RESUMO
BACKGROUND: Infections caused by multidrug resistant microorganisms are a global health problem, and Pseudomonas aeruginosa is an important nosocomial pathogen, easily disseminated in the hospital environment. The aim of this study was to determine SPM-1 in P. aeruginosa strains in 30 Brazilian hospitals and the genetic similarity of isolates. METHODS: We analyzed 161 isolates of carbapenem-resistant P. aeruginosa. Imipenem/EDTA and imipenem strip were used for phenotypic detection of MBL production; and real-time polymerase chain reaction (PCR) for genetic detection. Genetic similarity was determined by rep-PCR. RESULTS: We obtained 136/161 (84.5%) isolates with positive phenotypic result for metallo-ß-lactamase (MBL) and the blaSPM-1 gene was identified in 41 isolates. There was a predominant profile (>95% of genetic similarity) in 92.7% of isolates. This predominant profile was widely disseminated in Paraná state. CONCLUSION: SPM-1 is the main MBL identified in carbapenem-resistant P. aeruginosa in Southern Brazil. The genetic similarity among some isolates suggests a clonal expansion.
Assuntos
Genótipo , Filogenia , Infecções por Pseudomonas/epidemiologia , Pseudomonas aeruginosa/genética , Resistência beta-Lactâmica/genética , beta-Lactamases/genética , Antibacterianos/uso terapêutico , Técnicas de Tipagem Bacteriana , Brasil/epidemiologia , Carbapenêmicos/uso terapêutico , Células Clonais , Eletroforese em Gel de Campo Pulsado , Expressão Gênica , Hospitais , Humanos , Testes de Sensibilidade Microbiana , Epidemiologia Molecular , Infecções por Pseudomonas/tratamento farmacológico , Infecções por Pseudomonas/microbiologia , Pseudomonas aeruginosa/classificação , Pseudomonas aeruginosa/efeitos dos fármacos , Pseudomonas aeruginosa/isolamento & purificaçãoRESUMO
Multidrug-resistant bacteria (MDRB) have emerged as a public health problem and the World Health Organization recommends actions to control MDRB in healthcare-associated infections (HCAIs). This study describes a surveillance programme for MDRB in HCAIs at Curitiba, Brazil. MDRB in pneumonia, bloodstream, urinary tract and surgical site infections has been surveyed since January 2010. Carbapenem-resistant Acinetobacter baumannii and third generation resistant Klebsiella pneumoniae were the most frequent MDRB in HCAIs. Infection control strategies enrolling hospitals and public health have been developed. The data presented describe MDRB prevalence and the feasibility of this municipal MDRB surveillance programme in Brazil.