Polymyxin-Resistant Acinetobacter spp. Isolates: What is Next?

Univ Fed Sao Paulo, Div Infect Dis, Lab Especial Microbiol Clin, BR-04025010 Sao Paulo, SP, BrazilUniv Fed Sao Paulo, Div Infect Dis, Lab Especial Microbiol Clin, BR-04025010 Sao Paulo, SP, BrazilWeb of Scienc

Clonal Complex 258, the Most Frequently Found Multilocus Sequence Type Complex in KPC-2-Producing Klebsiella pneumoniae Isolated in Brazilian Hospitals

Universidade Federal de São Paulo, Lab Alerta, Div Infect Dis, Dept Med, São Paulo, BrazilUniversidade Federal de São Paulo, Cent Lab, Hosp São Paulo, São Paulo, BrazilUniversidade Federal de São Paulo, Lab Alerta, Div Infect Dis, Dept Med, São Paulo, BrazilUniversidade Federal de São Paulo, Cent Lab, Hosp São Paulo, São Paulo, BrazilWeb of Scienc

Efflux pumps expression and its association with porin down-regulation and β-lactamase production among Pseudomonas aeruginosa causing bloodstream infections in Brazil

Background: Multi-drug efflux pumps have been increasingly recognized as a major component of resistance in P. aeruginosa. We have investigated the expression level of efflux systems among clinical isolates of P. aeruginosa, regardless of their antimicrobial susceptibility profile.Results: Aztreonam exhibited the highest in vitro activity against the P. aeruginosa isolates studied (64.4% susceptibility), whereas susceptibility rates of imipenem and meropenem were both 47.5%. the MexXY-OprM and MexAB-OprM efflux systems were overexpressed in 50.8% and 27.1% of isolates studied, respectively. Overexpression of the MexEF-OprN and MexCD-OprJ systems was not observed. AmpC beta-lactamase was overexpressed in 11.9% of P. aeruginosa isolates. in addition, decreased oprD expression was also observed in 69.5% of the whole collection, and in 87.1% of the imipenem non-susceptible P. aeruginosa clinical isolates. the MBL-encoding genes bla(SPM-1) and bla(IMP-1) were detected in 23.7% and 1.7% P. aeruginosa isolates, respectively. the bla(GES-1) was detected in 5.1% of the isolates, while bla(GES-5) and bla(CTX-M-2) were observed in 1.7% of the isolates evaluated. in the present study, we have observed that efflux systems represent an adjuvant mechanism for antimicrobial resistance.Conclusions: Efflux systems in association of distinct mechanisms such as the porin down-regulation, AmpC overproduction and secondary beta-lactamases play also an important role in the multi-drug resistance phenotype among P. aeruginosa clinical isolates.Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)Universidade Federal de São Paulo, Div Infect Dis, BR-04039032 São Paulo, BrazilUniversidade Federal de São Paulo, Div Infect Dis, BR-04039032 São Paulo, BrazilFAPESP: FAPESP - 2006/01716-8CNPq: 307714/2006-3Web of Scienc

Clinical utilization of bacteriophages: a new perspective to combat the antimicrobial resistance in Brazil

Due to the emergence of multi-drug resistant bacteria, and the evident limitation in therapeutic options, alternatives to combat bacterial infections have been sought. One of these is phage therapy, which is the use of bacterial viruses to kill pathogenic bacteria responsible for the infection. These viruses called bacteriophages are very abundant organisms in the world and are harmless to humans. There are several advantages in using phage therapy, especially against multi-drug resistant pathogens, which tend to be dominated by individual strains. The advantages include fewer collateral effects such as lower disturbance of gut microbiota and less antimicrobials consumption, which itself leads to reducing antibiotic resistance rates. Unfortunately, few clinical studies have been initiated in Brazil and this area is little explored in our country. This manuscript describes clinical evidence of successful phage utilization on pathogens considered a threat in Brazil, highlighting the benefits of a possible phage utilization as an important tool to combat antimicrobial resistance in our country

First Description of KPC-2-Producing Klebsiella oxytoca in Brazil

The present work reports the detection of the first case of nosocomial Klebsiella oxytoca producing class A carbapenemase KPC-2 in Brazil. the isolate KPN106 carried a 65-kb IncW-type plasmid that harbors the bla(KPC) gene and Tn4401b. Moreover, we detected the presence of a class 1 integron containing a new allele, arr-8, followed by a 5'-truncated dhfrIIIc gene. in view of the recent results, we emphasize the high variability of the bacterial and genetic hosts of this resistance determinant.Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)FACEPEPFA/UPEUniv Pernambuco, Inst Ciencias Biol, Lab Resistencia Microbiana, Recife, PE, BrazilUniv Fed Pernambuco, Dept Genet, Lab Genet Microrganismos, Recife, PE, BrazilUniversidade Federal de São Paulo, Lab Alerta, São Paulo, BrazilCPqAM Fiocruz, Ctr Pesquisa Aggeu Magalhaes, Recife, PE, BrazilUniversidade Federal de São Paulo, Lab Alerta, São Paulo, BrazilWeb of Scienc

Unusual association of NDM-1 with KPC-2 and armA among Brazilian Enterobacteriaceae isolates

We report the microbiological characterization of four New Delhi metallo-beta-lactamase-1 (bla(NDM-1))-producing Enterobacteriaceae isolated in Rio de Janeiro, Brazil. bla(NDM-1) was located on a conjugative plasmid and was associated with Klebsiella pneumoniae carbapenemase-2 (bla(KPC-2)) or aminoglycoside-resistance methylase ( armA), a 16S rRNA methylase not previously reported in Brazil, in two distinct strains of Enterobacter cloacae. Our results suggested that the introduction of bla(NDM-1) in Brazil has been accompanied by rapid spread, since our isolates showed no genetic relationship.Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)Universidade Federal de São Paulo, Dept Med, Lab Especial Microbiol Clin, São Paulo, SP, BrazilDASA, Lab Diagnost Amer, São Paulo, SP, BrazilUniversidade Federal de São Paulo, Dept Med, Lab Especial Microbiol Clin, São Paulo, SP, BrazilWeb of Scienc

Linezolid Resistance in Brazilian Staphylococcus hominis Strains Is Associated with L3 and 23S rRNA Ribosomal Mutations

Univ São Paulo, Sch Pharm, Dept Clin Anal, BR-05508 São Paulo, BrazilHosp Beneficencia Portuguesa, Lab Clin Microbiol, São Paulo, SP, BrazilUniversidade Federal de São Paulo, Lab Alerta, São Paulo, SP, BrazilUniv São Paulo, Inst Biomed Sci, Dept Microbiol, BR-05508 São Paulo, BrazilUniversidade Federal de São Paulo, Lab Alerta, São Paulo, SP, BrazilWeb of Scienc