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Detection of antimicrobial resistance genes in Klebsiella pneumoniae isolated from nosocomial infection or colonization from several hospitals of São Paulo State, Brazil


Klebsiella pneumoniae which produces extended-spectrum B-lactamase (ESBL) are frequent1y involved in nosocomial infections in intensive care units (ICUs) inc1uding neonatal ICUs (NICUs). ESBL confer resistance to all penicillins, broad-spectrum cephalosporins and aztreonam. CTX-M-2 is the most prevalent ESBL type in Brazil. Carbapenems are the treatment of choice for serious infections caused by organisms producing ESBL. However, production of carbapenemases, such as metallo-B-lactamases (MBLs) and Klebsiella pneumoniae carbapenemase (KPCs) by K. pneumoniae has been described in Brazil, the most common being IMP-l and KPC-2, respectively. Moreover, K. pneumoniae producing 16S rRNA methylase RmtD has already been described in Brazil; this enzyme confers high-level resistance to all aminoglycosides in clinical use. Therapeutic options for these highly resistant organisms are very limited. The objectives of this research are to evaluate the genetic diversity of antimicrobial resistance genes, with focus on B-lactamases (ESBL and carbapenemases - MBLs and KPC) and 16S rRNA methylases, in K. pneumoniae isolated from clinical samples obtained from several hospitals of São Paulo State, Brazil and sent to Section of Bacteriology of Adolfo Lutz Institute in the last two years. Strains confirmed as K. pneumoniae by standard biochemical tests will be used for susceptibility testing by the disk diffusion and dilution methods to evaluate the susceptibility profiles and phenotypes of resistance. Pulsed-field electrophoresis will be used for epidemiological typing. PCR analyses and DNA sequencing will be used in the detection of resistance genes. Conjugation and transformation will be used to verify the transfer of genes and investigate the resistance phenotypes conferred by these genes. (AU)

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(References retrieved automatically from Web of Science and SciELO through information on FAPESP grants and their corresponding numbers as mentioned in the publications by the authors)
BUENO, MARIA FERNANDA C.; FRANCISCO, GABRIELA R.; O'HARA, JESSICA A.; GARCIA, DOROTI DE OLIVEIRA; DOI, YOHEI. Coproduction of 16S rRNA Methyltransferase RmtD or RmtG with KPC-2 and CTX-M Group Extended-Spectrum beta-Lactamases in Klebsiella pneumoniae. Antimicrobial Agents and Chemotherapy, v. 57, n. 5, p. 2397-2400, . (12/06827-1, 09/53229-0)
PEREIRA, GRAZIELLA HANNA; GARCIA, DOROTI O.; MOSTARDEIRO, MARCELO; FANTI, KARINA S. V. N.; LEVIN, ANNA S.. Outbreak of carbapenem-resistant Klebsiella pneumoniae: two-year epidemiologic follow-up in a tertiary hospital. Memórias do Instituto Oswaldo Cruz, v. 108, n. 1, p. 113-115, . (09/53229-0)

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