High prevalence of aminoglycoside modifying enzymes (EMAs) in clinical isolates of Klebsiella pneumoniae (KPN) producers of extended-spectrum β-lactamases (ESBL).
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Abstract
Klebsiella pneumoniae producing extended spectrum β-lactamases (ESBL) is a microbial agent involved in serious infections in hospital environments with high rates of mortality and morbidity due to the limited therapeutic options available and its rapid acquisition of resistance genes to various antibiotics. The objective was to determine the prevalence of genes for aminoglycoside modifying enzymes Alta prevalencia de enzimas modificadoras de aminoglucósidos (EMAs) en aislados clínicos de Klebsiella pneumoniae (KPN) productores de β-lactamasas de espectro extendido (BLEE) in Klebsiella pneumoniae producing extended spectrum β-lactamases. Fortytwo Klebsiella pneumoniae isolates were included in this study and from several hospitals in Quito, collected from May 2005 to August 2008. Identification was confirmed phenotypic, genotypic, production of ESBL and resistance profile to 30 antibiotics by standard methods. The detection of EMAs genes was performed by PCR using primers for the identification of genes ant (2")-Ia, aac (6')-Ib and aac(3)-IIa. Isolates showed an increased production of cefotaximasas on ceftazidimases. There was high resistance to β-lactamics, whereas there was no resistance to polymyxin B, colistin, tigecycline. It was clear the high prevalence of EMAs genes in the population studied.
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Ortega D, Alcocer I, Zurita J. High prevalence of aminoglycoside modifying enzymes (EMAs) in clinical isolates of Klebsiella pneumoniae (KPN) producers of extended-spectrum β-lactamases (ESBL). REMCB [Internet]. 2017Jul.6 [cited 2024Jul.3];30(1-2):16-7. Available from: https://remcb-puce.edu.ec/remcb/article/view/70
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Artículos Científicos
References
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MANDELL, BENNETT, & DOLIN. 2005.Principles and Practice of Infectious Dis-eases, 6th ed. The specific pathogens. 2:2578-2579.
HAEGGMAN, S.; LOFDAHL, S. & BUR-MAN, L. G. 1997. An allelic variant of the chromosome gene for class A beta-lactamase K2, specific for Klebsiella pneumoniae, is the ancestor of SHV-1. Antimicrob agents Chemother41: 2705-2709.
BURWEWN, D. R.; BANERJEE, S.N.; GAYNES, R. P. 1994. Ceftazidimeresistance among selected nosocomialgram-negative bacilli in the United States.J Infect Dis. 170: 1622-1625
BJORN, A.; ESPEDITO, Lee C. T. &IREDELL, J. R. 2007. Metallo β-Lactamaseor Extended-Spectrum β-Lactamase: a Wolfin Sheep’s Clothing. Journal of ClinicalMicrobiology45: 2034-2036.
CARPENTER J. L. 1990. Klebsiella pulmonary infections: Occurrence at one medical center and review. Rev Infect Dis. 12:672-682.
PATERSON, D. L. & BONOMO, R. A.2005. Extended-spectrum β-lactamases: aclinical update. Clin. Microbiol. 18: 657-686.
GISKE, C. G.; MONNET, D. L.; CARS,O. & YEHUDA, C. 2008. Behalf of Reaction on Antibiotic ResistanceClinical and Economic Impact of Com-mon Multidrug-Resistant Gram-NegativeBacilli. Antimicrobial Agents and Chemotherapy. 52(3): 813-821.
GALES, A. C.; JONES, R. N. & SANDER,H. S. 2006. Global assessment of the antimicrobial activity of polymyxin B against 54 731 clinical isolates of gram-negative bacilli: report from the SENTRYantimicrobial surveillance programme (2001–2004). Clin. Microbiol. Infect. 12:315–321.
GALES, A. C.; SANDER, H. S. & JONES,R. N. 2002. Urinary tract infection trends in Latin American hospitals: report from the sentry antimicrobial surveillance program (1997–2000). Diagn. Microbiol.Infect. Dis. 44: 289-299.
KOSTMAN, J. R.; EDLID, T. D.; LIPUMA, J. J. & STULL, T. L. 1992.Molecular Epidemiology of Pseudomonas cepacia Determined by Polymerase ChainReaction Ribotyping. Journal of Clinical Microbiology30 (8): 2084-2087.
LOPES, A.; RODRIGUES, J.; MAYSA,C.; MIRANDA, C.; NASCIMENTO, A. &MORAIS, M. 2007. Application of PCR ribotyping and tDNA-PCR for Klebsiellapneumoniaeidentification. InstitutoOswaldo Cruz102 (7): 827-832.
BAUER, A. W.; KIRBY, W. N. W.; SHER-RINS, G. J. & TURCK, M. 1966. Antibiotic susceptibility testing by standardized single disk method. American Journal of Clinical Pathology45: 493-496.
Clinical and laboratory Standards Institute Performance standards for antimicrobial susceptibility testing; fifteenth informational supplement Sixteenth International Supplement. CLSI document. 2008. Clinical and Laboratory Standards Institute, Wayne, Pennsylvania, USA.
PATERSON, D. & BONOMO, R. 2005.Extended-Spectrum β-Lactamases: a Clini-cal Update. Clinical Microbiology Reviews18(4): 657-686.
VAKULENKO, S. & MOBASHERY, S.2003. Versatility of aminoglycosides and prospects for their future. Clin MicrobiolRev16: 430-50.
DÍAZ, P.; BELLO, H.; DOMÍNGUEZ, M.;TRABAL, N.; MELLA, S.; ZEMELMAN,R. & GONZÁLEZ, G. 2004. Resistencia a gentamicina, amikacina y ciprofloxacinaen cepas hospitalarias de Klebsiella pneumoniae subespecie pneumoniae productoras de ß-lactamasas de espectro extendido Rev Méd Chile132: 1173-1178.
SENDA, K.; ARAKAWA, Y.; ICHIYAMA,S.; NAKASHIMA, K.; ITO, H.; OSHUKA,S. SHIMOKATA, K.; KATO, K. & OHTA,M1996. PCR detection of metallo-β-lacta-mase gene (blaIMP) in Gram-negative rods resistant to broad-spectrum β-lactams.Journal of Clinical Microbiology34: 2909-2913.
MELANO, R.; CORSO, A.; PETRONI, A.;CENTRÓN, D.; ORMAN, B.; PEREYRA,A.; MORENO, N. & GALAS, M. 2003.Multiple antibiotic-resistance mechanisms including a novel combination of extended-spectrum ß-lactamases in a Klebsiella pneumoniae clinical strain isolated in Argentina.J Antimicrob Chemother52: 36-42.
ESPINAL, P.; MANTILLA, J.; SAAVE-DRA, C.; LEAL, A.; ALPUCHE, C. &VALENZUELA, E. 2004. Epidemiología molecular de infección nosocomial porKlebsiella pneumoniae productora de β-lactamasas de espectro extendido. Biomédica 24: 252-61.
AKYAR I.2008.Antibiotic resistance rates of extended-spectrum beta-lactamase-producing Escherichia coli and Klebsiella spp. strains isolated from urinary tract infections in a private hospital.Mikrobiyol Bul.42(4): 713-5.
FEIZABADI, M. M.; ETEMADI, G.;YADEGARINIA, D.; RAHMATI, M.;SHABANPOOR, S. & BOKAEI, S. 2006.Antibiotic-resistance patterns and frequency of extended-spectrum beta-lactamase-producing isolates of Klebsiella pneumoniae in Tehran.Med Sci Monit.12(11): 362-365.
SÁNCHEZ, J.; IGLESIAS, J.; FERNÁN-DEZ, J.; PÉREZ-THEN, E.; RAMÍREZ,S.; ORTEGA, G.; JIMÉNEZ, L. 2005. Aislamiento de Klebsiella pneumoniae productora de Beta-Lactamasas de Espectro Extendido (BLEE) en recién nacidos en el Hospital Infantil Dr. Robert Reid Cabral de Santo Domingo, República Dominicana. Revista Panamericana de Infectología7(4):15-20.
MARTÍNEZ, P.; ESPINAL, P.; BUSTOS,A. &MATTAR, S. 2005. Prevalencia de Klebsiella pneumoniae y Escherichia coliproductoras de β-lactamasasde espectroextendido (BLEE), en el HospitalSan Jeró-nimo de Montería. MedUNAB8(1): 15-22.
SEKOWSKA, A, WRÓBLEWSKA, J. &Gospodarek, E. 2008. ESBL-positive and ESBL-negative Klebsiella pneumoniae and Klebsiella oxytoca strains occurrence in clinical specimens and susceptibility to selected antibiotics. Med Dosw Mikrobiol60(1): 39-44.
KIREMITCI, A.; DINLEYICI, EC.;ERBEN, N.; DURMAZ, G.; YARGIC,Z.A.; AYBEY, A. D. & USLUER, G. 2006.In vitro activity of ertapenem and other carbapenems against extended-spectrum beta-lactamase-producing Escherichia coli and Klebsiella pneumoniae clinical isolates in a tertiary care center in Turkey. Expert OpinPharmacother9 (9): 1441-1449.
MOREJÓN, M. G. 2006. Variantes terapéuticas en la sepsis provocada por gérmenes multirresistentes. Rev Cubana Farm 40 (2).
MARTÍNEZ, E.; ALQUICHIRE, C.;PÉREZ, C.; PRADA, G.; ROZO, V. &LAROTTA, J. 2007. Comparación de la actividad in vitro de la tigeciclina contra microorganismos causantes de infección enpacientes hospitalizados en Colombia: Estudio de evaluación y vigilancia de tigeciclina. Asociación Colombiana de Infectología 11 (4):159-170.
CURCIO, D. J. & ISTÚRIZ, R. E. 2006. Tigeciclina, la primera glicilciclina. Revista Panamericana de Infectología 8 (3): 35-42.
GONZÁLEZ, G.; MELLA, S.; ZEMELMAN, R.; BELLA, H. & DOMÍNGUEZ,M. 2004. Integrones y cassettes genéticos de resistencia: estructura y rol frente a losantibacterianos. Revista médica de Chile132: 619-626.
ZURITA, J.; AYABACA, J.; PAVÓN, L.;ESPINOSA, Y.; NARVÁEZ, I. & Grupo REDNARBEC. 2001. Se detectan Enterococcus facium resistenctes a vancomicina en dos hospitales de quito. Revista electrónica de la Sociedad Ecuatoriana de Medicina Crítica, volumen 2.
BISHARA, J.; LEIBOVICI, L.; HUMIN-ER, DRUKER, M.; SAMRA, Z.; KONIS-BERGER, H. & PITLIK, S. 1997. Five-year prospective study of bacteremic urinary tract infection in a single institution. Eur J Clin Microbiol Infect Dis. 16: 563-567.
MANDELL, BENNETT, & DOLIN. 2005.Principles and Practice of Infectious Dis-eases, 6th ed. The specific pathogens. 2:2578-2579.
HAEGGMAN, S.; LOFDAHL, S. & BUR-MAN, L. G. 1997. An allelic variant of the chromosome gene for class A beta-lactamase K2, specific for Klebsiella pneumoniae, is the ancestor of SHV-1. Antimicrob agents Chemother41: 2705-2709.
BURWEWN, D. R.; BANERJEE, S.N.; GAYNES, R. P. 1994. Ceftazidimeresistance among selected nosocomialgram-negative bacilli in the United States.J Infect Dis. 170: 1622-1625
BJORN, A.; ESPEDITO, Lee C. T. &IREDELL, J. R. 2007. Metallo β-Lactamaseor Extended-Spectrum β-Lactamase: a Wolfin Sheep’s Clothing. Journal of ClinicalMicrobiology45: 2034-2036.
CARPENTER J. L. 1990. Klebsiella pulmonary infections: Occurrence at one medical center and review. Rev Infect Dis. 12:672-682.
PATERSON, D. L. & BONOMO, R. A.2005. Extended-spectrum β-lactamases: aclinical update. Clin. Microbiol. 18: 657-686.
GISKE, C. G.; MONNET, D. L.; CARS,O. & YEHUDA, C. 2008. Behalf of Reaction on Antibiotic ResistanceClinical and Economic Impact of Com-mon Multidrug-Resistant Gram-NegativeBacilli. Antimicrobial Agents and Chemotherapy. 52(3): 813-821.
GALES, A. C.; JONES, R. N. & SANDER,H. S. 2006. Global assessment of the antimicrobial activity of polymyxin B against 54 731 clinical isolates of gram-negative bacilli: report from the SENTRYantimicrobial surveillance programme (2001–2004). Clin. Microbiol. Infect. 12:315–321.
GALES, A. C.; SANDER, H. S. & JONES,R. N. 2002. Urinary tract infection trends in Latin American hospitals: report from the sentry antimicrobial surveillance program (1997–2000). Diagn. Microbiol.Infect. Dis. 44: 289-299.
KOSTMAN, J. R.; EDLID, T. D.; LIPUMA, J. J. & STULL, T. L. 1992.Molecular Epidemiology of Pseudomonas cepacia Determined by Polymerase ChainReaction Ribotyping. Journal of Clinical Microbiology30 (8): 2084-2087.
LOPES, A.; RODRIGUES, J.; MAYSA,C.; MIRANDA, C.; NASCIMENTO, A. &MORAIS, M. 2007. Application of PCR ribotyping and tDNA-PCR for Klebsiellapneumoniaeidentification. InstitutoOswaldo Cruz102 (7): 827-832.
BAUER, A. W.; KIRBY, W. N. W.; SHER-RINS, G. J. & TURCK, M. 1966. Antibiotic susceptibility testing by standardized single disk method. American Journal of Clinical Pathology45: 493-496.
Clinical and laboratory Standards Institute Performance standards for antimicrobial susceptibility testing; fifteenth informational supplement Sixteenth International Supplement. CLSI document. 2008. Clinical and Laboratory Standards Institute, Wayne, Pennsylvania, USA.
PATERSON, D. & BONOMO, R. 2005.Extended-Spectrum β-Lactamases: a Clini-cal Update. Clinical Microbiology Reviews18(4): 657-686.
VAKULENKO, S. & MOBASHERY, S.2003. Versatility of aminoglycosides and prospects for their future. Clin MicrobiolRev16: 430-50.
DÍAZ, P.; BELLO, H.; DOMÍNGUEZ, M.;TRABAL, N.; MELLA, S.; ZEMELMAN,R. & GONZÁLEZ, G. 2004. Resistencia a gentamicina, amikacina y ciprofloxacinaen cepas hospitalarias de Klebsiella pneumoniae subespecie pneumoniae productoras de ß-lactamasas de espectro extendido Rev Méd Chile132: 1173-1178.
SENDA, K.; ARAKAWA, Y.; ICHIYAMA,S.; NAKASHIMA, K.; ITO, H.; OSHUKA,S. SHIMOKATA, K.; KATO, K. & OHTA,M1996. PCR detection of metallo-β-lacta-mase gene (blaIMP) in Gram-negative rods resistant to broad-spectrum β-lactams.Journal of Clinical Microbiology34: 2909-2913.
MELANO, R.; CORSO, A.; PETRONI, A.;CENTRÓN, D.; ORMAN, B.; PEREYRA,A.; MORENO, N. & GALAS, M. 2003.Multiple antibiotic-resistance mechanisms including a novel combination of extended-spectrum ß-lactamases in a Klebsiella pneumoniae clinical strain isolated in Argentina.J Antimicrob Chemother52: 36-42.
ESPINAL, P.; MANTILLA, J.; SAAVE-DRA, C.; LEAL, A.; ALPUCHE, C. &VALENZUELA, E. 2004. Epidemiología molecular de infección nosocomial porKlebsiella pneumoniae productora de β-lactamasas de espectro extendido. Biomédica 24: 252-61.
AKYAR I.2008.Antibiotic resistance rates of extended-spectrum beta-lactamase-producing Escherichia coli and Klebsiella spp. strains isolated from urinary tract infections in a private hospital.Mikrobiyol Bul.42(4): 713-5.
FEIZABADI, M. M.; ETEMADI, G.;YADEGARINIA, D.; RAHMATI, M.;SHABANPOOR, S. & BOKAEI, S. 2006.Antibiotic-resistance patterns and frequency of extended-spectrum beta-lactamase-producing isolates of Klebsiella pneumoniae in Tehran.Med Sci Monit.12(11): 362-365.
SÁNCHEZ, J.; IGLESIAS, J.; FERNÁN-DEZ, J.; PÉREZ-THEN, E.; RAMÍREZ,S.; ORTEGA, G.; JIMÉNEZ, L. 2005. Aislamiento de Klebsiella pneumoniae productora de Beta-Lactamasas de Espectro Extendido (BLEE) en recién nacidos en el Hospital Infantil Dr. Robert Reid Cabral de Santo Domingo, República Dominicana. Revista Panamericana de Infectología7(4):15-20.
MARTÍNEZ, P.; ESPINAL, P.; BUSTOS,A. &MATTAR, S. 2005. Prevalencia de Klebsiella pneumoniae y Escherichia coliproductoras de β-lactamasasde espectroextendido (BLEE), en el HospitalSan Jeró-nimo de Montería. MedUNAB8(1): 15-22.
SEKOWSKA, A, WRÓBLEWSKA, J. &Gospodarek, E. 2008. ESBL-positive and ESBL-negative Klebsiella pneumoniae and Klebsiella oxytoca strains occurrence in clinical specimens and susceptibility to selected antibiotics. Med Dosw Mikrobiol60(1): 39-44.
KIREMITCI, A.; DINLEYICI, EC.;ERBEN, N.; DURMAZ, G.; YARGIC,Z.A.; AYBEY, A. D. & USLUER, G. 2006.In vitro activity of ertapenem and other carbapenems against extended-spectrum beta-lactamase-producing Escherichia coli and Klebsiella pneumoniae clinical isolates in a tertiary care center in Turkey. Expert OpinPharmacother9 (9): 1441-1449.
MOREJÓN, M. G. 2006. Variantes terapéuticas en la sepsis provocada por gérmenes multirresistentes. Rev Cubana Farm 40 (2).
MARTÍNEZ, E.; ALQUICHIRE, C.;PÉREZ, C.; PRADA, G.; ROZO, V. &LAROTTA, J. 2007. Comparación de la actividad in vitro de la tigeciclina contra microorganismos causantes de infección enpacientes hospitalizados en Colombia: Estudio de evaluación y vigilancia de tigeciclina. Asociación Colombiana de Infectología 11 (4):159-170.
CURCIO, D. J. & ISTÚRIZ, R. E. 2006. Tigeciclina, la primera glicilciclina. Revista Panamericana de Infectología 8 (3): 35-42.
GONZÁLEZ, G.; MELLA, S.; ZEMELMAN, R.; BELLA, H. & DOMÍNGUEZ,M. 2004. Integrones y cassettes genéticos de resistencia: estructura y rol frente a losantibacterianos. Revista médica de Chile132: 619-626.
ZURITA, J.; AYABACA, J.; PAVÓN, L.;ESPINOSA, Y.; NARVÁEZ, I. & Grupo REDNARBEC. 2001. Se detectan Enterococcus facium resistenctes a vancomicina en dos hospitales de quito. Revista electrónica de la Sociedad Ecuatoriana de Medicina Crítica, volumen 2.