High Prevalence of Multidrug-Resistant Klebsiella pneumoniae Harboring Several Virulence and β-Lactamase Encoding Genes in a Brazilian Intensive Care Unit

Klebsiella pneumoniae is an important opportunistic pathogen that commonly causes nosocomial infections and contributes to substantial morbidity and mortality. We sought to investigate the antibiotic resistance profile, pathogenic potential and the clonal relationships between K. pneumoniae (n = 25) isolated from patients and sources at a tertiary care hospital’s intensive care units (ICUs) in the northern region of Brazil. Most of K. pneumoniae isolates (n = 21, 84%) were classified as multidrug resistant (MDR) with high-level resistance to β-lactams, aminoglycosides, quinolones, tigecycline, and colistin. All the 25 isolates presented extended-spectrum beta-lactamase-producing (ESBL), including carbapenemase producers, and carried the blaKPC (100%), blaTEM (100%), blaSHV variants (n = 24, 96%), blaOXA-1 group (n = 21, 84%) and blaCTX-M-1 group (n = 18, 72%) genes. The K2 serotype was found in 4% (n = 1) of the isolates, and the K1 was not detected. The virulence-associated genes found among the 25 isolates were mrkD (n = 24, 96%), fimH-1 (n = 22, 88%), entB (100%), iutA (n = 10, 40%), ybtS (n = 15, 60%). The genes related with efflux pumps and outer membrane porins found were AcrAB (100%), tolC (n = 24, 96%), mdtK (n = 22, 88%), OmpK35 (n = 15, 60%), and OmpK36 (n = 7, 28%). ERIC-PCR was employed to determine the clonal relationship between the different isolated strains. The obtained ERIC-PCR patterns revealed that the similarity between isolates was above 70%. To determine the sequence types (STs) a multilocus sequence typing (MLST) assay was used. The results indicated the presence of high-risk international clones among the isolates. In our study, the wide variety of MDR K. pneumoniae harboring β-lactams and virulence genes strongly suggest a necessity for the implementation of effective strategies to prevent and control the spread of antibiotic resistant infections

Dry matter production and macronutrient leaf composition in lettuce under fertigation with nitrogen, potassium and silicon

ABSTRACT The objective of this study was to evaluate, in greenhouse, the response of the lettuce cultivar 'Vera', with respect to the marketable shoot dry matter production and macronutrient accumulation, as a function of the application of different doses of nitrogen (N) and a potassium silicate-based leaf fertilizer. The lettuce was cultivated from August 10, 2012 (sowing) to October 16, 2012 (harvest). The experimental design was completely randomized with three replicates, referring to nine treatments, resulting from the combination between top-dressing doses of N (9, 54, 90, 126 and 171 kg ha-1) and Si/K2O (1.15, 6.90, 11.50, 16.10 and 21.85 kg ha-1), using the Plan Puebla III experimental matrix, and a control treatment without fertigation. Drip fertigation was used for the application of the doses. The highest doses of N and Si/K2O resulted in the highest marketable shoot dry matter production and highest leaf accumulation of magnesium, calcium, potassium and phosphorus