprofloxacin and piperacillin/tazobactam. Carbapenemase-producing K. pneumoniae (Kp-KPC) isolates were considered important causative agents of urinary tract infections, pneumonia and bloodstream infections in ICU patients. While rarely reported in the literature, we documented three cases of meningoencephalitis caused by Kp-KPC.


Conclusions: Our study documents the presence of Kp-KPC in three major Mato Grosso do Sul state hospitals, providing key national epidemiology data. This is an important mechanism of resistance in K. pneumoniae isolates from ICU patients and is associated with resistance to multiple classes of antimicrobial drugs.

Author Biographies

Caroline Conci Campos, Federal University of Mato Grosso do Sul, Campo Grande, Brazil
  Pharmaceutical Microbiology Research Laboratory,

.

Náthalia Franco Roriz, Federal University of Mato Grosso do Sul, Campo Grande, Brazil

Microbiology Research Laboratory

Camila Nogueira Espínola, Federal University of Mato Grosso do Sul, Campo Grande, Brazil

Microbiology Research Laboratory

Fernando Aguilar Lopes, Maria Aparecida Pedrossian University Hospital, Campo Grande, Brazil

Microbiology Laboratory

Caroline Tieppo, Regional Hospital of Mato Grosso do Sul, Campo Grande, Brazil

Microbiology Laboratory

Andyane Freitas Tetila, Maria Aparecida Pedrossian University Hospital, Campo Grande, Brazil

Hospital Infection Control Committee

Claudia Elizabeth Volpe Chaves, Regional Hospital of Mato Grosso do Sul, Campo Grande, Brazil

Hospital Infection Control Committee

Priscilla Alexandrino de Oliveira, Beneficent Association of Campo Grande, Campo Grande, Brazil

Hospital Infection Control Committee

Marilene Rodrigues Chang, Federal University of Mato Grosso do Sul, Campo Grande, Brazil

Microbiology Research Laboratory

Published
2017-09-05
How to Cite
Conci Campos C, Franco Roriz N, Nogueira Espínola C, Aguilar Lopes F, Tieppo C, Freitas Tetila A, Volpe Chaves C, Alexandrino de Oliveira P, Rodrigues Chang M (2017) KPC: an important mechanism of resistance in K. pneumoniae isolates from intensive care units in the Midwest region of Brazil. The Journal Of Infection In Developing Countries 11 (08): 646-651. https://doi.org/10.3855/jidc.8920
Section
Brief Original Articles

Keywords

intensive care units; Klebsiella pneumoniae; carbapenemase