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Mariano LSS, Nakamura-Silva R, Macedo LMDD, Oliveira-Silva MD, Goulart RDS, Pelisson M, Vespero EC, Silva-Sousa YTC, Pitondo-Silva A. Identification and antimicrobial susceptibility profile of bacteria isolated from primary endodontic infections. Braz Oral Res 2024; 38:e024. [PMID: 38597544 DOI: 10.1590/1807-3107bor-2024.vol38.0024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2022] [Accepted: 10/03/2023] [Indexed: 04/11/2024] Open
Abstract
This study aimed to identify and characterize the antimicrobial susceptibility profile of bacteria found in primary endodontic infections in the teeth of patients treated at the Dental Clinic of the University of Ribeirão Preto, São Paulo, Brazil. From September to December 2019, samples were obtained from 21 patients with primary endodontic infections. The collections were carried out in triplicate using paper cones placed close to the total length of the root canal. Bacterial isolation was performed in Brain Heart Infusion agar, Blood agar, and other selective culture media cultured at 37°C for up to 48 h under aerobiosis and microaerophilic conditions. The bacterial species were identified using the Vitek 2 automated system. The disk diffusion method on agar Müeller-Hinton was used to assess antimicrobial susceptibility with the recommended antimicrobials for each identified bacterial species. A total of 49 antibiotics were evaluated. Fifteen of the 21 samples collected showed bacterial growth, and 17 bacterial isolates were found. There were 10 different bacterial species identified: Enterococcus faecalis (four isolates), Streptococcus mitis/oralis (three isolates), Streptococcus anginosus (three isolates) being the most common, followed by Staphylococcus epidermidis, Enterococcus faecium, Streptococcus constellatus, Streptococcus alactolyticus, Enterobacter cloacae, Klebsiella variicola, and Providencia rettgeri (one isolate of each species). The analysis demonstrated significant susceptibility to most of the tested antibiotics. However, some Enterococcus isolates resisted the antibiotic's erythromycin, ciprofloxacin, and tetracycline. A Staphylococcus epidermidis isolate was characterized as multidrug-resistant. Five Streptococcus isolates were non-susceptible to all antibiotics tested.
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Affiliation(s)
| | - Rafael Nakamura-Silva
- Universidade de Ribeirão Preto, Postgraduate Program in Environmental Technology, Universidade de Ribeirão Preto, Ribeirão Preto, Brazil
| | | | - Mariana de Oliveira-Silva
- Universidade de Ribeirão Preto, Postgraduate Program in Environmental Technology, Universidade de Ribeirão Preto, Ribeirão Preto, Brazil
| | - Rafael da Silva Goulart
- Universidade de Ribeirão Preto, Postgraduate Program in Dentistry, Ribeirão Preto, SP, Brazil
| | - Marsileni Pelisson
- Universidade Estadual de Londrina, Department of Pathology, Clinical and Toxicological Analysis, Londrina, PR, Brazil
| | - Eliana Carolina Vespero
- Universidade Estadual de Londrina, Department of Pathology, Clinical and Toxicological Analysis, Londrina, PR, Brazil
| | | | - André Pitondo-Silva
- Universidade de Ribeirão Preto, Postgraduate Program in Dentistry, Ribeirão Preto, SP, Brazil
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2
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Nakamura-Silva R, de Sousa RC, Fujimoto RY, Pitondo-Silva A. Sewage from a secondary hospital in Ribeirão Preto, southeastern Brazil: a source of multidrug-resistant Enterobacteriaceae. Environ Monit Assess 2022; 195:204. [PMID: 36527506 DOI: 10.1007/s10661-022-10830-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/07/2022] [Accepted: 12/10/2022] [Indexed: 06/17/2023]
Abstract
Antimicrobial resistance is one of the severe threats to global health. Hospital sewage can serve as a reservoir for multi-resistant bacteria and promote the spread of antimicrobial resistance. This study aimed to investigate the antimicrobial susceptibility and the pathogenic potential of Enterobacteriaceae isolated from the sewage of a secondary hospital in Ribeirão Preto, a city in southeastern Brazil. The strains were isolated by membrane filtration and identified by matrix-assisted laser desorption ionization-time of flight (MALDI-TOF). The antimicrobial susceptibility profile was performed by disk diffusion. Polymerase chain reaction (PCR) assays were used to detect virulence genes among the strains. Twenty-eight isolates were obtained, with Klebsiella pneumoniae being the predominant species (71.4%, n = 20). All isolates were classified as multidrug-resistant, including four isolates that were non-susceptible to at least 50% of the tested antibiotics. All isolates were also non-susceptible to cefuroxime and sulfonamides antibiotics; however, they were susceptible to norfloxacin, ofloxacin, amikacin, gentamicin, netilmicin, ertapenem, cefazolin, cefaclor, and cefotetan. The virulence genes ycfM, fimH, mrkD, kfu, and entB were detected in several isolates. Our study showed that even in a secondary hospital, without the routine of major surgeries and intensive care admissions, the hospital sewage can harbor a high percentage of multidrug-resistant bacteria with pathogenic potential. This leads to the worrying risk of public health and environmental contamination.
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Affiliation(s)
- Rafael Nakamura-Silva
- Programa de Pós-Graduação em Tecnologia Ambiental, Universidade de Ribeirão Preto-UNAERP, Bloco J, Laboratório 1, Av. Costábile Romano, 2201, São Paulo 14096‑900, Ribeirânia, Ribeirão Preto, Brazil
| | - Ricardo Coelho de Sousa
- Empresa Brasileira de Pesquisa Agropecuária-EMBRAPA, Unidade Tabuleiros Costeios, Av. Beira Mar, 3250 Jardins, Sergipe, 49025040, Aracaju, Brazil
| | - Rodrigo Yudi Fujimoto
- Empresa Brasileira de Pesquisa Agropecuária-EMBRAPA, Unidade Tabuleiros Costeios, Av. Beira Mar, 3250 Jardins, Sergipe, 49025040, Aracaju, Brazil
| | - André Pitondo-Silva
- Programa de Pós-Graduação em Tecnologia Ambiental, Universidade de Ribeirão Preto-UNAERP, Bloco J, Laboratório 1, Av. Costábile Romano, 2201, São Paulo 14096‑900, Ribeirânia, Ribeirão Preto, Brazil.
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Nakamura-Silva R, Dias LL, Sousa RC, Fujimoto RY, Pitondo-Silva A. Multidrug-resistant and potentially pathogenic Enterobacteriaceae found in a tertiary hospital sewage in southeastern Brazil. Environ Monit Assess 2022; 194:782. [PMID: 36098842 DOI: 10.1007/s10661-022-10454-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/11/2021] [Accepted: 08/30/2022] [Indexed: 06/15/2023]
Abstract
Hospital sewage is considered an environment with the potential to favor the spread and increase of multidrug-resistant bacteria (MDR). The increase in antimicrobial resistance is one of the greatest global threats today. Therefore, this study aimed to evaluate the profile of antimicrobial susceptibility and virulence factors in Enterobacteriaceae isolated from the sewage of a tertiary hospital located in southeastern Brazil. For bacterial isolation, membrane filtering, serial dilution, and spread-plate techniques were used. The bacterial isolates were identified using the MALDI-TOF (matrix-assisted laser desorption ionization-time of flight) technique. Antimicrobial susceptibility profile was performed by disk-diffusion test. Virulence genes were screened by Polymerase Chain Reaction (PCR) and the hypermucoviscosity phenotype by string test. In total, 13 enterobacteria distributed in three species were identified (Klebsiella pneumoniae, Escherichia coli, and Citrobacter freundii) and 76.9% (n = 10) were classified as MDR. Two K. pneumoniae demonstrated the hypermucoviscosity phenotype. The virulence genes ycfM and entB were detected in all K. pneumoniae isolates (other genes found were fimH, mrkD, and kfu). The results indicated that the sewage from the analyzed hospital receives MDR bacteria and has the potential to contaminate and spread through the environment.
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Affiliation(s)
- Rafael Nakamura-Silva
- Programa de Pós-Graduação em Tecnologia Ambiental, Universidade de Ribeirão Preto - UNAERP, Av. Costábile Romano, 2201, São Paulo, 14096‑900, Ribeirão Preto, Brazil
| | - Leila Lúcia Dias
- Programa de Pós-Graduação em Tecnologia Ambiental, Universidade de Ribeirão Preto - UNAERP, Av. Costábile Romano, 2201, São Paulo, 14096‑900, Ribeirão Preto, Brazil
- Faculdade de Medicina, Universidade Federal de Uberlândia, Av. Pará, Uberlândia, Minas Gerais, 172038400‑902, Brazil
| | - Ricardo Coelho Sousa
- Empresa Brasileira de Pesquisa Agropecuária - EMBRAPA, Unidade Tabuleiros Costeios, Av. Beira Mar, 3250 jardins, Aracaju, Sergipe, 49025040, Brazil
| | - Rodrigo Yudi Fujimoto
- Empresa Brasileira de Pesquisa Agropecuária - EMBRAPA, Unidade Tabuleiros Costeios, Av. Beira Mar, 3250 jardins, Aracaju, Sergipe, 49025040, Brazil
| | - André Pitondo-Silva
- Programa de Pós-Graduação em Tecnologia Ambiental, Universidade de Ribeirão Preto - UNAERP, Av. Costábile Romano, 2201, São Paulo, 14096‑900, Ribeirão Preto, Brazil.
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Dias LL, Nakamura-Silva R, de Oliveira Junior GAT, Mego IOG, Mendonça GS, Pitondo-Silva A. Hospital liquid waste contaminated with multidrug-resistant bacteria raises a public health hazard alert in Brazil. Environ Monit Assess 2021; 193:719. [PMID: 34642819 DOI: 10.1007/s10661-021-09477-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/24/2021] [Accepted: 09/22/2021] [Indexed: 06/13/2023]
Abstract
The spread of multidrug-resistant bacteria (MDR) is a global concern because it poses a serious threat to public health. The inadequate handling of Health Services Waste (HSW) and, therefore, the incorrect disposal of infected liquids can cause contamination of the environment, the emergence of diseases caused by MDR bacteria, and the loss of the population's quality of life. The present study aimed to survey the bacteria and their antimicrobial resistance profiles, present in the liquid residues from infected surgeries performed in five years, often discharged into the sewage network of a large tertiary hospital located in the city of Uberlândia, which is considered one of the main economic and demographic centers of Brazil. A systematic and retrospective survey of the medical records of patients who underwent infected surgeries from January 2015 to December 2019 was carried out at the referred hospital. The bacterial species were previously identified and characterized for the antimicrobial susceptibility profile by the VITEK 2 automated system (bioMérieux, Brazil). In the evaluated period, 1658 infected surgeries were performed and the results showed 661 bacterial strains distributed in 48 different species, being Staphylococcus aureus the most prevalent species. The vast majority (85.6%) showed some type of antimicrobial resistance among these strains, with more than half (54.6%) being MDR. The results of this work raise an alert and concern for the risks to the environment and public health by dumping these infected liquid wastes directly into the sewage system without proper prior decontamination.
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Affiliation(s)
- Leila Lúcia Dias
- Programa de Pós-Graduação em Tecnologia Ambiental, Universidade de Ribeirão Preto - UNAERP., Av. Costábile Romano, 2201, São Paulo, 14096-900, Ribeirão Preto, Brazil
- Faculdade de Medicina, Universidade Federal de Uberlândia, Av. Pará, 1720, Minas Gerais, 38400-902, Uberlândia, Brazil
| | - Rafael Nakamura-Silva
- Programa de Pós-Graduação em Tecnologia Ambiental, Universidade de Ribeirão Preto - UNAERP., Av. Costábile Romano, 2201, São Paulo, 14096-900, Ribeirão Preto, Brazil
| | | | - Ivan Orlando Gonzales Mego
- Faculdade de Medicina, Universidade Federal de Uberlândia, Av. Pará, 1720, Minas Gerais, 38400-902, Uberlândia, Brazil
| | - Guilherme Silva Mendonça
- Faculdade de Medicina, Universidade Federal de Uberlândia, Av. Pará, 1720, Minas Gerais, 38400-902, Uberlândia, Brazil
| | - André Pitondo-Silva
- Programa de Pós-Graduação em Tecnologia Ambiental, Universidade de Ribeirão Preto - UNAERP., Av. Costábile Romano, 2201, São Paulo, 14096-900, Ribeirão Preto, Brazil.
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Cerdeira L, Nakamura-Silva R, Oliveira-Silva M, Sano E, Esposito F, Fuga B, Moura Q, Miranda CES, Wyres K, Lincopan N, Pitondo-Silva A. A novel hypermucoviscous Klebsiella pneumoniae ST3994-K2 clone belonging to Clonal Group 86. Pathog Dis 2021; 79:6373921. [PMID: 34550351 DOI: 10.1093/femspd/ftab047] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2021] [Accepted: 09/20/2021] [Indexed: 11/13/2022] Open
Abstract
Emergent hypervirulent Klebsiella pneumoniae has been responsible for severe diseases, representing a serious threat to public health. We report the whole-genome sequencing of a novel ST3994-K2 clone, a single locus variant of ST86 K2, which is considered a worrying hypervirulent clone that emerged in several parts of the world. The strain K. pneumonia Kpi144 was isolated in 2013 from a blood culture of a 69-year-old male patient admitted to a tertiary hospital in Teresina, state of Piauí, northeastern Brazil. The strain was susceptible to 41 antibiotics tested, presented hypermucoviscous phenotype and a virulent behavior was observed in the Galleria mellonella infection model. Moreover, the virulome showed several virulence genes. To the best of our knowledge, this is the first worldwide report of a novel ST3994-K2 K. pneumoniae clone, an SLV of ST86 K2, which is considered a worrying virulent clone that has emerged in several parts of the world, including South America and Brazil.
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Affiliation(s)
- Louise Cerdeira
- Department of Infectious Diseases, Central Clinical School, Monash University, Melbourne, VIC 3800, Australia.,Department of Vector Biology, Liverpool School of Tropical Medicine, Liverpool, L3 5QA, United Kingdom
| | - Rafael Nakamura-Silva
- Postgraduate Program in Environmental Technology, University of Ribeirão Preto, Ribeirão Preto, CEP 14096-900, São Paulo, Brazil
| | - Mariana Oliveira-Silva
- Postgraduate Program in Environmental Technology, University of Ribeirão Preto, Ribeirão Preto, CEP 14096-900, São Paulo, Brazil
| | - Elder Sano
- Institute of Biomedical Sciences, University of São Paulo, São Paulo, CEP 05508-000, Brazil.,One Health Brazilian Resistance Project (OneBR), University of São Paulo, São Paulo, CEP 05508-000, Brazil
| | - Fernanda Esposito
- One Health Brazilian Resistance Project (OneBR), University of São Paulo, São Paulo, CEP 05508-000, Brazil.,Department of Clinical Analysis, School of Pharmacy, University of São Paulo, São Paulo, CEP 05508-000, Brazil
| | - Bruna Fuga
- Institute of Biomedical Sciences, University of São Paulo, São Paulo, CEP 05508-000, Brazil.,One Health Brazilian Resistance Project (OneBR), University of São Paulo, São Paulo, CEP 05508-000, Brazil
| | - Quézia Moura
- Federal Institute of Education, Science and Technology of Espírito Santo, Vila Velha, CEP 29106-010, Brazil
| | | | - Kelly Wyres
- Department of Infectious Diseases, Central Clinical School, Monash University, Melbourne, VIC 3800, Australia
| | - Nilton Lincopan
- Institute of Biomedical Sciences, University of São Paulo, São Paulo, CEP 05508-000, Brazil.,One Health Brazilian Resistance Project (OneBR), University of São Paulo, São Paulo, CEP 05508-000, Brazil.,Department of Clinical Analysis, School of Pharmacy, University of São Paulo, São Paulo, CEP 05508-000, Brazil
| | - André Pitondo-Silva
- Postgraduate Program in Environmental Technology, University of Ribeirão Preto, Ribeirão Preto, CEP 14096-900, São Paulo, Brazil.,Postgraduate Program in Dentistry, University of Ribeirão Preto, Ribeirão Preto, CEP 14096-900, São Paulo, Brazil
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6
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Nakamura-Silva R, Oliveira-Silva M, Furlan JPR, Stehling EG, Miranda CES, Pitondo-Silva A. Characterization of multidrug-resistant and virulent Klebsiella pneumoniae strains belonging to the high-risk clonal group 258 (CG258) isolated from inpatients in northeastern Brazil. Arch Microbiol 2021; 203:4351-4359. [PMID: 34110479 DOI: 10.1007/s00203-021-02425-0] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2021] [Revised: 05/31/2021] [Accepted: 06/02/2021] [Indexed: 12/24/2022]
Abstract
Multidrug-resistant (MDR) and hypervirulent Klebsiella pneumoniae (hvKp) clones have become a major threat to global public health. The clonal group 258 (CG258) is considered a high-risk CG and the K. pneumoniae strains belonging to it are often multi-resistant and to spread mainly in the hospital environment. This study aimed to characterize the antimicrobial resistance profile, virulence factors, and the clonal relationships among 13 K. pneumoniae strains belonging to CG258 from patients admitted to a tertiary hospital in Teresina, in the state of Piauí, northeastern Brazil. Ten strains were classified as MDR and three as extensively drug-resistant (XDR). Three different β-lactamase-encoding genes (blaKPC, blaOXA-1-like, and blaCTX-M-Gp1) and six virulence genes (fimH, ycfM, mrkD, entB, ybtS, and kfu) were detected. Moreover, two hypermucoviscous K. pneumoniae strains and one capsular K-type 2 were found. Multilocus sequence typing analysis revealed ten different sequence types (STs) (ST14, ST17, ST20, ST29, ST45, ST101, ST268, ST1800, ST3995, and ST3996) belonging to CG258, being two (ST3995 and ST3996) described for the first time in this study.
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Affiliation(s)
- Rafael Nakamura-Silva
- Postgraduate Program in Environmental Technology, Universidade de Ribeirão Preto, Ribeirão Preto, São Paulo, Brazil
| | - Mariana Oliveira-Silva
- Postgraduate Program in Environmental Technology, Universidade de Ribeirão Preto, Ribeirão Preto, São Paulo, Brazil
| | - João Pedro Rueda Furlan
- School of Pharmaceutical Sciences of Ribeirão Preto, Universidade de São Paulo, Ribeirão Preto, São Paulo, Brazil
| | - Eliana Guedes Stehling
- School of Pharmaceutical Sciences of Ribeirão Preto, Universidade de São Paulo, Ribeirão Preto, São Paulo, Brazil
| | - Carlos Eduardo Saraiva Miranda
- Postgraduate Program in Dentistry, Universidade de Ribeirão Preto, UNAERP. Bloco J, Laboratório 1. Av. Costábile Romano, 2201 - Ribeirânia, Ribeirão Preto, São Paulo, CEP: 14096-900, Brazil
| | - André Pitondo-Silva
- Postgraduate Program in Environmental Technology, Universidade de Ribeirão Preto, Ribeirão Preto, São Paulo, Brazil. .,Postgraduate Program in Dentistry, Universidade de Ribeirão Preto, UNAERP. Bloco J, Laboratório 1. Av. Costábile Romano, 2201 - Ribeirânia, Ribeirão Preto, São Paulo, CEP: 14096-900, Brazil.
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7
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de Campos TA, de Almeida FM, de Almeida APC, Nakamura-Silva R, Oliveira-Silva M, de Sousa IFA, Cerdeira L, Lincopan N, Pappas GJ, Pitondo-Silva A. Multidrug-Resistant (MDR) Klebsiella variicola Strains Isolated in a Brazilian Hospital Belong to New Clones. Front Microbiol 2021; 12:604031. [PMID: 33935984 PMCID: PMC8085564 DOI: 10.3389/fmicb.2021.604031] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2020] [Accepted: 03/25/2021] [Indexed: 01/18/2023] Open
Abstract
Klebsiella variicola is mainly associated with opportunistic infections and frequently identified as Klebsiella pneumoniae. This misidentification implies a wrong epidemiology result as well as incorrect attribution to K. pneumoniae as the etiology of some severe infections. Recently, huge efforts have been made to study K. variicola, however, the biological aspects of this species are still unclear. Here we characterized five K. variicola strains initially identified as K. pneumoniae, with a Vitek-2 System and 16S rRNA sequencing. One-step multiplex polymerase chain reaction and Whole Genome Sequencing (WGS) identified them as K. variicola. Additionally, WGS analysis showed that all the strains are closely related with K. variicola genomes, forming a clustered group, apart from K. pneumoniae and K. quasipneumoniae. Multilocus sequence typing analysis showed four different sequence types (STs) among the strains and for two of them (Kv97 and Kv104) the same ST was assigned. All strains were multidrug-resistant (MDR) and three showed virulence phenotypes including invasion capacity to epithelial cells, and survival in human blood and serum. These results showed the emergence of new K. variicola clones with pathogenic potential to colonize and cause infection in different tissues. These characteristics associated with MDR strains raise great concern for human health.
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Affiliation(s)
- Tatiana Amabile de Campos
- Departamento de Biologia Celular, Instituto de Ciências Biológicas, Universidade de Brasília, Brasília, Brazil.,Programa de Pós-graduação em Biologia Microbiana, Universidade de Brasília, Brasília, Brazil
| | | | | | - Rafael Nakamura-Silva
- Programa de Pós-graduação em Tecnologia Ambiental, Universidade de Ribeirão Preto, Ribeirão Preto, Brazil
| | - Mariana Oliveira-Silva
- Programa de Pós-graduação em Tecnologia Ambiental, Universidade de Ribeirão Preto, Ribeirão Preto, Brazil
| | | | - Louise Cerdeira
- Instituto de Ciências Biológicas, Universidade de São Paulo, São Paulo, Brazil.,Department of Infectious Diseases, Central Clinical School, Monash University, Melbourne, VIC, Australia
| | - Nilton Lincopan
- Department of Infectious Diseases, Central Clinical School, Monash University, Melbourne, VIC, Australia
| | - Georgios Joannis Pappas
- Departamento de Biologia Celular, Instituto de Ciências Biológicas, Universidade de Brasília, Brasília, Brazil.,Programa de Pós-graduação em Biologia Molecular, Universidade de Brasília, Brasília, Brazil
| | - André Pitondo-Silva
- Programa de Pós-graduação em Tecnologia Ambiental, Universidade de Ribeirão Preto, Ribeirão Preto, Brazil.,Programa de Pós-graduação em Odontologia, Universidade de Ribeirão Preto, Ribeirão Preto, Brazil
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Cerdeira L, Nakamura-Silva R, Oliveira-Silva M, Fuga B, Moura Q, Vespero EC, Lincopan N, Pitondo-Silva A. Draft genome sequences of PDR and XDR Klebsiella pneumoniae belonging to high-risk CG258 isolated from a Brazilian tertiary hospital. Infect Genet Evol 2020; 87:104643. [PMID: 33246084 DOI: 10.1016/j.meegid.2020.104643] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/23/2020] [Revised: 08/06/2020] [Accepted: 11/23/2020] [Indexed: 10/22/2022]
Affiliation(s)
- Louise Cerdeira
- Instituto de Ciências Biomédicas, Universidade de São Paulo, São Paulo, Brazil; Department of Infectious Diseases, Central Clinical School, Monash University, Melbourne, Australia
| | - Rafael Nakamura-Silva
- Postgraduate Program in Environmental Technology, University of Ribeirão Preto, Ribeirão Preto, São Paulo, Brazil
| | - Mariana Oliveira-Silva
- Postgraduate Program in Environmental Technology, University of Ribeirão Preto, Ribeirão Preto, São Paulo, Brazil
| | - Bruna Fuga
- Instituto de Ciências Biomédicas, Universidade de São Paulo, São Paulo, Brazil
| | - Quézia Moura
- Instituto de Ciências Biomédicas, Universidade de São Paulo, São Paulo, Brazil
| | - Eliana Carolina Vespero
- Department of Pathology, Clinical and Toxicological Analysis, State University of Londrina, Londrina, Paraná, Brazil
| | - Nilton Lincopan
- Instituto de Ciências Biomédicas, Universidade de São Paulo, São Paulo, Brazil
| | - André Pitondo-Silva
- Postgraduate Program in Environmental Technology, University of Ribeirão Preto, Ribeirão Preto, São Paulo, Brazil; Postgraduate Program in Dentistry, University of Ribeirão Preto, Ribeirão Preto, São Paulo, Brazil.
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Nakamura-Silva R, Macedo LMD, Cerdeira L, Oliveira-Silva M, Silva-Sousa YTC, Pitondo-Silva A. First report of hypermucoviscous Klebsiella variicola subsp. variicola causing primary endodontic infection. Clin Microbiol Infect 2020; 27:303-304. [PMID: 32771643 DOI: 10.1016/j.cmi.2020.07.045] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2020] [Revised: 07/10/2020] [Accepted: 07/30/2020] [Indexed: 01/23/2023]
Affiliation(s)
- Rafael Nakamura-Silva
- Postgraduate Program in Environmental Technology, University of Ribeirão Preto, Ribeirão Preto, SP, Brazil
| | | | - Louise Cerdeira
- Institute of Biomedical Sciences, University of São Paulo, São Paulo, Brazil; Department of Infectious Diseases, Central Clinical School, Monash University, Melbourne, Australia
| | - Mariana Oliveira-Silva
- Postgraduate Program in Environmental Technology, University of Ribeirão Preto, Ribeirão Preto, SP, Brazil
| | | | - André Pitondo-Silva
- Postgraduate Program in Dentistry, University of Ribeirão Preto, Ribeirão Preto, SP, Brazil; Postgraduate Program in Environmental Technology, University of Ribeirão Preto, Ribeirão Preto, SP, Brazil.
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10
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Ferreira RL, da Silva BCM, Rezende GS, Nakamura-Silva R, Pitondo-Silva A, Campanini EB, Brito MCA, da Silva EML, Freire CCDM, da Cunha AF, Pranchevicius MCDS. High Prevalence of Multidrug-Resistant Klebsiella pneumoniae Harboring Several Virulence and β-Lactamase Encoding Genes in a Brazilian Intensive Care Unit. Front Microbiol 2019; 9:3198. [PMID: 30723463 PMCID: PMC6349766 DOI: 10.3389/fmicb.2018.03198] [Citation(s) in RCA: 122] [Impact Index Per Article: 24.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2018] [Accepted: 12/10/2018] [Indexed: 01/24/2023] Open
Abstract
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 bla KPC (100%), bla TEM (100%), bla SHV variants (n = 24, 96%), bla OXA-1 group (n = 21, 84%) and bla CTX-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.
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Affiliation(s)
- Roumayne L. Ferreira
- Departamento de Genética e Evolução, Universidade Federal de São Carlos, São Carlos, Brazil
- Laboratório Central de Saúde Pública do Tocantins, Palmas, Brazil
| | - Brenda C. M. da Silva
- Departamento de Genética e Evolução, Universidade Federal de São Carlos, São Carlos, Brazil
| | - Graziela S. Rezende
- Departamento de Genética e Evolução, Universidade Federal de São Carlos, São Carlos, Brazil
| | | | | | - Emeline Boni Campanini
- Departamento de Genética e Evolução, Universidade Federal de São Carlos, São Carlos, Brazil
| | | | - Eulália M. L. da Silva
- Department of Cell Cycle and Cancer Biology, Oklahoma Medical Research Foundation, Oklahoma City, OK, United States
| | | | - Anderson F. da Cunha
- Departamento de Genética e Evolução, Universidade Federal de São Carlos, São Carlos, Brazil
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Nava RG, Oliveira-Silva M, Nakamura-Silva R, Pitondo-Silva A, Vespero EC. New sequence type in multidrug-resistant Klebsiella pneumoniae harboring the bla NDM-1-encoding gene in Brazil. Int J Infect Dis 2018; 79:101-103. [PMID: 30496852 DOI: 10.1016/j.ijid.2018.11.012] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2018] [Revised: 11/18/2018] [Accepted: 11/20/2018] [Indexed: 11/29/2022] Open
Abstract
OBJECTIVES The aim of this study was to investigate the blaNDM gene, pathogenic potential, and antimicrobial resistance of clinical isolates of carbapenem-resistant Klebsiella pneumoniae isolated from patients admitted to the University Hospital of Londrina between January 2014 and March 2017. METHODS blaNDM-1 and virulence genes were investigated using conventional PCR methods Antimicrobial susceptibility testing was performed by disk diffusion method according to the Clinical and Laboratory Standards Institute guidelines of 2017. Clonal relationships of the New Delhi metallo-β-lactamase (NDM)-positive isolates were determined by enterobacterial repetitive intergenic consensus (ERIC)-PCR and multilocus sequence typing (MLST). RESULTS A total of 825 K. pneumoniae were identified, with four isolates (Kp6408, Kp6410, Kp6411, and Kp6715) presenting the blaNDM-1 gene. All NDM-1-producing isolates showed co-production of blaKPC-2 and blaTEM genes and also the virulence genes kfu, entB, mrkD, and fimH. Three isolates (Kp6408, Kp6410, and Kp6715) were classified as multidrug-resistant (MDR) and one (Kp6411) as extensively drug-resistant (XDR). ERIC-PCR analyses demonstrated that the isolates shared about 60% genetic similarity. MLST revealed four different sequence types (STs), described for the first time in Brazil, with two novel STs described in this study: ST3371 and ST3372. CONCLUSION This study reports the identification of NDM-1 associated with KPC and virulence genes in four MDR K. pneumoniae with STs first described in Brazil.
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Affiliation(s)
- Roseane Galdioli Nava
- Department of Pathology, Clinical and Toxicological Analysis, State University of Londrina, Londrina, Paraná, Brazil
| | | | - Rafael Nakamura-Silva
- School of Dentistry, University of Ribeirão Preto, Ribeirão Preto, São Paulo, Brazil
| | - André Pitondo-Silva
- School of Dentistry, University of Ribeirão Preto, Ribeirão Preto, São Paulo, Brazil
| | - Eliana Carolina Vespero
- Department of Pathology, Clinical and Toxicological Analysis, State University of Londrina, Londrina, Paraná, Brazil.
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Azevedo PAA, Furlan JPR, Oliveira-Silva M, Nakamura-Silva R, Gomes CN, Costa KRC, Stehling EG, Pitondo-Silva A. Detection of virulence and β-lactamase encoding genes in Enterobacter aerogenes and Enterobacter cloacae clinical isolates from Brazil. Braz J Microbiol 2018; 49 Suppl 1:224-228. [PMID: 29858139 PMCID: PMC6328715 DOI: 10.1016/j.bjm.2018.04.009] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2017] [Revised: 03/02/2018] [Accepted: 04/19/2018] [Indexed: 12/03/2022] Open
Abstract
Enterobacter cloacae and E. aerogenes have been increasingly reported as important opportunistic pathogens. In this study, a high prevalence of multi-drug resistant isolates from Brazil, harboring several β-lactamase encoding genes was found. Several virulence genes were observed in E. aerogenes, contrasting with the E. cloacae isolates which presented none.
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Affiliation(s)
- Paola Aparecida Alves Azevedo
- Universidade de São Paulo, Faculdade de Ciências Farmacêuticas de Ribeirão Preto, Departamento de Análises Clínicas, Toxicológicas e Bromatológicas, Ribeirão Preto, SP, Brazil
| | - João Pedro Rueda Furlan
- Universidade de São Paulo, Faculdade de Ciências Farmacêuticas de Ribeirão Preto, Departamento de Análises Clínicas, Toxicológicas e Bromatológicas, Ribeirão Preto, SP, Brazil
| | - Mariana Oliveira-Silva
- Universidade de São Paulo, Faculdade de Ciências Farmacêuticas de Ribeirão Preto, Departamento de Análises Clínicas, Toxicológicas e Bromatológicas, Ribeirão Preto, SP, Brazil
| | - Rafael Nakamura-Silva
- Universidade de São Paulo, Faculdade de Ciências Farmacêuticas de Ribeirão Preto, Departamento de Análises Clínicas, Toxicológicas e Bromatológicas, Ribeirão Preto, SP, Brazil
| | - Carolina Nogueira Gomes
- Universidade de São Paulo, Faculdade de Ciências Farmacêuticas de Ribeirão Preto, Departamento de Análises Clínicas, Toxicológicas e Bromatológicas, Ribeirão Preto, SP, Brazil
| | | | - Eliana Guedes Stehling
- Universidade de São Paulo, Faculdade de Ciências Farmacêuticas de Ribeirão Preto, Departamento de Análises Clínicas, Toxicológicas e Bromatológicas, Ribeirão Preto, SP, Brazil
| | - André Pitondo-Silva
- Universidade de São Paulo, Faculdade de Ciências Farmacêuticas de Ribeirão Preto, Departamento de Análises Clínicas, Toxicológicas e Bromatológicas, Ribeirão Preto, SP, Brazil.
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