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Dos Santos PAS, Silva MJA, Gouveia MIM, Lima LNGC, Quaresma AJPG, De Lima PDL, Brasiliense DM, Lima KVB, Rodrigues YC. The Prevalence of Metallo-Beta-Lactamese-(MβL)-Producing Pseudomonas aeruginosa Isolates in Brazil: A Systematic Review and Meta-Analysis. Microorganisms 2023; 11:2366. [PMID: 37764210 PMCID: PMC10534863 DOI: 10.3390/microorganisms11092366] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2023] [Revised: 08/12/2023] [Accepted: 08/19/2023] [Indexed: 09/29/2023] Open
Abstract
The purpose of the current study is to describe the prevalence of Pseudomonas aeruginosa (PA)-producing MβL among Brazilian isolates and the frequency of blaSPM-1 in MβL-PA-producing isolates. From January 2009 to August 2023, we carried out an investigation on this subject in the internet databases SciELO, PubMed, Science Direct, and LILACS. A total of 20 papers that met the eligibility requirements were chosen by comprehensive meta-analysis software v2.2 for data retrieval and analysis by one meta-analysis using a fixed-effects model for the two investigations. The prevalence of MβL-producing P. aeruginosa was 35.8% or 0.358 (95% CI = 0.324-0.393). The studies' differences were significantly different from one another (x2 = 243.15; p < 0.001; I2 = 92.18%), so they were divided into subgroups based on Brazilian regions. There was indication of asymmetry in the meta-analyses' publishing bias funnel plot; so, a meta-regression was conducted by the study's publication year. According to the findings of Begg's test, no discernible publishing bias was found. blaSPM-1 prevalence was estimated at 66.9% or 0.669 in MβL-PA isolates (95% CI = 0.593-0.738). The analysis of this one showed an average heterogeneity (x2 = 90.93; p < 0.001; I2 = 80.20%). According to the results of Begg's test and a funnel plot, no discernible publishing bias was found. The research showed that MβL-P. aeruginosa and SPM-1 isolates were relatively common among individuals in Brazil. P. aeruginosa and other opportunistic bacteria are spreading quickly and causing severe infections, so efforts are needed to pinpoint risk factors, reservoirs, transmission pathways, and the origin of infection.
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Affiliation(s)
- Pabllo Antonny Silva Dos Santos
- Program in Parasitic Biology in the Amazon Region (PPGBPA), State University of Pará (UEPA), Belém 66087-662, PA, Brazil; (P.A.S.D.S.); (L.N.G.C.L.); (P.D.L.D.L.); (D.M.B.); (K.V.B.L.)
- Bacteriology and Mycology Section, Evandro Chagas Institute (SABMI/IEC), Ministry of Health, Ananindeua 67030-000, PA, Brazil; (M.I.M.G.); (A.J.P.G.Q.)
| | - Marcos Jessé Abrahão Silva
- Bacteriology and Mycology Section, Evandro Chagas Institute (SABMI/IEC), Ministry of Health, Ananindeua 67030-000, PA, Brazil; (M.I.M.G.); (A.J.P.G.Q.)
- Program in Epidemiology and Health Surveillance (PPGEVS), Evandro Chagas Institute (IEC), Ministry of Health, Ananindeua 67030-000, PA, Brazil
| | - Maria Isabel Montoril Gouveia
- Bacteriology and Mycology Section, Evandro Chagas Institute (SABMI/IEC), Ministry of Health, Ananindeua 67030-000, PA, Brazil; (M.I.M.G.); (A.J.P.G.Q.)
| | - Luana Nepomuceno Gondim Costa Lima
- Program in Parasitic Biology in the Amazon Region (PPGBPA), State University of Pará (UEPA), Belém 66087-662, PA, Brazil; (P.A.S.D.S.); (L.N.G.C.L.); (P.D.L.D.L.); (D.M.B.); (K.V.B.L.)
- Bacteriology and Mycology Section, Evandro Chagas Institute (SABMI/IEC), Ministry of Health, Ananindeua 67030-000, PA, Brazil; (M.I.M.G.); (A.J.P.G.Q.)
- Program in Epidemiology and Health Surveillance (PPGEVS), Evandro Chagas Institute (IEC), Ministry of Health, Ananindeua 67030-000, PA, Brazil
| | - Ana Judith Pires Garcia Quaresma
- Bacteriology and Mycology Section, Evandro Chagas Institute (SABMI/IEC), Ministry of Health, Ananindeua 67030-000, PA, Brazil; (M.I.M.G.); (A.J.P.G.Q.)
| | - Patrícia Danielle Lima De Lima
- Program in Parasitic Biology in the Amazon Region (PPGBPA), State University of Pará (UEPA), Belém 66087-662, PA, Brazil; (P.A.S.D.S.); (L.N.G.C.L.); (P.D.L.D.L.); (D.M.B.); (K.V.B.L.)
| | - Danielle Murici Brasiliense
- Program in Parasitic Biology in the Amazon Region (PPGBPA), State University of Pará (UEPA), Belém 66087-662, PA, Brazil; (P.A.S.D.S.); (L.N.G.C.L.); (P.D.L.D.L.); (D.M.B.); (K.V.B.L.)
- Bacteriology and Mycology Section, Evandro Chagas Institute (SABMI/IEC), Ministry of Health, Ananindeua 67030-000, PA, Brazil; (M.I.M.G.); (A.J.P.G.Q.)
- Program in Epidemiology and Health Surveillance (PPGEVS), Evandro Chagas Institute (IEC), Ministry of Health, Ananindeua 67030-000, PA, Brazil
| | - Karla Valéria Batista Lima
- Program in Parasitic Biology in the Amazon Region (PPGBPA), State University of Pará (UEPA), Belém 66087-662, PA, Brazil; (P.A.S.D.S.); (L.N.G.C.L.); (P.D.L.D.L.); (D.M.B.); (K.V.B.L.)
- Bacteriology and Mycology Section, Evandro Chagas Institute (SABMI/IEC), Ministry of Health, Ananindeua 67030-000, PA, Brazil; (M.I.M.G.); (A.J.P.G.Q.)
- Program in Epidemiology and Health Surveillance (PPGEVS), Evandro Chagas Institute (IEC), Ministry of Health, Ananindeua 67030-000, PA, Brazil
| | - Yan Corrêa Rodrigues
- Bacteriology and Mycology Section, Evandro Chagas Institute (SABMI/IEC), Ministry of Health, Ananindeua 67030-000, PA, Brazil; (M.I.M.G.); (A.J.P.G.Q.)
- Program in Epidemiology and Health Surveillance (PPGEVS), Evandro Chagas Institute (IEC), Ministry of Health, Ananindeua 67030-000, PA, Brazil
- Department of Natural Science, State University of Pará (DCNA/UEPA), Belém 66050-540, PA, Brazil
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Dos Santos PAS, Rodrigues YC, Marcon DJ, Lobato ARF, Cazuza TB, Gouveia MIM, Silva MJA, Souza AB, Lima LNGC, Quaresma AJPG, Brasiliense DM, Lima KVB. Endemic High-Risk Clone ST277 Is Related to the Spread of SPM-1-Producing Pseudomonas aeruginosa during the COVID-19 Pandemic Period in Northern Brazil. Microorganisms 2023; 11:2069. [PMID: 37630629 PMCID: PMC10457858 DOI: 10.3390/microorganisms11082069] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2023] [Revised: 07/20/2023] [Accepted: 07/20/2023] [Indexed: 08/27/2023] Open
Abstract
Pseudomonas aeruginosa is a high-priority bacterial agent that causes healthcare-acquired infections (HAIs), which often leads to serious infections and poor prognosis in vulnerable patients. Its increasing resistance to antimicrobials, associated with SPM production, is a case of public health concern. Therefore, this study aims to determine the antimicrobial resistance, virulence, and genotyping features of P. aeruginosa strains producing SPM-1 in the Northern region of Brazil. To determine the presence of virulence and resistance genes, the PCR technique was used. For the susceptibility profile of antimicrobials, the Kirby-Bauer disk diffusion method was performed on Mueller-Hinton agar. The MLST technique was used to define the ST of the isolates. The exoS+/exoU- virulotype was standard for all strains, with the aprA, lasA, toxA, exoS, exoT, and exoY genes as the most prevalent. All the isolates showed an MDR or XDR profile against the six classes of antimicrobials tested. HRC ST277 played a major role in spreading the SPM-1-producing P. aeruginosa strains.
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Affiliation(s)
- Pabllo Antonny Silva Dos Santos
- Program in Parasitic Biology in the Amazon Region (PPGBPA), State University of Pará (UEPA), Tv. Perebebuí, 2623-Marco, Belém 66087-662, PA, Brazil; (P.A.S.D.S.); (D.J.M.); (L.N.G.C.L.); (D.M.B.)
- Bacteriology and Mycology Section, Evandro Chagas Institute (SABMI/IEC), Ministry of Health, Ananindeua 67030-000, PA, Brazil; (A.R.F.L.); (T.B.C.); (M.I.M.G.); (M.J.A.S.); (A.B.S.); (A.J.P.G.Q.)
| | - Yan Corrêa Rodrigues
- Bacteriology and Mycology Section, Evandro Chagas Institute (SABMI/IEC), Ministry of Health, Ananindeua 67030-000, PA, Brazil; (A.R.F.L.); (T.B.C.); (M.I.M.G.); (M.J.A.S.); (A.B.S.); (A.J.P.G.Q.)
- Program in Epidemiology and Health Surveillance (PPGEVS), Evandro Chagas Institute (IEC), Ministry of Health, Ananindeua 67030-000, PA, Brazil
- Department of Natural Science, State University of Pará (DCNA/UEPA), Belém 66050-540, PA, Brazil
| | - Davi Josué Marcon
- Program in Parasitic Biology in the Amazon Region (PPGBPA), State University of Pará (UEPA), Tv. Perebebuí, 2623-Marco, Belém 66087-662, PA, Brazil; (P.A.S.D.S.); (D.J.M.); (L.N.G.C.L.); (D.M.B.)
- Bacteriology and Mycology Section, Evandro Chagas Institute (SABMI/IEC), Ministry of Health, Ananindeua 67030-000, PA, Brazil; (A.R.F.L.); (T.B.C.); (M.I.M.G.); (M.J.A.S.); (A.B.S.); (A.J.P.G.Q.)
| | - Amália Raiana Fonseca Lobato
- Bacteriology and Mycology Section, Evandro Chagas Institute (SABMI/IEC), Ministry of Health, Ananindeua 67030-000, PA, Brazil; (A.R.F.L.); (T.B.C.); (M.I.M.G.); (M.J.A.S.); (A.B.S.); (A.J.P.G.Q.)
| | - Thalyta Braga Cazuza
- Bacteriology and Mycology Section, Evandro Chagas Institute (SABMI/IEC), Ministry of Health, Ananindeua 67030-000, PA, Brazil; (A.R.F.L.); (T.B.C.); (M.I.M.G.); (M.J.A.S.); (A.B.S.); (A.J.P.G.Q.)
| | - Maria Isabel Montoril Gouveia
- Bacteriology and Mycology Section, Evandro Chagas Institute (SABMI/IEC), Ministry of Health, Ananindeua 67030-000, PA, Brazil; (A.R.F.L.); (T.B.C.); (M.I.M.G.); (M.J.A.S.); (A.B.S.); (A.J.P.G.Q.)
| | - Marcos Jessé Abrahão Silva
- Bacteriology and Mycology Section, Evandro Chagas Institute (SABMI/IEC), Ministry of Health, Ananindeua 67030-000, PA, Brazil; (A.R.F.L.); (T.B.C.); (M.I.M.G.); (M.J.A.S.); (A.B.S.); (A.J.P.G.Q.)
- Program in Epidemiology and Health Surveillance (PPGEVS), Evandro Chagas Institute (IEC), Ministry of Health, Ananindeua 67030-000, PA, Brazil
| | - Alex Brito Souza
- Bacteriology and Mycology Section, Evandro Chagas Institute (SABMI/IEC), Ministry of Health, Ananindeua 67030-000, PA, Brazil; (A.R.F.L.); (T.B.C.); (M.I.M.G.); (M.J.A.S.); (A.B.S.); (A.J.P.G.Q.)
| | - Luana Nepomuceno Gondim Costa Lima
- Program in Parasitic Biology in the Amazon Region (PPGBPA), State University of Pará (UEPA), Tv. Perebebuí, 2623-Marco, Belém 66087-662, PA, Brazil; (P.A.S.D.S.); (D.J.M.); (L.N.G.C.L.); (D.M.B.)
- Bacteriology and Mycology Section, Evandro Chagas Institute (SABMI/IEC), Ministry of Health, Ananindeua 67030-000, PA, Brazil; (A.R.F.L.); (T.B.C.); (M.I.M.G.); (M.J.A.S.); (A.B.S.); (A.J.P.G.Q.)
- Program in Epidemiology and Health Surveillance (PPGEVS), Evandro Chagas Institute (IEC), Ministry of Health, Ananindeua 67030-000, PA, Brazil
| | - Ana Judith Pires Garcia Quaresma
- Bacteriology and Mycology Section, Evandro Chagas Institute (SABMI/IEC), Ministry of Health, Ananindeua 67030-000, PA, Brazil; (A.R.F.L.); (T.B.C.); (M.I.M.G.); (M.J.A.S.); (A.B.S.); (A.J.P.G.Q.)
| | - Danielle Murici Brasiliense
- Program in Parasitic Biology in the Amazon Region (PPGBPA), State University of Pará (UEPA), Tv. Perebebuí, 2623-Marco, Belém 66087-662, PA, Brazil; (P.A.S.D.S.); (D.J.M.); (L.N.G.C.L.); (D.M.B.)
- Bacteriology and Mycology Section, Evandro Chagas Institute (SABMI/IEC), Ministry of Health, Ananindeua 67030-000, PA, Brazil; (A.R.F.L.); (T.B.C.); (M.I.M.G.); (M.J.A.S.); (A.B.S.); (A.J.P.G.Q.)
- Program in Epidemiology and Health Surveillance (PPGEVS), Evandro Chagas Institute (IEC), Ministry of Health, Ananindeua 67030-000, PA, Brazil
| | - Karla Valéria Batista Lima
- Program in Parasitic Biology in the Amazon Region (PPGBPA), State University of Pará (UEPA), Tv. Perebebuí, 2623-Marco, Belém 66087-662, PA, Brazil; (P.A.S.D.S.); (D.J.M.); (L.N.G.C.L.); (D.M.B.)
- Bacteriology and Mycology Section, Evandro Chagas Institute (SABMI/IEC), Ministry of Health, Ananindeua 67030-000, PA, Brazil; (A.R.F.L.); (T.B.C.); (M.I.M.G.); (M.J.A.S.); (A.B.S.); (A.J.P.G.Q.)
- Program in Epidemiology and Health Surveillance (PPGEVS), Evandro Chagas Institute (IEC), Ministry of Health, Ananindeua 67030-000, PA, Brazil
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Camargo CH, Yamada AY, Souza ARD, Lima MDJDC, Cunha MPV, Ferraro PSP, Sacchi CT, Santos MBND, Campos KR, Tiba-Casas MR, Freire MP, Barretti P. Genomics and Antimicrobial Susceptibility of Clinical Pseudomonas aeruginosa Isolates from Hospitals in Brazil. Pathogens 2023; 12:918. [PMID: 37513765 PMCID: PMC10384983 DOI: 10.3390/pathogens12070918] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2023] [Revised: 07/05/2023] [Accepted: 07/07/2023] [Indexed: 07/30/2023] Open
Abstract
Pseudomonas aeruginosa, an opportunistic pathogen causing infections in immunocompromised patients, usually shows pronounced antimicrobial resistance. In recent years, the frequency of carbapenemases in P. aeruginosa has decreased, which allows use of new beta-lactams/combinations in antimicrobial therapy. Therefore, the in vitro evaluation of these drugs in contemporary isolates is warranted. We evaluated the antimicrobial susceptibility and genomic aspects of 119 clinical P. aeruginosa isolates from 24 different hospitals in Brazil in 2021-2022. Identification was performed via MALDI-TOF-MS, and antimicrobial susceptibility was identified through broth microdilution, gradient tests, or disk diffusion. Whole-genome sequencing was carried out using NextSeq equipment. The most active drug was cefiderocol (100%), followed by ceftazidime-avibactam (94.1%), ceftolozane-tazobactam (92.4%), and imipenem-relebactam (81.5%). Imipenem susceptibility was detected in 59 isolates (49.6%), and the most active aminoglycoside was tobramycin, to which 99 (83.2%) isolates were susceptible. Seventy-one different sequence types (STs) were detected, including twelve new STs described herein. The acquired resistance genes blaCTX-M-2 and blaKPC-2 were identified in ten (8.4%) and two (1.7%) isolates, respectively. Several virulence genes (exoSTUY, toxA, aprA, lasA/B, plcH) were also identified. We found that new antimicrobials are effective against the diverse P. aeruginosa population that has been circulating in Brazilian hospitals in recent years.
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Affiliation(s)
- Carlos Henrique Camargo
- Centro de Bacteriologia, Instituto Adolfo Lutz, Sao Paulo 01246-902, SP, Brazil
- Faculdade de Medicina, Universidade de São Paulo, Sao Paulo 01246-902, SP, Brazil
| | - Amanda Yaeko Yamada
- Centro de Bacteriologia, Instituto Adolfo Lutz, Sao Paulo 01246-902, SP, Brazil
- Faculdade de Medicina, Universidade de São Paulo, Sao Paulo 01246-902, SP, Brazil
| | | | | | | | | | | | | | | | | | | | - Pasqual Barretti
- Faculdade de Medicina de Botucatu, Universidade Estadual Paulista, Botucatu 18618-686, SP, Brazil
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Barbu IC, Gheorghe-Barbu I, Grigore GA, Vrancianu CO, Chifiriuc MC. Antimicrobial Resistance in Romania: Updates on Gram-Negative ESCAPE Pathogens in the Clinical, Veterinary, and Aquatic Sectors. Int J Mol Sci 2023; 24:7892. [PMID: 37175597 PMCID: PMC10178704 DOI: 10.3390/ijms24097892] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2023] [Revised: 04/20/2023] [Accepted: 04/21/2023] [Indexed: 05/15/2023] Open
Abstract
Multidrug-resistant Gram-negative bacteria such as Acinetobacter baumannii, Pseudomonas aeruginosa, and members of the Enterobacterales order are a challenging multi-sectorial and global threat, being listed by the WHO in the priority list of pathogens requiring the urgent discovery and development of therapeutic strategies. We present here an overview of the antibiotic resistance profiles and epidemiology of Gram-negative pathogens listed in the ESCAPE group circulating in Romania. The review starts with a discussion of the mechanisms and clinical significance of Gram-negative bacteria, the most frequent genetic determinants of resistance, and then summarizes and discusses the epidemiological studies reported for A. baumannii, P. aeruginosa, and Enterobacterales-resistant strains circulating in Romania, both in hospital and veterinary settings and mirrored in the aquatic environment. The Romanian landscape of Gram-negative pathogens included in the ESCAPE list reveals that all significant, clinically relevant, globally spread antibiotic resistance genes and carrying platforms are well established in different geographical areas of Romania and have already been disseminated beyond clinical settings.
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Affiliation(s)
- Ilda Czobor Barbu
- Microbiology-Immunology Department, Faculty of Biology, University of Bucharest, 050095 Bucharest, Romania
- The Research Institute of the University of Bucharest, 050095 Bucharest, Romania
| | - Irina Gheorghe-Barbu
- Microbiology-Immunology Department, Faculty of Biology, University of Bucharest, 050095 Bucharest, Romania
- The Research Institute of the University of Bucharest, 050095 Bucharest, Romania
| | - Georgiana Alexandra Grigore
- Microbiology-Immunology Department, Faculty of Biology, University of Bucharest, 050095 Bucharest, Romania
- The Research Institute of the University of Bucharest, 050095 Bucharest, Romania
- National Institute of Research and Development for Biological Sciences, 060031 Bucharest, Romania
| | - Corneliu Ovidiu Vrancianu
- Microbiology-Immunology Department, Faculty of Biology, University of Bucharest, 050095 Bucharest, Romania
- The Research Institute of the University of Bucharest, 050095 Bucharest, Romania
| | - Mariana Carmen Chifiriuc
- Microbiology-Immunology Department, Faculty of Biology, University of Bucharest, 050095 Bucharest, Romania
- The Research Institute of the University of Bucharest, 050095 Bucharest, Romania
- Academy of Romanian Scientists, 050044 Bucharest, Romania
- Romanian Academy, 010071 Bucharest, Romania
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Sakata RAO, Cayô R, Gales AC, Cuba GT, Pignatari ACC, Kiffer CRV. Broad-spectrum antimicrobial consumption trend and correlation with bacterial infections and resistance over 5 years. J Glob Antimicrob Resist 2021; 28:115-119. [PMID: 34933139 DOI: 10.1016/j.jgar.2021.10.031] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2021] [Revised: 09/30/2021] [Accepted: 10/24/2021] [Indexed: 10/19/2022] Open
Abstract
OBJECTIVES Consumption trends of four broad spectrum antimicrobials and their correlation with resistance in Gram-negative bacilli (GNB) from 2013 to 2017 within intensive care units were explored. METHODS Consumption meropenem (MEM), polymyxin B (PMB), piperacillin-tazobactam (PTZ), and cefepime (FEP) in DDD/1,000 patient-days was measured. Infection-related GNB isolates were grouped according to specific resistance profiles. Time series of antimicrobial consumption and their parametric correlation with each grouped resistant GNB were explored. RESULTS A total of 1,423 GNB were evaluated. A significant linear decline in consumption was observed for MEM (slope -3.88, CI95% -4.96 to -2.81, p < 0.0001) and for PMB (slope -3.51, CI95% -5.528 to -1.495, p = 0.0009). A significant decline for MEM non-susceptible Acinetobacter spp. (R2 = 0.476, p = 0.006) and an increase in FEP non-susceptible E. coli (R2 = 0.124, p = 0.006) were observed. A significant correlation between MEM consumption and MEM non-susceptible Acinetobacter spp. (r = 0.43, p = 0.001) was observed. MEM consumption and MEM non-susceptible Acinetobacter spp. showed a correlation. CONCLUSIONS Reduction in consumption of broad-spectrum antimicrobials may alter the frequency of infection-related isolates and their resistance profiles.
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Affiliation(s)
- Renata A O Sakata
- Universidade Federal de São Paulo (UNIFESP), Laboratório Especial de Microbiologia Clínica (LEMC), Division of Infectious Diseases, Departament of Internal Medicine, Escola Paulista de Medicina (EPM), São Paulo - SP, Brazil
| | - Rodrigo Cayô
- Universidade Federal de São Paulo (UNIFESP), Laboratório de Imunologia e Bacteriologia (LIB), Setor de Biologia Molecular, Microbiologia e Imunologia, Departamento de Ciências Biológicas (DCB), Instituto de Ciências Ambientais, Químicas e Farmacêuticas (ICAQF), Diadema - SP, Brazil; Universidade Federal de São Paulo (UNIFESP), Laboratório Alerta, Division of Infectious Diseases, Departament of Internal Medicine, Escola Paulista de Medicina (EPM), São Paulo - SP, Brazil
| | - Ana C Gales
- Universidade Federal de São Paulo (UNIFESP), Laboratório Especial de Microbiologia Clínica (LEMC), Division of Infectious Diseases, Departament of Internal Medicine, Escola Paulista de Medicina (EPM), São Paulo - SP, Brazil; Universidade Federal de São Paulo (UNIFESP), Laboratório Alerta, Division of Infectious Diseases, Departament of Internal Medicine, Escola Paulista de Medicina (EPM), São Paulo - SP, Brazil
| | - Gabriel T Cuba
- Universidade Federal de São Paulo (UNIFESP), Laboratório Especial de Microbiologia Clínica (LEMC), Division of Infectious Diseases, Departament of Internal Medicine, Escola Paulista de Medicina (EPM), São Paulo - SP, Brazil
| | - Antonio C C Pignatari
- Universidade Federal de São Paulo (UNIFESP), Laboratório Especial de Microbiologia Clínica (LEMC), Division of Infectious Diseases, Departament of Internal Medicine, Escola Paulista de Medicina (EPM), São Paulo - SP, Brazil; Universidade Federal de São Paulo (UNIFESP), Laboratório Alerta, Division of Infectious Diseases, Departament of Internal Medicine, Escola Paulista de Medicina (EPM), São Paulo - SP, Brazil
| | - Carlos R V Kiffer
- Universidade Federal de São Paulo (UNIFESP), Laboratório Especial de Microbiologia Clínica (LEMC), Division of Infectious Diseases, Departament of Internal Medicine, Escola Paulista de Medicina (EPM), São Paulo - SP, Brazil.
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Belkhair J, Nachat S, Rouhi S, Ouassif H, Abbassi S, Soraa N. Evaluation of in vitro activity of ceftolozane-tazobactam in combination with other classes of antibacterial agents against Enterobacterales and Pseudomonas aeruginosa-the EM200 study. New Microbes New Infect 2021; 41:100872. [PMID: 33912351 PMCID: PMC8066805 DOI: 10.1016/j.nmni.2021.100872] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2020] [Revised: 02/28/2021] [Accepted: 03/12/2021] [Indexed: 11/27/2022] Open
Abstract
Ceftolozane-tazobactam is a cephalosporin/β-lactamase inhibitor combination developed for use against some β-lactam- and multidrug-resistant Gram-negative organisms. This study aimed to evaluate the in vitro activity of ceftolozane-tazobactam against clinical bacterial isolates at the University Hospital of Marrakech. This is a descriptive and analytical prospective study. A total of 143 Enterobacterales and 48 Pseudomonas aeruginosa isolates were collected from January 2018 to December 2018 from patients with respiratory, urinary and intra-abdominal infections. The identification was made by Phoenix automated system (BioMérieux). MIC50/90 were tested by broth microdilution for ceftolozane-tazobactam, and other drugs using dried panels. Antimicrobial susceptibility results were interpreted according to CLSI guidelines. Ceftolozane-tazobactam inhibited 98% of Escherichia coli (MIC50/90; 0.25/0.5 μg/mL). The susceptibility rate of Klebsiella pneumoniae to ceftolozane-tazobactam was 68.8% (MIC50/90, 0.5/>32 μg/mL); other Enterobacterales have shown susceptibility rates of 80.4% (MIC50/90; 0.5/8 μg/mL). In carbapenemase-producing K. pneumoniae, the bla OXA-48 mutation was found in two isolates. Susceptibility of P. aeruginosa to ceftolozane-tazobactam was 91.7% (MIC50/90, 0.5/>32 μg/mL). In non-carbapenemase-producing P. aeruginosa, AmpC mutations were found in all isolates. Ceftolozane-tazobactam was satisfactorily active against a wide range of tested isolates and offers clinicians a potential therapeutic option even against resistant strains in patients with intra-abdominal infections, urinary tract infections and nosocomial pneumonia.
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Affiliation(s)
- J Belkhair
- Laboratory of Microbiology, Arrazi Hospital, University Hospital Center of Mohamed VI, Faculty of Medecine & Pharmacy, Cadi Ayyad University, Marrakech, Morocco
| | - S Nachat
- Laboratory of Microbiology, Arrazi Hospital, University Hospital Center of Mohamed VI, Faculty of Medecine & Pharmacy, Cadi Ayyad University, Marrakech, Morocco
| | - S Rouhi
- Laboratory of Microbiology, Arrazi Hospital, University Hospital Center of Mohamed VI, Faculty of Medecine & Pharmacy, Cadi Ayyad University, Marrakech, Morocco
| | - H Ouassif
- Laboratory of Microbiology, Arrazi Hospital, University Hospital Center of Mohamed VI, Faculty of Medecine & Pharmacy, Cadi Ayyad University, Marrakech, Morocco
| | - S Abbassi
- Laboratory of Microbiology, Arrazi Hospital, University Hospital Center of Mohamed VI, Faculty of Medecine & Pharmacy, Cadi Ayyad University, Marrakech, Morocco
| | - N Soraa
- Laboratory of Microbiology, Arrazi Hospital, University Hospital Center of Mohamed VI, Faculty of Medecine & Pharmacy, Cadi Ayyad University, Marrakech, Morocco
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García-Betancur JC, Appel TM, Esparza G, Gales AC, Levy-Hara G, Cornistein W, Vega S, Nuñez D, Cuellar L, Bavestrello L, Castañeda-Méndez PF, Villalobos-Vindas JM, Villegas MV. Update on the epidemiology of carbapenemases in Latin America and the Caribbean. Expert Rev Anti Infect Ther 2020; 19:197-213. [PMID: 32813566 DOI: 10.1080/14787210.2020.1813023] [Citation(s) in RCA: 34] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
INTRODUCTION Carbapenemases are β-lactamases able to hydrolyze a wide range of β-lactam antibiotics, including carbapenems. Carbapenemase production in Enterobacterales, Pseudomonas aeruginosa, and Acinetobacter spp., with and without the co-expression of other β-lactamases is a serious public health threat. Carbapenemases belong to three main classes according to the Ambler classification: class A, class B, and class D. AREAS COVERED Carbapenemase-bearing pathogens are endemic in Latin America. In this review, we update the status of carbapenemases in Latin America and the Caribbean. EXPERT OPINION Understanding the current epidemiology of carbapenemases in Latin America and the Caribbean is of critical importance to improve infection control policies limiting the dissemination of multi-drug-resistant pathogens and in implementing appropriate antimicrobial therapy.
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Affiliation(s)
| | - Tobias Manuel Appel
- Grupo de Resistencia Antimicrobiana y Epidemiología Hospitalaria, Universidad El Bosque . Bogotá, Colombia
| | - German Esparza
- Programa de Aseguramiento de Calidad. PROASECAL SAS, Bogotá, Colombia
| | - Ana C Gales
- Division of Infectious Diseases, Department of Internal Medicine, Escola Paulista de Medicina/Universidade Federal de São Paulo - UNIFESP , São Paulo, Brazil
| | | | | | - Silvio Vega
- Complejo Hospitalario Metropolitano , Ciudad de Panamá, Panama
| | - Duilio Nuñez
- Infectious Diseases División, IPS Hospital Central , Asunción, Paraguay
| | - Luis Cuellar
- Servicio de Infectologia, Instituto Nacional de Enfermedades Neoplasicas , Lima, Peru
| | | | - Paulo F Castañeda-Méndez
- Department of Infectious Diseases, Hospital San Angel Inn Universidad , Ciudad de México, Mexico
| | | | - María Virginia Villegas
- Grupo de Resistencia Antimicrobiana y Epidemiología Hospitalaria, Universidad El Bosque . Bogotá, Colombia.,Centro Médico Imbanaco . Cali, Colombia
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Rodrigues YC, Furlaneto IP, Maciel AHP, Quaresma AJPG, de Matos ECO, Conceição ML, Vieira MCDS, Brabo GLDC, Sarges EDSNF, Lima LNGC, Lima KVB. High prevalence of atypical virulotype and genetically diverse background among Pseudomonas aeruginosa isolates from a referral hospital in the Brazilian Amazon. PLoS One 2020; 15:e0238741. [PMID: 32911510 PMCID: PMC7482967 DOI: 10.1371/journal.pone.0238741] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2020] [Accepted: 08/21/2020] [Indexed: 12/23/2022] Open
Abstract
Pseudomonas aeruginosa is an opportunistic pathogen causing different types of infections, particularly in intensive care unit patients. Characteristics that favor its persistence artificial environments are related to its high adaptability, wide arsenal of virulence factors and resistance to several antimicrobial classes. Among the several virulence determinants, T3SS stands as the most important due to the clinical impact of exoS and exoU genes in patient’s outcome. The molecular characterization of P. aeruginosa isolates helps in the comprehension of transmission dynamics and enhance knowledge of virulence and resistance roles in infection process. In the present study, we investigated virulence and resistance properties and the genetic background of P. aeruginosa isolated from ICUs patients at a referral hospital in Brazilian Amazon. A total of 54 P. aeruginosa isolates were characterized by detecting 19 virulence-related genes, antimicrobial susceptibility testing, molecular detection of β-lactamase-encoding genes and genotyping by MLST and rep-PCR. Our findings showed high prevalence of virulence-related markers, where 53.7% of the isolates presented at least 17 genes among the 19 investigated (P = 0.01). The rare exoS+/exoU+ cytotoxic virulotype was detected in 55.6% of isolates. Antimicrobial susceptibility testing revealed percentages of antibiotic resistance above 50% to carbapenems, cephalosporins and fluoroquinolones associated to MDR/XDR isolates. Isolates harboring both blaSPM-1 and blaOXA genes were also detected. Genotyping methods demonstrated a wide genetic diversity of strains spread among the different intensive care units, circulation of international MDR/XDR high-risk clones (ST111, ST235, ST244 and ST277) and emergence of seven novel MLST lineages. Finally, our findings highlight the circulation of strains with high virulence potential and resistance to antimicrobials and may be useful on comprehension of pathogenicity process, treatment guidance and establishment of strategies to control the spread of epidemic P. aeruginosa strains.
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Affiliation(s)
- Yan Corrêa Rodrigues
- Programa de Pós-graduação em Biologia Parasitária na Amazônia, Centro de Ciências Biológicas e da Saúde, Universidade do Estado do Pará (UEPA), Belém, Pará, Brazil
- * E-mail: (YCR); (KVBL)
| | - Ismari Perini Furlaneto
- Programa de Pós-graduação em Educação em Saúde, Centro Universitário do Pará (CESUPA), Belém, Pará Brazil
| | - Arthur Henrique Pinto Maciel
- Laboratório de Biologia Molecular, Seção de Bacteriologia e Micologia, Instituto Evandro Chagas (IEC), Ministério da Saúde, Ananindeua, Pará, Brazil
| | - Ana Judith Pires Garcia Quaresma
- Laboratório de Biologia Molecular, Seção de Bacteriologia e Micologia, Instituto Evandro Chagas (IEC), Ministério da Saúde, Ananindeua, Pará, Brazil
| | - Eliseth Costa Oliveira de Matos
- Departamento de Patologia, Centro de Ciências Biológicas e da Saúde, Universidade do Estado do Pará (UEPA), Belém, Pará, Brazil
| | - Marília Lima Conceição
- Programa de Pós-graduação em Biologia Parasitária na Amazônia, Centro de Ciências Biológicas e da Saúde, Universidade do Estado do Pará (UEPA), Belém, Pará, Brazil
| | - Marcelo Cleyton da Silva Vieira
- Laboratório de Biologia Molecular, Seção de Bacteriologia e Micologia, Instituto Evandro Chagas (IEC), Ministério da Saúde, Ananindeua, Pará, Brazil
| | - Giulia Leão da Cunha Brabo
- Laboratório de Biologia Molecular, Seção de Bacteriologia e Micologia, Instituto Evandro Chagas (IEC), Ministério da Saúde, Ananindeua, Pará, Brazil
| | | | - Luana Nepomuceno Godim Costa Lima
- Programa de Pós-graduação em Biologia Parasitária na Amazônia, Centro de Ciências Biológicas e da Saúde, Universidade do Estado do Pará (UEPA), Belém, Pará, Brazil
- Laboratório de Biologia Molecular, Seção de Bacteriologia e Micologia, Instituto Evandro Chagas (IEC), Ministério da Saúde, Ananindeua, Pará, Brazil
| | - Karla Valéria Batista Lima
- Programa de Pós-graduação em Biologia Parasitária na Amazônia, Centro de Ciências Biológicas e da Saúde, Universidade do Estado do Pará (UEPA), Belém, Pará, Brazil
- Laboratório de Biologia Molecular, Seção de Bacteriologia e Micologia, Instituto Evandro Chagas (IEC), Ministério da Saúde, Ananindeua, Pará, Brazil
- * E-mail: (YCR); (KVBL)
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Activity of ceftolozane-tazobactam and comparators against gram-negative bacilli: Results from the study for monitoring antimicrobial resistance trends (SMART - Brazil; 2016-2017). Braz J Infect Dis 2020; 24:310-321. [PMID: 32663440 PMCID: PMC9392090 DOI: 10.1016/j.bjid.2020.05.010] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2020] [Revised: 05/10/2020] [Accepted: 05/28/2020] [Indexed: 11/30/2022] Open
Abstract
Multi-drug resistant Gram-negative bacilli (GNB) have been reported as cause of serious hospital-acquired infections worldwide. The aim of this study was to investigate the in vitro activity of ceftolozane-tazobactam compared to other agents against GNB isolated from patients admitted to Brazilian medical centers between the years 2016 and 2017. Presence of β-lactamase encoding genes was also evaluated. Methods Antimicrobial susceptibility testing of GNB isolated from intra-abdominal (IAI), respiratory (RTI), and urinary tract infections (UTI) was performed according to ISO 227-1 guidelines and interpreted following CLSI and BrCAST/EUCAST guidelines. Qualifying Enterobacteriaceae isolates were screened for the presence of β-lactamase genes by PCR followed by DNA sequencing. Results 1748 GNB collected from UTI (45.2%), IAI (25.7%) and RTI (29.1%) were evaluated. Ceftolozane-tazobactam remained highly active (94.7%) against E. coli isolates. Among K. pneumoniae, susceptibility rates were 85.9% and 85.4% for amikacin and colistin, whereas ceftolozane-tazobactam (44.1% susceptible) and carbapenems (55.2-62.2% susceptible) showed poor activity due to blaKPC-2. Against E. cloacae amikacin, imipenem, and meropenem retained good activity (>90%). Ceftolozane-tazobactam was the most potent β-lactam agent tested against P. aeruginosa (90.9% susceptible), including ceftazidime and imipenem resistant isolates. β-lactamase encoding genes testing was carried out in 433 isolates. blaCTX-M variants were predominant in E. coli, P. mirabilis and E. cloacae. Among the K. pneumoniae molecularly tested, most carried blaKPC (68.5%), with all harboring blaKPC-2, except two isolates carrying blaKPC-3 or blaKPC-30. ESBL encoding genes, mainly CTX-M family, were frequently detected in K. pneumoniae, plasmid-mediated AmpC were rare. A variety of PDC encoding genes were detected in P. aeruginosa isolates with five isolates harboring MBL and one KPC encoding genes. Conclusion Ceftolozane-tazobactam was very active against E. coli, P. mirabilis and P. aeruginosa isolates and could constitute an excellent therapeutic option including for those isolates resistant to extended-spectrum cephalosporins and carbapenems but not producers of carbapenemases.
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Tuon FF, Cieslinski J, Rodrigues SDS, Serra FB, Paula MDND. Evaluation of in vitro activity of ceftolozane-tazobactam against recent clinical bacterial isolates from Brazil - the EM200 study. Braz J Infect Dis 2020; 24:96-103. [PMID: 32360070 PMCID: PMC9392040 DOI: 10.1016/j.bjid.2020.04.004] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2019] [Revised: 02/23/2020] [Accepted: 04/08/2020] [Indexed: 12/31/2022] Open
Abstract
Background The emergence of antibiotic resistance is increasing and there are few effective antibiotics to treat infections caused by resistant and multidrug resistant bacterial pathogens. This study aimed to evaluate the in vitro activity of ceftolozane–tazobactam against clinical bacterial isolates from Brazil. Methods A total of 673 Gram-negative bacterial isolates including Escherichia coli, Klebsiella pneumoniae, Pseudomonas aeruginosa and other Enterobacterales collected from 2016 to 2017 were tested, most of them isolated from patients in intensive care units. Minimum inhibitory concentrations (MIC50/90) were determined by broth microdilution for amikacin, aztreonam, cefepime, cefotaxime, cefoxitin, ceftolozane–tazobactam, ceftazidime, ceftriaxone, ciprofloxacin, colistin, ertapenem, imipenem, levofloxacin, meropenem, and piperacillin-tazobactam using dried panels. Antimicrobial susceptibility results were interpreted according to Clinical and Laboratory Standards Institute criteria. Results Susceptibility rates to ceftolozane–tazobactam ranged from 40.4% to 94.9%. P. aeruginosa susceptibility rate to ceftolozane–tazobactam was 84.9% (MIC50/90, 1/16 μg/mL) and 99.2% to colistin. For E. coli, ceftolozane–tazobactam inhibited 94.9% (MIC50/90, 0.25/1 μg/mL) of the microorganisms. The susceptibility rate of K. pneumoniae to ceftolozane–tazobactam was 40.4% (MIC50/90, 16/>32 μg/mL). Other Enterobacterales have shown susceptibility rates of 81.1% (MIC50/90, 0.5/16 μg/mL) to ceftolozane–tazobactam, 93.9% to meropenem, 90.9% to amikacin (90.9%), and 88.6% to ertapenem. In non-carbapenemase producing isolates, AmpC mutations were found three isolates. Conclusions Ceftolozane–tazobactam has shown relevant activity against a large variety of the analyzed microorganisms collected from multiple centers in Brazil, showing promising results even in multidrug resistant strains.
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Affiliation(s)
- Felipe Francisco Tuon
- Pontifícia Universidade Católica do Paraná, Faculdade de Medicina, Laboratório de Doenças Infecciosas Emergentes, Curitiba, PR, Brazil.
| | - Juliette Cieslinski
- Pontifícia Universidade Católica do Paraná, Faculdade de Medicina, Laboratório de Doenças Infecciosas Emergentes, Curitiba, PR, Brazil
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The Current Burden of Carbapenemases: Review of Significant Properties and Dissemination among Gram-Negative Bacteria. Antibiotics (Basel) 2020; 9:antibiotics9040186. [PMID: 32316342 PMCID: PMC7235769 DOI: 10.3390/antibiotics9040186] [Citation(s) in RCA: 114] [Impact Index Per Article: 28.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2020] [Revised: 03/29/2020] [Accepted: 04/01/2020] [Indexed: 11/16/2022] Open
Abstract
Carbapenemases are β-lactamases belonging to different Ambler classes (A, B, D) and can be encoded by both chromosomal and plasmid-mediated genes. These enzymes represent the most potent β-lactamases, which hydrolyze a broad variety of β-lactams, including carbapenems, cephalosporins, penicillin, and aztreonam. The major issues associated with carbapenemase production are clinical due to compromising the activity of the last resort antibiotics used for treating serious infections, and epidemiological due to their dissemination into various bacteria across almost all geographic regions. Carbapenemase-producing Enterobacteriaceae have received more attention upon their first report in the early 1990s. Currently, there is increased awareness of the impact of nonfermenting bacteria, such as Acinetobacter baumannii and Pseudomonas aeruginosa, as well as other Gram-negative bacteria that are carbapenemase-producers. Outside the scope of clinical importance, carbapenemases are also detected in bacteria from environmental and zoonotic niches, which raises greater concerns over their prevalence, and the need for public health measures to control consequences of their propagation. The aims of the current review are to define and categorize the different families of carbapenemases, and to overview the main lines of their spread across different bacterial groups.
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Phenotypic and Molecular Detection of the Metallo-Beta-Lactamases in Carbapenem-Resistant Pseudomonas aeruginosa Isolates from Clinical Samples. Jundishapur J Microbiol 2020. [DOI: 10.5812/jjm.90034] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023] Open
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Plasmid Carrying bla CTX-M-2 and bla GES-1 in Extensively Drug-Resistant Pseudomonas aeruginosa from Cerebrospinal Fluid. Antimicrob Agents Chemother 2019; 63:AAC.00186-19. [PMID: 31061147 DOI: 10.1128/aac.00186-19] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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de Oliveira Santos IC, Pereira de Andrade NF, da Conceição Neto OC, da Costa BS, de Andrade Marques E, Rocha-de-Souza CM, Asensi MD, D'Alincourt Carvalho-Assef AP. Epidemiology and antibiotic resistance trends in clinical isolates of Pseudomonas aeruginosa from Rio de janeiro - Brazil: Importance of mutational mechanisms over the years (1995-2015). INFECTION GENETICS AND EVOLUTION 2019; 73:411-415. [PMID: 31121306 DOI: 10.1016/j.meegid.2019.05.015] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/30/2018] [Revised: 04/29/2019] [Accepted: 05/15/2019] [Indexed: 12/11/2022]
Abstract
Pseudomonas aeruginosa is a major health concern globally and treating infections caused by MDR-isolates unarguably a humongous challenge that remains an unmet need in modern medicine. To determine patterns and mechanisms of antimicrobial resistance and its spread over the years in Rio de Janeiro, Brazil, 88 P. aeruginosa isolates were selected from 1995 to 2015. Phenotypic and genotypic characterization of antimicrobial resistance was evaluated and isolates were submitted to clonality by PFGE and MLST. PFGE analysis showed a great variability of clonal groups mainly over the past 10 years of this study. STs predominant in the early years (ST804, ST1860, ST487 and ST1602) associated to multidrug resistance (MDR) phenotype were replaced by ST277, ST244, ST1945, ST1791 with extensive drug resistance (XDR) in last years, with significant increase in resistance to carbapenems, fluoroquinolones and aminoglycosides. Colistin resistance was detected in 3.5%. The main mechanisms of antimicrobial resistance were mutational mechanisms (mutations in oprD, mexT and gyrA genes). We found the ESBL genes blaTEM (n = 2), blaSHV (n = 3) and blaCTX (n = 1).The carbapenemases genes was present in ST277 (blaSPM, n = 3), ST1560 (blaKPC, n = 3) and ST1944 (blaKPC, n = 2). The 16S RNA methylase gene (rmtD) was found in five isolates belonged to ST277. In conclusion, molecular epidemiological investigation reveals an increase of antimicrobial resistance in P. aeruginosa over 21 years in Rio de Janeiro with higher population structure and occurrence of high risk clone in the last years. The mutational mechanisms of resistance were present in all XDR isolates.
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Affiliation(s)
- Ivson Cassiano de Oliveira Santos
- Laboratório de Pesquisa em Infecção Hospitalar, Oswaldo Cruz Institute, Fiocruz, Brasil Avenue 4365, Manguinhos, 21040-360, Rio de Janeiro, Rio de Janeiro, Brazil.
| | - Natacha Ferreira Pereira de Andrade
- Laboratório de Pesquisa em Infecção Hospitalar, Oswaldo Cruz Institute, Fiocruz, Brasil Avenue 4365, Manguinhos, 21040-360, Rio de Janeiro, Rio de Janeiro, Brazil
| | - Orlando Carlos da Conceição Neto
- Laboratório de Pesquisa em Infecção Hospitalar, Oswaldo Cruz Institute, Fiocruz, Brasil Avenue 4365, Manguinhos, 21040-360, Rio de Janeiro, Rio de Janeiro, Brazil
| | - Bianca Santos da Costa
- Laboratório de Pesquisa em Infecção Hospitalar, Oswaldo Cruz Institute, Fiocruz, Brasil Avenue 4365, Manguinhos, 21040-360, Rio de Janeiro, Rio de Janeiro, Brazil
| | - Elizabeth de Andrade Marques
- Departamento de Microbiologia, Imunologia e Parasitologia, Faculdade de Ciências Médicas, Universidade do Estado do Rio de Janeiro, Boulervard 28 de setembro, 77, Vila Isabel, Rio de Janeiro 20551-030, Brazil
| | - Cláudio Marcos Rocha-de-Souza
- Laboratório de Pesquisa em Infecção Hospitalar, Oswaldo Cruz Institute, Fiocruz, Brasil Avenue 4365, Manguinhos, 21040-360, Rio de Janeiro, Rio de Janeiro, Brazil
| | - Marise Dutra Asensi
- Laboratório de Pesquisa em Infecção Hospitalar, Oswaldo Cruz Institute, Fiocruz, Brasil Avenue 4365, Manguinhos, 21040-360, Rio de Janeiro, Rio de Janeiro, Brazil
| | - Ana Paula D'Alincourt Carvalho-Assef
- Laboratório de Pesquisa em Infecção Hospitalar, Oswaldo Cruz Institute, Fiocruz, Brasil Avenue 4365, Manguinhos, 21040-360, Rio de Janeiro, Rio de Janeiro, Brazil
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Shortridge D, Gales AC, Streit JM, Huband MD, Tsakris A, Jones RN. Geographic and Temporal Patterns of Antimicrobial Resistance in Pseudomonas aeruginosa Over 20 Years From the SENTRY Antimicrobial Surveillance Program, 1997-2016. Open Forum Infect Dis 2019; 6:S63-S68. [PMID: 30895216 PMCID: PMC6419917 DOI: 10.1093/ofid/ofy343] [Citation(s) in RCA: 74] [Impact Index Per Article: 14.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
Abstract
Background The SENTRY Antimicrobial Surveillance Program was established in 1997 and encompasses over 750 000 bacterial isolates from ≥400 medical centers worldwide. Among the pathogens tested, Pseudomonas aeruginosa remains a common cause of multidrug-resistant (MDR) bloodstream infections and pneumonia in hospitalized patients. In the present study, we reviewed geographic and temporal trends in resistant phenotypes of P. aeruginosa over 20 years of the SENTRY Program. Methods From 1997 to 2016, 52 022 clinically significant consecutive isolates were submitted from ≥200 medical centers representing the Asia-Pacific region, Europe, Latin America, and North America. Only 1 isolate per patient per infection episode was submitted. Isolates were identified by standard algorithms and/or matrix-assisted laser desorption ionization-time of flight mass spectrometry. Susceptibility testing was performed by Clinical and Laboratory Standards Institute (CLSI) methods and interpreted using CLSI and European Committee on Antimicrobial Susceptibility Testing 2018 criteria at JMI Laboratories. Results The most common infection from which P. aeruginosa was isolated was pneumonia in hospitalized patients (44.6%) followed by bloodstream infection (27.9%), with pneumonia having a slightly higher rate of MDR (27.7%) than bloodstream infections (23.7%). The region with the highest percentage of MDR phenotypes was Latin America (41.1%), followed by Europe (28.4%). The MDR rates were highest in 2005–2008 and have decreased in the most recent period. Colistin was the most active drug tested (99.4% susceptible), followed by amikacin (90.5% susceptible). Conclusions Over the 20 years of SENTRY Program surveillance, the rate of MDR P. aeruginosa infections has decreased, particularly in Latin America. Whether the trend of decreasing resistance in P. aeruginosa is maintained will be documented in future SENTRY Program and other surveillance reports.
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de Paula-Petroli SB, Campana EH, Bocchi M, Bordinhão T, Picão RC, Yamada-Ogatta SF, Carrara-Marroni FE. Early detection of a hypervirulent KPC-2-producing Pseudomonas aeruginosa ST235 in Brazil. J Glob Antimicrob Resist 2018; 12:153-154. [PMID: 29391216 DOI: 10.1016/j.jgar.2018.01.014] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2017] [Revised: 01/18/2018] [Accepted: 01/19/2018] [Indexed: 11/17/2022] Open
Affiliation(s)
- Suelen Balero de Paula-Petroli
- Laboratório de Biologia Molecular de Microrganismos, Departamento de Microbiologia, Universidade Estadual de Londrina (UEL), Londrina, PR, Brazil
| | - Eloiza Helena Campana
- Laboratório de Investigação de Microbiologia Médica, Instituto de Microbiologia Paulo de Góes, Universidade Federal do Rio de Janeiro (UFRJ), Rio de Janeiro, RJ, Brazil
| | - Mayara Bocchi
- Laboratório de Microbiologia Clínica, Hospital Universitário de Londrina, Departamento de Patologia, Análises Clínicas e Toxicológicas, Universidade Estadual de Londrina (UEL), Londrina, PR, Brazil
| | - Thiago Bordinhão
- Laboratório de Microbiologia Clínica, Hospital Universitário de Londrina, Departamento de Patologia, Análises Clínicas e Toxicológicas, Universidade Estadual de Londrina (UEL), Londrina, PR, Brazil
| | - Renata Cristina Picão
- Laboratório de Investigação de Microbiologia Médica, Instituto de Microbiologia Paulo de Góes, Universidade Federal do Rio de Janeiro (UFRJ), Rio de Janeiro, RJ, Brazil
| | - Sueli Fumie Yamada-Ogatta
- Laboratório de Biologia Molecular de Microrganismos, Departamento de Microbiologia, Universidade Estadual de Londrina (UEL), Londrina, PR, Brazil
| | - Floristher Elaine Carrara-Marroni
- Laboratório de Microbiologia Clínica, Hospital Universitário de Londrina, Departamento de Patologia, Análises Clínicas e Toxicológicas, Universidade Estadual de Londrina (UEL), Avenida Robert Koch 60, Vila Operária, 86038-360, Londrina, PR, Brazil.
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Balero de Paula S, Cayô R, Streling AP, Silva Nodari C, Pereira Matos A, Eches Perugini MR, Gales AC, Carrara-Marroni FE, Yamada-Ogatta SF. Detection of blaVIM-7 in an extensively drug-resistant Pseudomonas aeruginosa isolate belonging to ST1284 in Brazil. Diagn Microbiol Infect Dis 2017; 89:80-82. [DOI: 10.1016/j.diagmicrobio.2017.06.008] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2017] [Revised: 06/06/2017] [Accepted: 06/12/2017] [Indexed: 10/19/2022]
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